Al44 AGA ABSTRACTS GASTROENTEROLOGY Vol. 118, No.4

alternative to IRMS not only for 13C-UBT, what has frequently beenproven, as also for 13C-OABT.

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Symptom Female % Male % Total %(95% el)

Postprandial fullness 182' 143 16.4(15.9,16.9)Fullsoon after starting 10eat 19.4' 12.5 16.2(15.7-16.7)Loss of appetite 14.5' 9.3 12.1(117-12.5)Nausea 11.2' 5.2 8.5(8.1-8.9)Belching/burping (bothersome) 8.1' 5.5 6.9(6.6-7.3)Bloating 138' 7.9 11.1(10.6-11.5)Abdominal pain and/or discomfort 12.5' 8.8 10.8(10.4-11.2)

'p<0.001 vs males by Chi-square test

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851

A U.S, NATIONAL SURVEY OF UPPER GASTROINTESTINALSYMPTOMS IN 21,000 COMMUNITY PARTICIPANTS.Michael Camilleri, William E. Whitehead, Walter Stewart, Peter J. Kahr­ilas, Amnon Sonnenberg, Patricia Robinson, Sheldon Sloan, Dennis Rev­icki, Mary Kaye Willian, Mayo Clin, Rochester, MN; Univ of NorthCarolina, Chapel Hill, NC; Innovative Med Research, Baltimore, MD;Northwestern Univ, Chicago, IL; VA Med Ctr, Albuquerque, NM; JanssenPharmaceutica, Titusville, NJ; MEDTAP Intl Inc, Bethesda, MD.

Previous prevalence reports of upper gastrointestinal symptoms in the U.S.included relatively small samples or a restricted geographic group. Our aimwas to characterize symptoms suggestive of gastroesophageal reflux, uppergut dysmotility and abdominal pain in a representative sample of the U.S.community. Questionnaire development included extensive literature re­view, review by experts, computerization and pilot testing, test-retestreliability, and questionnaire revision based on the results. A computer­assisted telephone interview surveyed people, aged ;:;, 18 years, using aquota method (NEJM 1998;339:813-8) to insure the sample was represen­tative for region, age and gender (total 24 strata). Ten attempts were madeto contact a household and member. One interview was completed perhousehold. We assessed symptoms occuring ;:;,3 times in a three-monthrecall period. Results: A total of21,128 interviews were completed (11,423females, 9,705 males) in 1999. The response rate was 73.7%. Most symp­toms showed significant gender differences in prevalence (table). Signifi­cant but lesser gender differences were noted for the % prevalences offluid/food regurgitation [overall prevalence (OP) 7.7%], dysphagia OP6.7%, and vomiting OP 2.3%. No gender differences were observed forheartburn 19.8% and bitter/acid/sour taste in mouth 13.2%. Conclusion:Heartburn and fullness soon after starting to eat are respectively reportedby -20% and 16% of the population. Females are significantly more likelyto report many upper GI symptoms compared with males. Supported byJanssen Pharmaceutica.

852

A NATIONAL SURVEY OF IRRITABLE BOWEL SYNDROMEemS) IN FEMALES: PHYSICIAN AND PATIENT PERSPECTIVES.Lin Chang, Margaret M. Heitkemper, Eric Carter, UCLA Sch of Medicine,Los Angeles, CA; Univ of Washington, Seattle, WA; Glaxo Wellcome,Raleigh-Durham, NC.

BACKGROUND: IRS is a common gastrointestinal disorder predomi­nantly affecting women. Limited knowledge of the burden of illnesshinders effective IBS management. AIMS: 1) Determine symptom sever­ity, health care utilization, and impact on lifestyle in female IBS patients,and 2) Determine perceptions of patients and physicians regarding IBSdiagnosis and treatment. METHODS: A sample of 21,043 US householdsyielded a random sample of 1010 adult women without IBS (mean age

849

SCINTIGRAPHY VS 13-C BREATH TEST TO DETERMINE GAS­TRIC EMPTYING IN PATIENTS WITH LIVER CIRRHOSIS.Inngard Greving, S. Weis, C. Monnerjahn, W. Erie, E. Almus, V. Buhman,B. May, Paul Enck, Dept of Gastroenterology, Bochum, Germany; Dept ofRadiology, Bochum, Germany; Dept of Gen Surg, Tuebingen, Germany,

