Idiopathic Gastroparesis Symptom Severity and Functional Dyspepsia Not Associated With Gastric Emptying Rate

Gastric emptying (GE) rate was not correlated with functional dyspepsia (FD) and idiopathic gastroparesis symptom severity. These findings were published in Clinical Gastroenterology and Hepatology.

Patients (N=504) diagnosed with FD at the Leuven University Hospital in Belgium between 2006 and 2017 were included in this study. Epigastric symptoms over the previous 3 months were assessed by the Rome III questionnaire and GE rate by a breath test following consumption of a 250-kcal solid meal. Patients were divided into groups based on GE rate: normal or delayed (T_½ >109 minutes) and 1.5 times (>163.5 minutes) and 2 times (>218 minutes) the upper limit.

Patients were 70% women, aged mean 43.6±0.7 years, and BMI was 23.3±0.2 kg/m². The reported symptoms were postprandial fullness (81%), bloating (78%), belching (56%), early satiation (54%), epigastric pain (53%), nausea (51%), and epigastric burning (23%), occurring several times per week. The average weight loss since onset of symptoms was 4.1±0.3 kg.

The average T_½ among the patients was 95.6±2.7 minutes and nearly a quarter (24%) exhibited delayed GE rate (³109 minutes). During the GE test, patients indicated via the Rome III questionnaire that they were experiencing postprandial fullness (20±0.8), bloating (16±0.8), epigastric pain (15±0.8), belching (13±0.6), nausea (12±0.7), and epigastric burning (10±0.7) with total scores of 86±3.

Severity scores reached their maximum for bloating and belching at 30 minutes, fullness at 45 minutes, nausea at 90 minutes, epigastric burning at 105 minutes, and epigastric pain at 120 minutes.

Weight loss correlated with overall symptom severity (r, 0.22; P <.0001), nausea (r, 0.25; P <.0001), postprandial fullness (r, 0.19; P <.0001), belching (r, 0.13; P =.01), and bloating (r, 0.12; P =.02) but not with GE rate (r, 0.04; P =.4).

Stratified by GE rate, patients with delayed GE had higher maximum severity scores for nausea (1.0±.01 vs 0.7±0.06; P =.01). Nausea was associated with 1.5 times upper limit of GE (r, -0.3; P =.03). Epigastric burning (r, -0.6; P =.003) and belching (r, -0.4; P =.05) were associated with >2 times upper limit of GE.

This study was limited by its low sample size and single center design.

These data indicated GE rate was not a reliable indicator of specific symptoms of FD and could indicate that idiopathic gastroparesis may be a distinct clinical entity from FD.

Reference

Carbone F, De Buysscher R, Van den Houte K, Schol J, Goelen N, Tack J. Relationship between gastric emptying rate and simultaneously assessed symptoms in functional dyspepsia. Clin Gastroenterol Hepatol. Published online March 18, 2021. doi: 10.1016/j.cgh.2021.03.023