Combined Gastric Alimetry and Gastric Emptying Scintigraphy Testing Increases Clinician Certainty in the Diagnosis and Management of Suspected Gastroparesis

Sep 30, 2026

Combined gastric alimetry and gastric emptying scintigraphy testing aims to improve diagnostic and management confidence in patients with suspected gastroparesis. Gastric emptying scintigraphy is the reference standard, while body surface gastric mapping provides non-invasive gastric electrophysiology assessment combined with validated symptom profiling. A randomized prospective pilot study compared clinical decisions derived from either test and then from the alternative test. Combined results significantly increased diagnostic and management certainty (P < 0.05).

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

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Background/Aims

Methods

Results

Conclusion

Keywords

Introduction

Original Article J Neurogastroenterol Motil 2026 January 32(1):61-70 [https://doi.org/10.5056/jnm25094](https://doi.org/10.5056/jnm25094)[ ](https://doi.org/10.5056/jnm25094)pISSN 2093-0879 eISSN 2093-0887 JNM Journal of Neurogastroenterology and Motility Combined Gastric Alimetry and Gastric Emptying Scintigraphy Testing Increases Clinician Certainty in the Diagnosis and Management of Suspected Gastroparesis Ryan Abraham,1,2 Daphne Foong,1,3 and Vincent Ho1,2* 1School of Medicine, Western Sydney University, Sydney, NSW, Australia; 2Department of Gastroenterology and Hepatology, Campbelltown Hospital, Campbelltown, NSW, Australia; and 3Alimetry Ltd, Auckland, New Zealand Background/Aims: Gastric emptying scintigraphy (GES) is the reference standard test for diagnosing gastroparesis. Body surface gastric mapping (BSGM) via Gastric Alimetry is a new test of gastric function that combines non-invasive assessment of gastric electrophysiology and validated symptom profiling. This randomized, prospective pilot study evaluated the impact of GES vs BSGM test results on clinical decision-making. Methods: Patients with chronic gastroduodenal symptoms from a tertiary center referred for GES were recruited. Subjects separately underwent baseline assessment with GES and BSGM testing. Two motility-specialists were first asked to devisea management plan after reviewing a test result (GES or BSGM, in random order). They were then asked to repeat the management plan after reviewing the other test result (BSGM or GES). Clinician-perceived certainty measures were assessed. Results: Sixteen patients, 13 (81.0%) female, median age 30 years, median body mass index 22.5 kg/m2, were recruited. At baseline, a diagnosis was established in 2/16 (12 . 5%) and increased to 8/16 (50 .0%) with both tests. Abnormal test results were found in 11 patients. In patients with normal results, BSGM symptom profiling phenotyped 5 additional patients. All patients received an intervention following the first unblinding, with subsequent management changes made in 75.0%(BSGM) and 62.5%(GES) of patients. The combined GES and BSGM results significantly increased diagnostic and management certainty (P < 0 .05), with both tests having similar influence on management (P > 0 .05). Conclusion: The combined GES and BSGM test results significantly enhanced diagnostic and management confidence inpatients with suspected gastroparesis within a tertiary center. Keywords: Body surface gastric mapping; Clinical decision-making; Gastric emptying; Gastroparesis INTRODUCTION Gastroparesis is a chronic and debilitating gastric disease currently defined as persistent upper gastrointestinal (GI) symptoms and delayed gastric emptying with no mechanical gastric outlet obstruction.1 The condition is associated with poor quality of life, psychological distress, frequent hospitalizations, and consequent high healthcare utilization and associated costs.2-6 Despite the significant clinical burden, current diagnostic and management approaches remain suboptimal, with only 30.0% of patients experiencing symptom improvement following standard care.7 This challenge in effectively managing chronic symptoms is further exacerbated by the persistently high economic burden placed on these patients, which remains significantly elevated compared to controls even years after initial diagnosis and treatment.5 Gastric emptying scintigraphy (GES) remains the reference standard for diagnosing gastroparesis.8 However, its clinical utility has been increasingly questioned due to its variability over time, overlapping results between normal and delayed gastric emptying, and poor correlation with symptoms.9,10 GES provides a detailed measure of gastric emptying rate from the stomach, but is unreliable Received May 26, 2025 Revised June 26, 2025 Accepted July 30, 2025 *Correspondence: Vincent Ho, MBBS BSc (Med), MMed (ClinEpi), MClinEd, PhD School of Medicine, Western Sydney Univers

FAQs

What is the reference standard test for diagnosing gastroparesis in this study?

Gastric emptying scintigraphy (GES) is described as the reference standard for diagnosing gastroparesis.

How was the randomized, prospective pilot study designed to compare tests?

Participants underwent baseline assessment with both GES and body surface gastric mapping (BSGM). Two motility specialists first created management plans after reviewing one test result in random order, then repeated the plan after reviewing the other test result.

What was the main finding about combining GES and BSGM results?

Combined GES and BSGM results significantly increased diagnostic and management certainty, while both tests had similar influence on management.

Sep 30, 2026

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