It has been stated that cirrhotic patients may have a prolongation of gastricemptying (GE). The aim of this study was to evaluate if the 13-C breath testfor measurement of GE of solids and liquids - in comparison to scintigra­phy - is suitable to diagnose delayed GE in cirrhotic patients. Methods: Wetested 9 patients with liver cirrhosis (6m13f; mean age: 52yrs; 33% CHILDA, 66% CHILD B; 55% alcoholism, 22% virus hepatitis, 11% PBC, 11%AIH); 5 had symptoms of gastroparesis. Diabetes mellitus, stomach ulcer,or opiod therapy which could be responsible for gastroparesis were ex­cluded. On a first visit fasted patients received a standard solid meal dopedwith 100m J..tl(=9Img) 13C octanoic acid. At 15 minutes intervals breathsamples were taken over 4 hours and examined by infrared spectrometryfor the 12CO/13CO ratio. On a second day gastric emptying for liquids weremeasured with 300ml water labelled with 150 J.Lg Na-acetate. Breathsamples were collected every 10 minutes for 2 hours and examined withinfrared spectometry (Wagner Analysentechnik, Bremen, Germany). On athird occasion patients underwent sequence-scintigraphy with a standardmeal enriched with 99mTC-Sn-Colloid and distribution of the radiosiotopeover the stomach was assessed for 100min. Half time (t'/2) and lag time(t-Iag) were calculated for each measure and compared between them. Thesequence of GE measures was randomized. Results: Scintigraphically, GEwas normal in all cases: Median (1/2 = 27.5 (17-50) min, t-Iag = I (0-3)min (norm values tV2 <60min, t-Iag <5 min). Liquid GE as measured bybreath test was normal in all but 2 patients (median tV2 = 66 (49-140) min,t-Iag = 38 (0-45) min)(nonn: t'/2<75 min, t-Iag<20 min). Solid meal GEwas prolonged in all nine patients (t1/ 2 = 136 (104-544) min, t-lag = 112(55-347) min (norm: (1/2 <75 min, t-Iag <50 min). Conclusion: Livercirrhosis is not associated with a prolongation of GE as measured byscintigraphy, but pathologic when measured with 13-C breath testing. Thiscasts doubts on the reliability of the breath test in cases in which 13Coxidation in liver metabolism may be abnormal, (Supported by grants fromDeutsche Forschungsgemeinschaft and Berufsgenossenschaften)

850

IS THE ACCURACY OF ISOTOPE-SELECTIVE NON-DISPER­SIVE INFRARED SPECTROMETRY (NDIRS) SUFFICIENT FORDETERMINATION OF GASTRIC EMPTYING USING THE 13C_OCTANOIC ACID BREATH TEST e3C-OABT): COMPARISONWITH ISOTOPE-RATIO MASS SPECTROMETRY (IRMS).Andreas Leodolter, Ulrike von Amim, Claudia Gerards, Bernhard Glas­brenner, Peter Malfertheiner, Dept of Gastroenterology, Magdeburg, Ger­many.

Background: The 13C-OABT is a non-invasive simple and reliable tool fordetermination of /,astric emptying. Analysis of breath samples for deter­mination of the I C/ 12C-ratio requires highly accurate detection methods.Therefore IRMS is most frequently used and up to now only one study hascompared the accuracy of a less expensive NDIRS system (Clin Chem.1997; 43: 518-22) for determination of gastric emptying. Aim of our studywas to confirm the previous findings using another NDIRS system forevaluation of gastric emptying by the 13C-OABT compared to IRMS.Methods: A total of 35 sublects (18m, 17f, age 23-68y) with dyspepticsymptoms were studied. A 3C-OABT was performed after an overnightfast by giving a test meal consisting on 50 g white bread, 10 g butter, 50 gcooked ham, 200 ml orange juice and an one-egg omelette containing 91mg 13C-octanoic acid in the yolk. Breath samples were collected at 15 minintervals for a 4 hour period using IOml glass tubes (for IRMS) and breathsamples bags (for NDIRS). Breath samples were analyzed either by IRMS(ABCA-system, PDZ-Europa, Crewe, UK) and by NDIRS (FANci2, FANLtd., Leipzig, Germany), Lag phase and gastric half emptying time (tV2)were calculated by non-linear regression analysis. Based on the Europeanvalidation a gastric emptying time up to 120 min is considered as nonna!.Results: A reasonable linear correlation of gastric emptying parameterswas found between the two methods (t1/2: y = 1.02 x - 2.2, 1'=0.918; lagphase: y = 1.04 x + 2.0, r=0.924). In only one case a discordant resultwas observed after categorisation in normal and abnormal gastric empty­ing. Conclusion: The accuracy of the tested NDIRS-system for detenni­nation of gastric emptying is convincing. Because of the easy handling, thelower purchase price, and the proven accuracy, the NDIRS is a useful