Gastric emptying of indigestible tablets in relation to composition and time of ingestion of meals studied by metal detector

Enteric-coated tablets leave the stomach mainly during the interdigestive phase. Composition as well as time of ingestion of meals may influence their gastric emptying considerably. In 12 normal volunteers gastric emptying of a plastic tablet with a metal core was followed by a metal detector in relation to different compositions and various times of ingestion of meals. With an empty stomach and after ingestion of 250 ml water, the mean time for gastric emptying of the tablet was 38±11 min (mean±SEM) and 38±8 min. Two hundred fifty milliliters of milk (652 kJ) and a formula diet (1000 kJ) delayed gastric emptying time to 128±14 and 152±6 min, respectively (P<0.05). Breakfast (2200 kJ) further retarded gastric emptying compared with both liquids to 249±24 min (P<0.05). There was a close correlation between nutritive density and gastric emptying of the tablet (r=0.92;P<0.0001). Main meals also delayed gastric emptying of tablets when compared to empty stomach (P<0.05). A snack after breakfast further delayed gastric emptying from 201±10 to 278±19 min (P<0.05). The largest delay was observed following ingestion of breakfast, lunch, dinner, and additional snacks (509±220 min). We conclude that the delay of gastric emptying of enteric-coated tablets by food is related to its nutritive density and eating habits. The gastric emptying of an enteric coated tablet that is ingested early in the morning may be delayed until late at night when several meals and snacks are ingested during the day, leading to unwanted alterations in bioavailability and to possible adverse effects.