What is an isotope meal ?

Question

My daughter has been very unwell for over a year. She cannot keep food down and is sick after every meal. She does not have an eating dis-order. At the moment she is in hospital and has been for 2 weeks. She asked them to tube feed her. This they did gladly and inserted the tube into her stomach. This did not work and she was sick again. They then inserted it into her lower intestine and it worked for a few days then she was sick again. They are going to send her for an isotope meal (?) If she cannot keep anything down how will this work ? The doctors do not know what is going on with her and she is desparate. All she wants is to be healthy again. Please only genuine answers. We don't want to lose her.

Answer 1

It is a way of tracing what happens to certain minerals in food after being eaten. For example, how much is retained in the body, how much is excreted etc.


Note : A Barium meal is NOT the same as an isotope meal

Most minerals have several naturally-occurring stable isotopes, all with a fixed abundance. In
order to follow the metabolism of a mineral, it is necessary to ingest it in an altered form so that
it can be distinguished from the naturally-abundant mineral. The form of the ingested mineral
can be altered by enriching one of the low-abundance isotopes. This so-called ‘tracer’ or ‘label’
is injected and/or taken orally and its appearance in the plasma, urine and faeces can be monitored
over several days. The concept of a tracer is important in isotope work. A true tracer is
one that does not perturb the system it is investigating. Only radioisotopes can be called true
tracers, since they are administered in extremely small quantities. The term ‘label’ is more
appropriate for stable isotopes, since they are usually given in quantities equivalent to the
amount received in the normal diet. The word ‘tracer’ is, however, still used in some stable-isotope
studies with the implicit understanding that it will almost certainly perturb the system
under investigation. The underlying assumption in this type of work is that the label (or tracer)
behaves in the same kinetic way as the naturally-abundant mineral (sometimes called the
tracee), otherwise the use of labels to mimic the behaviour of the native mineral is invalid.
There must be no discrimination by the body between the two forms of the mineral. Although
stable isotopes were the first tracers to be used in nutritional science (Schoenheimer &
Rittenburg, 1935), radioisotopes quickly became the standard amongst researchers after the
Second World War. It wasn’t until the early 1960s that the first mineral study was published
using an enriched stable isotope of Fe, 58Fe (Lowman & Krivit, 1963). The first studies using
Ca (McPherson, 1965) and Cr (Donaldson et al. 1968) followed shortly afterwards, and the late
1970s saw the first Zn and Cu stable-isotope studies performed (King et al. 1978). A combination
of advances in MS and concern about exposure to ionising radiation led to a growing number
of researchers switching to stable-isotope tracers. Several reviews and guides have been
written subsequently (Buckley, 1988; Turnlund, 1989, 1991, 1994; Mellon & Sandstrom,
1996). The stable isotopes used in nutrition studies are normally incorporated in food either
intrinsically (Janghorbani et al. 1981b; Weaver, 1985; Fox et al. 1991) or extrinsically
(Janghorbani et al. 1982; Christensen et al. 1983; Johnson & Lykken, 1988; Weaver, 1988). An
intrinsic label is one in which the stable isotope is incorporated biosynthetically into a plant or
animal, whereas an extrinsic label is simply added to the food before ingestion. Nutritional
researchers are often interested in knowing how much of a mineral in a food, meal or diet is
utilised for normal body functions. This is known as the bioavailability of the mineral. It is not
possible to measure the utilisation of minerals directly so absorption and retention are used as
indirect measures instead. Stable isotopes are ideal for investigating the absorption and retention
of minerals because of the ease in distinguishing the label from the native element. There
are two definitions of absorption: apparent and true. Apparent absorption is the quantity of mineral
that is absorbed and retained in the body within the experimental time period (usually several
days) from a single test meal. True absorption is the quantity of mineral that has been
absorbed from a single test meal. True absorption is, by definition, always greater than apparent
absorption. Knowledge of the quantity of label given and the subsequent quantity recovered in
the faeces is sufficient to calculate the apparent absorption. If the mineral is prone to large
endogenous losses, a second label can be given intravenously at the same time as the oral label
and both are followed in the faeces. Endogenous losses can then be accounted for and the true
absorption of the mineral calculated. This is known as a dual-tracer experiment and is valid if
the oral and intravenous (IV) labels behave in the same way kinetically. Dual-tracer experiments
can also be used to calculate true absorption from urine and plasma samples.

