1. Gastric Emptying (Don’t miss the post) Mike Avison Bradford Royal Infirmary

2. What are the issues? What do they eat? Anterior only or Ant-Post geometric mean? Posture, compliance, movement How do we parametrise the result? Normal range

3. What to eat Leave this for discussion at the end –(We use scrambled egg on toast)

4. Don’t miss the POST! Food is moved back and forth in AP direction Generally from a posterior distribution in the early phase to an anterior distribution On occasions this significantly effects the numerical result if anterior only view is used:- a slow excretion can be “balanced” by a P-A drift

5. Patient 1 anterior only

6. Patient 1 ant & post

7. Patient 2 anterior only

8. Patient 2 ant & post

9. Effect on T 50 (minutes) Mean Extension AP T 50 rangenwith Ant only 30-60448 61-120932 121-100032704 >1000 1 17

10. Posture Compliance Movement Solid phase should last at least one hour Long time to stand still Movement can be quite a nuisance to correct for Seated? Or spot views every 5 minutes –can you then interleave patients?

11. How do we parameterise the result? Half empty from start of study? Half empty from end of plateau Measure plateau too and add it to half emptying time of excretion curve Can we measure half emptying time when it is longer than 60 minutes? –fit a lin / exp curve and extrapolate? Just state proportion left at 60 minutes

12. Normal Range What’s known –There is wide variation among “normals” –Liquids are about 5 - 15 minutes (t 50 ) –Solids may be 20 - 60 minutes but… Not many studies depends on meal to ?some? extent Should we all set up local normal ranges? Or should we standardise procedure and use the same normal range?

13. What should they eat? Considerations –label holds –easy to make –limited cooking facilities available Ideal? –Cook in microwave with disposable items?