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Patients with delayed GE and proximal distribution at 4h had more severe nausea, retching, and vomiting compared to 4h distal distribution. Severely delayed 4h proximal distribution had more nausea than severely delayed 4h distal distribution. Increased early distal IMD in patients with delayed GE was associated with regurgitation and early satiety whereas increased late proximal IMD was associated with nausea, retching, and vomiting. Differentiating proximal from distal meal distribution patterns helps to relate symptoms to gastric dy