Answer 2

This is a bit longwinded, however it does just about cover everything. Secondly, I hope the doctors find the problem and that your daughter has a full recovery and gets well soon

The organs of the digestive system don't show up on x-ray unless they are 'outlined' by barium meal. This is a medical test used to examine the condition of the digestive tract using a heavy, white, radio-opaque powder called barium sulfate. This powder is usually flavoured and mixed with a liquid which is then swallowed by the patient. The mixture passes quickly into the digestive tract and its progress is followed by taking x-rays over different periods of time, depending on which part of the digestive tract the doctor wants to observe. A barium swallow involves x-ray examination of the oesophagus, and is used to help diagnose swallowing or reflux problems.

Problems that may be diagnosed with barium meal
By looking at the x-rays, the doctor is able to see a wide range of problems including:

Abnormal shape of the digestive tract
Areas of narrowing
Filling problems
Ulceration
Damage to the digestive tract lining.
Medical issues to consider
Before the procedure, you need to discuss a range of issues with your doctor including:
If constipated, you will be given a laxative the night before the barium meal.
For eight hours beforehand, you are not allowed to eat or drink anything. The x-rays will be easier to read without food particles in the digestive tract.
Tell your doctor if you have insulin-dependent diabetes, so that you can decide together the best time for your fast and subsequent test.
Pregnant women should not undergo this test.
Test procedure
You swallow the barium drink. The drink is fizzy because it contains ingredients that cause gas, which helps to expand your stomach and duodenum. (You may have to resist the urge to burp.) In some cases, a muscle relaxant may be injected into your abdominal wall. You will be asked by the radiographer to stand or lie in a number of different postures, while x-rays are taken. The x-ray machine is linked to a television monitor, and photographs or video footage can be taken if necessary. Generally, the procedure takes around 20 minutes. If necessary, you may need to have follow-up x-rays; in some cases, several x-rays over three to six hours in order to examine the small intestine and colon.

After the test
After the procedure, you can expect:
Constipation
Light coloured faeces.
Possible complications
Barium meal is a safe test, but complications can sometimes occur. These may include:
Accidentally breathing in the barium meal instead of swallowing it.
If a section of the digestive tract has an undiagnosed perforation, the barium meal may leak into the abdominal cavity.
If the bowel is obstructed, the barium meal can become impacted.
The barium meal can lodge in the appendix and cause appendicitis.
There may be side effects (such as blurred vision) from the drugs used during the test.
Taking care of yourself at home
Be advised by your doctor, but general suggestions include:
Barium meal can cause constipation, so it is best to drink plenty of fluids for at least one full day following the test.
Eat more fruit than usual for the next day or two to help move your bowels.
See your doctor if you haven't had a bowel motion within three days.
Long term outlook
You will need to make another appointment with your doctor to discuss the results of your barium meal. A negative result may require further tests if symptoms persist. Treatment depends on the diagnosis.

Other tests
Other tests used to examine the digestive tract include:
Barium enema - examinations of the small intestine and colon are usually done via barium enema. The preparation isn't swallowed, but gently flushed into the bowel through the anus. X-rays are then taken.
Flexible endoscopy - an endoscope, a slender tube with a lens at one end and a telescope at the other, is inserted into the patient via an orifice (such as mouth or anus) or a small incision. The doctor looks down the telescoped end for a magnified view.
Computerised tomography (CT) scan - the use of x-rays and digital computer technology to create an image of internal body structures.

Answer 3

The isotope meal is an investigative procedure not a treatment.r A meal usually liquid is given and it contains radioactive isotopes. X.rays or scans are taken while the isotope is still in the body and it can help in the diagnosis of various diseases. Whether it will help in your daughters case remains to be seen but it seems the doctors are doing all they can to get to the root of the problem.There may be other tests to follow but you have my best wishes for a happy result to your problems.

Answer 4

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