2 Indications and current treatments
2.1 The procedure is used to investigate gastrointestinal (GI) motility‑related symptoms. Motility disorders can sometimes be difficult to diagnose. They include conditions such as gastroparesis and slow transit constipation. Gastroparesis is a chronic disorder of the stomach, characterised by delayed gastric emptying in the absence of mechanical obstruction. Treatment includes medical therapies (such as erythromycin and metoclopramide), botulinum toxin, gastric electrical stimulation, jejunostomy and parenteral nutrition. Slow transit constipation comprises a number of symptoms including straining, hard stools, sensation of incomplete evacuation and infrequent bowel movements. Management includes medical therapies such as laxatives and lifestyle advice (for example, increasing exercise, and intake of water and fibre).
2.2 The standard procedure used to assess upper GI motility is gastric emptying scintigraphy. It involves ingestion of a standardised radiolabelled meal. An X‑ray is taken after 4 hours to determine the extent of gastric emptying.
2.3 Slow transit constipation is assessed using a radiopaque marker examination. The patient ingests a number of radiopaque markers and has an X‑ray(s) after a predefined time period (usually 4 or 5 days) to determine whether markers have been evacuated.