Effect of liquid and solid test meals on symptoms and gastric myoelectrical activity in patients with gastroparesis and functional dyspepsia

Authors: KOCH, KENNETH - Wake Forest University; VAN NATTA, MARK - Johns Hopkins University; PARKMAN, HENRY - Temple University; GROVER, MADHUSUDAN - Mayo Clinic; ABELL, THOMAS - University Of Louisville; MCCALLUM, RICHARD - Texas Tech University; SHALTOUT, HOSSAM - Wake Forest University; SAROSIEK, IRENE - Texas Tech University; FARRUGIA, GIANRICO - Mayo Clinic; SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC); TONASCIA, JAMES - Johns Hopkins University; MIRIEL, LAURA - Johns Hopkins University; HAMILTON, FRANK - National Institute Of Diabetes And Digestive And Kidney Diseases; PASRICHA, PANKAJ - Johns Hopkins School Of Public Health

Submitted to: Neurogastroenterology & Motility
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/14/2022
Publication Date: 4/11/2022
Citation: Koch, K.L., Van Natta, M., Parkman, H.P., Grover, M., Abell, T.L., McCallum, R.W., Shaltout, H.A., Sarosiek, I., Farrugia, G., Shulman, R.J., Tonascia, J., Miriel, L., Hamilton, F., Pasricha, P.J. 2022. Effect of liquid and solid test meals on symptoms and gastric myoelectrical activity in patients with gastroparesis and functional dyspepsia. Neurogastroenterology & Motility. https://doi.org/10.1111/nmo.14376.
DOI: https://doi.org/10.1111/nmo.14376

Interpretive Summary: Many adults and children suffer from symptoms of nausea, abdominal pain, belly distention, and/or bloating after eating. Some of these individuals have abnormally slow stomach emptying. In this study carried out in adults, we found that whether stomach emptying was abnormally slow or not, individuals with these symptoms after eating had similar stomach muscular activity suggesting that the two disorders are similar in their physiology. Additional studies are necessary to determine if diet or other interventions are needed to improve the quality of life for these individuals.

Technical Abstract: Patients with gastroparesis (GP) and functional dyspepsia (FD) have similar symptoms, but the pathophysiology of postprandial symptoms remains uncertain. To compare symptoms and gastric myoelectrical activity (GMA) after liquid and solid test meals in patients with GP and FD. Patients enrolled in the Gastroparesis Clinical Research Consortium Registry were studied. Clinical characteristics were measured with standard questionnaires. GP was determined by 4-h solid-phase gastric scintigraphy. GMA was measured using electrogastrography before and after ingestion of a water load or nutrient bar on separate days. Symptoms were measured on visual analog scales. GMA responses to the water load for individual patients were also determined. 284 patients with GP and 113 with FD were identified who ingested both test meals. Patients with GP and FD had similar maximal tolerated volumes of water mean (SD) 378 (218) ml vs. 402 (226) ml, p = 0.23] and reported similar intensity of fullness, nausea, bloating, and abdominal discomfort after the test meals. Twenty-six percent and 19% of the patients with GP and FD, respectively, ingested subthreshold (<238 ml) volumes of water (p = 0.15). Gastric dysrhythmias were recorded in 66% of the GP and 65% of the FD patients after the water load. Symptoms and GMA were similar in both groups after ingestion of the nutrient bar. The similarity in GMA responses and symptoms after ingestion of solid or liquid test meals suggests GP and FD are closely related gastric neuromuscular disorders.