Validation of a stable isotope gastric emptying test for normal, accelerated or delayed gastric emptying

Neurogastroenterol Motil. 2001 Dec;13(6):567-74. doi: 10.1046/j.1365-2982.2001.00288.x.


To validate a 13C-Spirulina platensis breath test for measurement of accelerated or delayed gastric emptying, we measured gastric emptying of egg containing 13C-S. platensis and 99mTc-sulphur colloid by breath 13 CO2 every 15 min over 3 h and scintigraphy every 15-30 min over 5 h in 57 healthy volunteers. Thirty-three received no treatment, 10 received erythromycin, and 14 atropine. A generalized linear regression model predicted half-emptying time by scintigraphy (t1/2S) from breath 13CO2 (t1/2B) data. Accuracy was assessed by standard deviation (SD) of differences between t1/2S and t1/2B and by receiver operating characteristic (ROC) curves. Regression models using breath samples at baseline, and 45, 90, 105 and 120 min, predicted t1/2B (mean +/- SD) at 118 +/- 59 min, similar to t1/2S (118 +/- 67 min). Correlation between t1/2B and t1/2S was significant (r=0.88; P < 0.0001). Differences between t1/2S and t1/2B were: 18-19.2 min for t1/2 < 70-150 min, and 68.3 min for t1/2 > 150 min. Breath test detected abnormal emptying with a sensitivity of 86% and specificity of 80%. Thus, the 13C-S. platensis test measures gastric emptying t1/2 for solids, which is accelerated or delayed to mimic a range of conditions from dumping syndrome to severe gastroparesis, with high sensitivity and specificity. Additional breath samples are needed to increase sensitivity in detecting accelerated gastric emptying.

Publication types

  • Clinical Trial
  • Evaluation Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Aging / physiology
  • Algorithms
  • Anti-Bacterial Agents / adverse effects
  • Atropine / adverse effects
  • Bacterial Proteins / chemistry
  • Breath Tests*
  • Carbon Dioxide / analysis
  • Carbon Isotopes
  • Erythromycin / adverse effects
  • Female
  • Gastric Emptying / drug effects*
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Models, Statistical
  • Parasympatholytics / adverse effects
  • Sex Characteristics
  • Spirulina


  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Carbon Isotopes
  • Parasympatholytics
  • Carbon Dioxide
  • Erythromycin
  • Atropine