Disclosures: Lee reports receiving funding from Covidien.
September 29, 2020
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Baseline features may predict more severe symptoms in gastroparesis

Disclosures: Lee reports receiving funding from Covidien.
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Baseline features of gastroparesis, identified with gastric motility testing, may help identify patient risk for more severe longitudinal symptoms and worse quality of life, according to study results.

Allen Lee, MD, of the division of gastroenterology at the University of Michigan, and colleagues wrote that gastric motility testing is routinely performed in gastroparesis, but past research has not found a correlation between gastric emptying rates and symptoms.

“While previous studies have significantly improved our knowledge of clinical and demographic features associated with outcomes in gastroparesis, these studies were performed predominantly in patients with known delayed gastric emptying,” they wrote. “It is unclear if similar features are associated with longitudinal outcomes in patients with symptoms, but no prior diagnosis, of gastroparesis.”

Lee and colleagues conducted a prospective, observational study comprising 150 patients with gastroparesis symptoms. Patients underwent simultaneous scintigraphy (GES) and wireless motility capsule (WMC) measurement of gastric emptying, as well as other motility parameters.

Patients completed assessments of upper GI symptoms and quality of life at baseline, and 3 and 6 months after testing. Researchers then determined which baseline parameters predicted longitudinal changes in symptoms and quality of life.

Patients reported moderate GI symptoms and quality of life scores at baseline, which improved over the course of 6 months.

Researchers found that some clinical variables, including female sex, harder stools (based on Bristol stool form score) and presence of functional dyspepsia were predictive of more severe upper GI symptoms. After controlling for these factors, delayed gastric emptying, by either GES or WMC, was associated with worse symptom severity and quality of life scores.

Additionally, low gastric and elevated small bowel contractile parameters by WMC were independently associated with more severe upper GI symptoms and worse quality of life scores.

“Although not recommended in current guidelines, our data suggest that gastric motility tests may help to risk stratify and provide prognostic information,” Lee and colleagues wrote. “Future analyses will determine whether motility test results may predict response to different therapeutic options in specific patient subsets.”