Can the 13C-octanoic acid breath test accurately measure gastric emptying after sleeve gastrectomy and Roux-en-Y gastric bypass? A proof-of concept analysis

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Background Bariatric surgery alters gastrointestinal anatomy and physiology, complicating functional assessments such as gastric emptying. The 13C-octanoic acid breath test is a simple, non-invasive alternative to scintigraphy, though its validity in bariatric populations requires further validation. Methods For this proof-of-concept analysis, gastric emptying data were derived from a cross-sectional study including individuals with obesity, sleeve gastrectomy, and Roux-en-Y gastric bypass (RYGB). Gastric emptying was measured simultaneously using the 13 C-octanoic breath test and the reference method, scintigraphy. Gastric emptying half-times (GET 1/2 ) were compared between the two methods using Wilcoxon signed-rank tests in each group. Concordance between both methods was assessed using Kendall's tau correlation coefficients, and Bland-Altman plots. Results No significant inter-method differences were observed for GET 1/2 in any group. Mean differences were -26.7 minutes (95% CI: -72.3; 18.6) for obesity, -3.92 minutes (95% CI: -30.8; 23.0) for sleeve gastrectomy, and -8.55 minutes (95% CI: -21.3; 4.18) for RYGB. Kendall's tau coefficients indicated positive rank associations within each group, but were non-significant (Obesity: 0.8, P =0.16; sleeve gastrectomy: 0.90, P =0.13; RYGB: 0.57, P =0.33). Bland-Altman plots demonstrated acceptable agreement between the measurements across all groups. Conclusion This proof-of-concept analysis suggests that the 13C-octanoic acid breath test has potential as a valid, non-invasive method for assessing gastric emptying in post-bariatric surgery patients. However, larger validation studies are warranted to confirm these preliminary findings.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.