Studies demonstrated13C breath testing accurately measures gastric emp-tying. If reliable, the half emptying time (t 1/2) by breath testing shouldaccurately estimate t 1/2 by scintigraphy. This study proposes to comparereliability of breath testing using a13C labeled food, edible photosyntheticalga, Spirulina platensis with scintigraphy in pediatric patients. 39 children,referred for gastroesophageal reflux disease (GERD) evaluation were stud-ied. 25 children (Group I) 3–16 years were studied simultaneously withbreath tests and scintigraphy after ingesting a test meal of two eggs labeledwith 1.0 mCi 99m Tc sulfur colloid and 200 mg13C labeled Spirulina.14 children (Group II), 13 age 1 month to 2 years and 1 age 7 ingestedTc labeled liquid, formula or milk, and13C labeled Spirulina. Duplicatebreath samples were obtained for Group I by blowing into a tube witha straw and for Group II collected using a bag and mask. Breath samplesobtained at baseline, 30, 75, 90 and 180 minutes after ingestion werestored and analyzed for13CO2, by isotope ratio mass spectroscopy andpercent cumulative total at time intervals determined and t 1/2 calcu-lated. Scintigraphy obtained counts over the stomach during continuousscanning for 60 minutes followed by intermittent imaging at 15 minuteintervals for as long as 4 hours and t 1/2 calculated. T 1/2 for the twogroups—solid/straw (Group I) and liquid/mask (Group II) using thePearson correlation coefficient were analyzed. Adequate collections forboth methods were obtained for 36 children, 12 Group I and 24 GroupII. There was a clear distinction between the two groups. Values forGroup II showed a moderate to strong linear relationship. CalculatedPearson correlation coefficient r5 0.626, p 5 0.026, one outlierexcluded r5 0.787, p5 0.004. Group I r5 .284, p5 0.179. Excluding2 outliers did not affect results r5 0.287, p5 0.184 a weak correlation.13C breath test showed less variability without. A mask and bag tocollect breath after a liquid test meal appears a reliable test comparedto scintigraphy. Solid meal and straw collection did not. Breath testingfor gastric emptying is safe and non-invasive in pediatric patients.Further study to assess the confounding variable for type of meal andcollection method is warranted. Research supported by Meretek Diag-nostics, Houston, TX.

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Helicobacter pylori and severe morning sicknessNilda Santiago MD, Lianette Perez MD, Alvaro Reymunde MD FACG.Ponce Gastroenterology Research, Ponce, PR.

More than 60% of pregnant women develop severe morning sickness,sometimes associated to more serious symptoms such as weight loss andelectrolyte imbalances. This condition usually begins early (1st 16 weeks)but can last throughout the pregnancy.Purpose:To determine a possible relationship between H. pylori infectionand severe morning sickness among Puerto Rican females.Method: Forty five pregnant patients with gestation between the 6th and16th week with complaints of severe morning sickness (defined as dailynausea and vomiting) were enrolled in the study. After signing informedconsent their blood was drawn and tested for H. pylori (Flex SureAntibody Test). Patients were compared with 44 asymptomatic controlsmatched for gestational age. The data obtained was submitted to sta-tistical analysis.Results: Forty out of the 45 patients with severe morning sickness testedpositive for anti H. pylori IgG (89%). In the control group 3 patients testedpositive and 41 out of 44 were negative (93%). The results showedstatistical significance (p, 0.001).Conclusions: Our findings support an association between H. pylori in-fection and symptoms of severe morning sickness. This raises the questionof whether it would be wise to test females who are considering becomingpregnant and offer preconception eradication therapy to those who are H.pylori positive to decrease the likelihood of suffering these symptomsduring the pregnancy.

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Gastric myoelectrical activity in maximum satiety in patients withfunctional dyspepsiaRobert Schmitz, Zhiyue Lin, Irene Sarosiek, Richard W McCallum*.University of Kansas Medical Center, Kansas City, Kansas, UnitedStates.

Purpose:Functional dyspepsia is a common clinical syndrome consistingof recurrent or persistent abdominal symptoms of epigastric pain andfullness, early satiety, nausea, and/or vomiting in the absence of organicdisease. Gastric myoelectrical abnormalities as well as impaired accom-modation of the proximal stomach have been reported in high proportion ofpatients with functional dyspepsia. The aim of this study was to evaluatethe gastric myoelectrical activity at maximum satiety in patients withfunctional dyspepsia compared to healthy subjects.Methods: The study was conducted in 10 healthy volunteers and 10patients with functional dyspepsia. Gastric myoelectrical activity was con-tinuously recorded using a cutaneous electrogastrography (EGG) for 30min in the fasting state and for 1 hour after rapid ingestion of the caloricliquid, ensure, to achieve maximum satiety. The dominant frequency of theEGG, the change of postprandial EGG peak power and the percentages ofnormal 2–4 cycles/min (cpm) slow waves and dysrhythmias during eachrecording session were calculated and compared between the patients andhealthy subjects.Results:The mean ensure ingestion to maximum satiety was 482 cc for thepatients and 566 cc for the healthy subjects, not found statistically signif-icant. The mean percentage of 2–4 cpm slow waves in the fasting stateobtained from patients was significantly lower than in healthy subjects(73 6 4% vs. 906 3%, p, 0.05). Compared to EGG in the fasting state,significant decreases of the EGG dominant frequencies were observed afterthe ingestion of ensure in both healthy subjects (2.96 0.1 cpm vs. 2.560.2 cpm, p, 0.05) and patients (3.06 0.2 cpm 2.46 0.2 cpm, p, 0.05).The ingestion of ensure significantly induced bradygastria (primary dys-rhythmia in this study) in both healthy subjects (fasting vs. fed state: 763% vs. 306 4%, p, 0.05) and patients (206 4% vs. 346 7%, p, 0.05).The degree of bradygastria induced by the ingestion of ensure in patientswas not significantly different from the healthy subjects. The mean post-prandial EGG power increase in the patients was significantly less than inthe healthy subjects (20.746 1.1 dB vs. 3.16 1.1 dB, p, 0.05). 5 of 10patients vs. 2 of 10 healthy subjects demonstrated a decrease in EGG powerafter the ingestion of ensure.Conclusions:Maximal satiety achieved by rapid ingestion of the caloricliquid ensure induces: 1) bradygastria in functional dyspepsia patients andhealthy subjects and 2) a significant power reduction in the functionaldyspepsia group. Gastric dysrhythmia could contribute to accommodationdifferences, enhanced visceral perception and thus symptoms of patientswith functional dyspepsia.

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Inflammation & intestinal metaplasia in the gastric cardia ofpatients presenting for upper endoscopyPrateek Sharma*, Margarita Topalovski, Matthew Mayo, Allan Weston.

Purpose: Inflammation (carditis) and intestinal metaplasia (IM) in thegastric cardia have been topics of interest given the rapidly rising incidenceof adenocarcinoma in this location. The exact site for obtaining bx duringupper endoscopy (EGD) from the gastric cardia is unclear. This is a detailedanalysis of bx obtained from two separate locations within the gastriccardia and their associated features.Methods: Patients presenting to the GI Lab for EGD for any sx wereinvited to participate in the study. The patient demographics, grade oferosive esophagitis (EE)-LA scale, were noted and the following bx pro-tocol was used: 4 from upper cardia (forceps across the SCJ-part squamous,part gastric/columnar) 4 from low cardia (within 1 cm of SCJ), 4 body &4 antrum. Carditis was graded using the updated Sydney classification; allslides were stained with H&E and alcian blue at pH 2.5 (for detection of

2463AJG – September, 2000 Abstracts