Gastrointestinal symptoms profile in pediatric patients with gastroparesis compared to healthy controls

Authors: FEBO-RODRIGUEZ, LIZ - University Of Miami; CHUMPITAZI, BRUNO - Children'S Nutrition Research Center (CNRC); MUSAAD, SALMA - Children'S Nutrition Research Center (CNRC); SHER, ANDREW - Baylor College Of Medicine; VARNI, JAMES - Texas A&M University; SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC)

Submitted to: Journal of Pediatric Gastroenterology and Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/1/2022
Publication Date: 6/1/2022
Citation: Febo-Rodriguez, L., Chumpitazi, B.P., Musaad, S., Sher, A.C., Varni, J.W., Shulman, R.J. 2022. Gastrointestinal symptoms profile in pediatric patients with gastroparesis compared to healthy controls. Journal of Pediatric Gastroenterology and Nutrition. https://doi.org/10.1097/MPG.0000000000003484.
DOI: https://doi.org/10.1097/MPG.0000000000003484

Interpretive Summary: A large number of children and adults develop stomach pain, nausea, vomiting, and/or abdominal distention, as well as other symptoms after eating. Some of these individuals have abnormally slow stomach emptying. It is not clear how these symptoms differ from those in normal individuals or if symptoms differ between those with versus without slow stomach emptying. In this study we found in children that symptoms differed significantly from those in healthy children. Importantly, except for more constipation in children with slow stomach emptying, symptoms did not differ between those with versus those without slow stomach emptying. The results underscore the critical need to develop highly effective treatments (nutritional or other therapies) for children with these symptoms.

Technical Abstract: The primary objective was to compare the patient-reported gastrointestinal symptoms profiles of pediatric patients with gastroparesis to matched healthy controls using the PedsQL^TM Gastrointestinal Symptoms Scales. The secondary objectives were to compare pediatric patients with gastroparesis to pediatric patients with gastroparesis-like symptoms and normal gastric emptying and to compare pediatric patients with gastroparesis-like symptoms and normal gastric emptying to matched healthy controls. The PedsQL^TM Gastrointestinal Symptoms Scales were completed by 64 pediatric patients with gastroparesis, 59 pediatric patients with gastroparesis-like symptoms and normal gastric emptying, and 200 age, gender, and race/ethnicity matched healthy controls. The PedsQL^TM Gastrointestinal Symptoms Scales encompass 10 individual multi-item scales which measure stomach pain, stomach discomfort when eating, food and drink limits, trouble swallowing, heartburn and reflux, nausea and vomiting, gas and bloating, constipation, blood in poop, and diarrhea/fecal incontinence. Based on gastric emptying scintigraphy testing, those with abnormal gastric retention were classified as having gastroparesis. The gastrointestinal symptoms profile analysis identified large differences between those with gastroparesis compared to healthy controls (most Ps<0.001), with the largest effect sizes for upper gastrointestinal symptoms including stomach pain, stomach discomfort when eating, food and drink limits, nausea and vomiting. Those with gastroparesis self-reported similar gastrointestinal symptoms to those with normal gastric emptying, except for increased constipation. Pediatric patients with gastroparesis self-reported broad multidimensional gastrointestinal symptoms profiles in comparison to healthy controls with large differences, indicating the critical need for more highly efficacious interventions to bring patient functioning within the normal range of healthy functioning.