Unexplained Nausea & Vomiting?
A Gastric Emptying Test May Offer Answers
An Interview with Dr. Eva Alsheik
Living with chronic, unexplained nausea and vomiting can cause significant disruptions to your physical, mental, and emotional wellbeing.
If you’ve been experiencing chronic nausea and vomiting—and still don’t know why—a gastric emptying test (GET) could offer valuable answers.
Dr. Eva Alsheik, Director of the Center for Motility Disorders at Henry Ford Health in Detroit, frequently speaks with her gastroenterology patients about the potential benefits of undergoing a GET. Here, she answers some of patients’ top questions.
Q: First, Dr. Alsheik, what is a gastric emptying test? Why should people with unexplained, chronic nausea & vomiting consider getting one?
A: A gastric emptying test, also called a gastric emptying scan or gastric emptying study, is a test for people who continue to have symptoms like nausea and vomiting, and early satiety (feeling very full after a few bites of food). The test shows how quickly or slowly food empties from the stomach, and it’s often our best tool to help us diagnose a condition called gastroparesis.
Q: What is gastroparesis?
A: Gastroparesis is a medical condition that causes food to digest more slowly than normal.
Typically, in a healthy digestive system, the stomach contracts to move food from the stomach through the digestive tract. But with gastroparesis, the stomach does not empty properly. This is what causes the chronic nausea, vomiting, and early satiety symptoms.
Q: Tell us more about the GET. What happens during the procedure?
A: The first thing I say to my patients about a GET is that it’s a very boring procedure! I usually tell them to bring a book or an iPad because they’ll be sitting around for a few hours.
The test itself is straightforward: The patient eats a standardized test meal of Egg Beaters®, toast, and jam (or a substitute meal in case of gluten or egg allergies). Then, every hour on the hour, they get a scan of their belly to see what percent of the test meal is still retained in their stomach. The scans are painless, like an X-ray or CAT scan.
Although the test is not complex, I of course want to recognize that it can be very challenging for patients—mentally, physically, and emotionally—to eat a meal. The good news is that the GET will show if a patient’s stomach is not emptying properly.
Generally speaking, if there is greater than 10% food retention after four hours this means that the patient is diagnosed with gastroparesis.
I would also say to patients: If you feel that your results were inaccurate or that you cannot tolerate the food at the time of the test, you can always ask to have the test repeated.
Q: Is there any preparation needed before a GET can be performed?
A: Great question. The short answer is yes: It’s very important for patients to talk with their doctor ahead of a GET about what medications they’re taking and why—especially if any of them medications are related to regulating blood sugar. Great question. The short answer is yes: It’s very important for patients to talk with their doctor ahead of a GET about what medications they’re taking and why—especially if any of them medications are related to regulating blood sugar.
In general, we want the patient to stop taking anything that speeds up or slows down the digestive tract. For example, if a patient is taking a prokinetic drug, like metoclopramide, erythromycin, or domperidone, we would ask that they stop taking those medications for at least 72 hours. In those cases, we would ask that they work with their provider about how to approach their medication regimen.
Q: How long does the GET take?
A: A proper gastric emptying test should take 4 full hours. I always tell patients, “If they try to kick you out after 2 hours, don’t let them!”
To accurately diagnose gastroparesis, we need the full 4 hours of data to see what’s happening with a patient’s digestion.
After the 4-hour test, patients are free to head home and go about their day normally.
Q: If someone reading this article thinks they could benefit from a GET, how should they go about getting one?
A: My advice is to be direct and ask your doctor for a gastric emptying test. If you’ve had chronic, unexplained nausea and vomiting symptoms that haven’t improved even with diet and lifestyle modifications or medications, a GET could give you valuable information.
In most cases, a GET is scheduled after another procedure called an upper endoscopy, which we perform to make sure there’s nothing blocking the stomach or otherwise causing nausea, vomiting, and early satiety symptoms.
If your doctor seems unwilling to schedule a GET for you, my advice is to find another who will. Don’t be afraid of seeing a mid-level provider like a physician assistant (PA) or nurse practitioner (NP). They can also schedule a GET for you, and their availability is often much better.
If you have trouble finding a facility nearby that performs GETs, try seeking out an academic or research hospital in your region.
Q: Gastroparesis can be a challenging condition to live with—physically, mentally, and emotionally. What advice do you have for people with gastroparesis?
A: That’s another great question. My first message to my patients with gastroparesis is always, “I believe you.” Gastroparesis is not easy to live with, and I can only imagine how their symptoms have totally upended their lives.
But the biggest thing I want my patients, and any patient with gastroparesis, to know is that I’ll never stop treating them. They may stop responding to medications, but I’ll still be here. They may not ever get back to feeling 100 percent like themselves, but my goal is to help them have more good days than bad. There is hope, and I’m going to work my hardest for them. I’ll never give up hope that they can get back the quality of life that they once knew.
To find out if a gastric emptying test is right for you, contact your healthcare provider.
To learn more about GETs, watch a video at EnterraMedical.com/GET-Overview. For more resources and support for navigating chronic nausea and vomiting associated with gastroparesis, visit EnterraMedical.com/resources.
About Dr. Alsheik
Eva Alsheik, MD is a Senior Staff Member at the Division of Gastroenterology and Hepatology, and the Director of the Center for Motility Disorders at Henry Ford Health in Detroit, Michigan. She completed her medical doctorate at American University in St. Maarten, and her residency and fellowship at Drexel University in Philadelphia, PA.
IMPORTANT SAFETY INFORMATION
Enterra Therapy for treatment of chronic, resistant to medication nausea and vomiting associated with gastroparesis caused by diabetes or an unknown origin in patients aged 18 to 70 years: patients should always discuss potential risks and benefits of the device with their physician.
*HUMANITARIAN DEVICE
Authorized by Federal law for use in the treatment of chronic intractable (drug refractory) nausea and vomiting secondary to gastroparesis of diabetic or idiopathic etiology in patients aged 18 to 70 years. The effectiveness of this device for this use has not been demonstrated. What does this mean?