Amarasiri L, de Silva M, de Silva HJ, Devanarayana NM. Comparison of gastric emptying of solid and semi-solid meals using real-time ultrasonography in healthy Sri Lankan adults. World J Gastrointest Pathophysiol 2025; 16(3): 106482 [PMID: 41024982 DOI: 10.4291/wjgp.v16.i3.106482]
Corresponding Author of This Article
Niranga M Devanarayana, MD, PhD, Professor, Department of Physiology, Faculty of Medicine, University of Kelaniya, Thalagolla Road, Ragama 11010, Western, Sri Lanka. niranga@kln.ac.lk
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Pathophysiol. Sep 22, 2025; 16(3): 106482 Published online Sep 22, 2025. doi: 10.4291/wjgp.v16.i3.106482
Comparison of gastric emptying of solid and semi-solid meals using real-time ultrasonography in healthy Sri Lankan adults
Lakmali Amarasiri, Minerva de Silva, Hithanadura Janaka de Silva, Niranga M Devanarayana
Lakmali Amarasiri, Department of Physiology, Faculty of Medicine, University of Colombo, Colombo 80000, Western Province, Sri Lanka
Minerva de Silva, Department of Gastroenterology and Hepatology, St George’s Hospital, London SW17 0QT, United Kingdom
Hithanadura Janaka de Silva, Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama 11010, Western Province, Sri Lanka
Niranga M Devanarayana, Department of Physiology, Faculty of Medicine, University of Kelaniya, Ragama 11010, Western, Sri Lanka
Author contributions: Amarasiri L, de Silva M, de Silva HJ and Devanarayana NM contributed to the concept; Amarasiri L, de Silva M and Devanarayana NM collected the data; Amarasiri L analyzed the data and wrote the initial manuscript; Devanarayana NM, and de Silva HJ contributed by critically analyzing and revising the paper; and all authors approved the final version of the manuscript.
Supported by the University of Kelaniya Grant, No. RP/03/04/11/01/2011.
Institutional review board statement: This study was supported by the Ethics Committee of the Faculty of Medicine, University of Kelaniya, No. P93/05/2013.
Informed consent statement: Informed written consent was obtained from all study participants.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The dataset used during the current study is available from the corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Niranga M Devanarayana, MD, PhD, Professor, Department of Physiology, Faculty of Medicine, University of Kelaniya, Thalagolla Road, Ragama 11010, Western, Sri Lanka. niranga@kln.ac.lk
Received: February 27, 2025 Revised: April 29, 2025 Accepted: July 3, 2025 Published online: September 22, 2025 Processing time: 204 Days and 14.7 Hours
Abstract
BACKGROUND
Routine assessment of solid gastric emptying is challenging due to the prolonged test duration and complex meal preparation. Replacing solid test meals with easily prepared, commercially available semisolid meals and shortening the test duration can significantly enhance the feasibility and practicality of gastric emptying evaluations.
AIM
To compare the gastric emptying and antral motility of solid vs semi-solid meals of similar volume and nutritional consistency, and to assess the feasibility of meal substitution and reduction in test duration during the solid gastric emptying assessment.
METHODS
Thirty healthy volunteers (17 males, age: 29.4 ± 6.0 years, body mass index: 23.4 ± 2.94 and 13 females, age: 37.2 ± 11.9 years, body mass index: 22.9 ± 4.34) underwent gastric emptying by real-time ultrasonography after a solid meal and a comparable commercially prepared semi-solid meal (each meal, total calorie 350 kcal, carbohydrates 60%, fat 30% and proteins 10%), on separate dates 1 week apart. The gastric antral area was measured at 5 minutes, 15 minutes, 30 minutes, 45 minutes, 60 minutes, 90 minutes, 120 minutes, 150 minutes, 180 minutes, 210 minutes, and 240 minutes post-ingestion using a previously validated technique and compared between meals.
RESULTS
Mean and median antral areas, gastric emptying rates, gastric residual ratios, and motility index at each time point were almost similar between meals for up to 3 hours. At the end of 4 hours, the mean emptied percentage of the semisolid meal and solid meal was 81.1% and 70.6%, respectively. The emptying rate of the semisolid meal at 90 minutes significantly correlated with that of 240 minutes. There was no correlation between the solid meal emptying rates at 90 minutes and 240 minutes.
CONCLUSION
Gastric emptying, residual antral cross-sectional area and antral motility of a semisolid meal are almost similar to that of a solid meal of the same nutritional value until three hours post-ingestion. A semisolid test meal can effectively substitute a solid test meal during ultrasound assessment of gastric emptying, without compromising the validity of the results. Additionally, the ease of preparation and administration of semisolid meals enhances the overall feasibility of gastric emptying assessments.
Core Tip: Semisolids are commonly believed to empty from the stomach faster than solids, with a significantly shorter lag time. However, using semisolid and solid meals of identical volume and nutritional composition, we demonstrated that gastric emptying rates and antral motor activities were comparable for both meal types up to three hours post-ingestion, with similar half-emptying times. Real-time ultrasonography using a pre-prepared, commercially available, and culturally acceptable semisolid test meal proved to be a reliable and valid method for assessing gastric emptying. This approach offers an effective alternative to traditional solid meal gastric emptying measurements.
