Rapid gastric emptying in patients with functional diarrhea

Objective: To analyze our experience in patients with chronic diarrhea by using a noninvasive transit study that measures gastric emptying as well as small bowel and colonic transit. Material and Methods: Results from 94 consecutive transit tests, for which diarrhea was the main indication, were reviewed and correlated with the final classification of patients as having an organic or nonorganic disorder. Results: Sixty patients were considered to have a nonorganic cause of diarrhea, of whom 15 had previously undergone cholecystectomy. The other 34 patients were considered to have diarrhea on the basis of an organic diagnosis. Gastric emptying was more often rapid in patients with a nonorganic cause (P<0.05), but not if cholecystectomy had been performed previously. Small bowel transit was fast more often in patients with organic diarrhea than in those with no organic cause of the diarrhea (P<0.05); colonic transits showed no significant differences among groups. Conclusion: The findings implicate a motor abnormality of the upper gut, rapid gastric emptying, as a pathophysiologic mechanism of functional bowel disorders with diarrhea. The results imply that additional prospective observations should be worthwhile.