Gastrointestinal symptoms profile in gastroparesis compared to other functional and organic gastrointestinal diseases

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

Submitted to: Journal of Pediatric Gastroenterology and Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/7/2023
Publication Date: 7/1/2023
Citation: Varni, J.W., Chumpitazi, B.P., Febo-Rodriguez, L., Shulman, R.J. 2023. Gastrointestinal symptoms profile in gastroparesis compared to other functional and organic gastrointestinal diseases. Journal of Pediatric Gastroenterology and Nutrition. 77(1):e1-e7. https://doi.org/10.1097/MPG.0000000000003806.
DOI: https://doi.org/10.1097/MPG.0000000000003806

Interpretive Summary: Slow stomach emptying (gastroparesis) can cause severe stomach symptoms that often impact the ability to eat and result in poor nutrition. Other gastrointestinal (stomach/intestine) issues seemingly can cause similar symptoms. In this study we wanted to find out what exactly, if any, symptoms of slow stomach emptying are found in other common gastrointestinal problems. We determined the symptoms in children with slow stomach emptying and compared their symptoms to children with other gastrointestinal problems. The severity of symptoms of those with slow stomach emptying were worse than those in almost every other type of gastrointestinal problem. This was particularly true for the symptoms of stomach discomfort when eating, nausea, and vomiting. This study highlights the great need to find better strategies for slow stomach emptying in children given how the disorder greatly impacts the child.

Technical Abstract: The primary objective was to compare the patient-reported gastrointestinal symptoms profiles of pediatric patients with gastroparesis to pediatric patients with 1 of 7 other functional gastrointestinal disorders and organic gastrointestinal diseases using the Pediatric Quality of Life Inventory(PedsQL) Gastrointestinal Symptoms Scales. The gastrointestinal symptoms profiles of 64 pediatric patients with gastroparesis who manifested abnormal gastric retention based on gastric emptying scintigraphy testing were compared to 582 pediatric patients with 1 of 7 physician-diagnosed gastrointestinal disorders (functional abdominal pain, irritable bowel syndrome, functional dyspepsia, gastroesophageal reflux disease, functional constipation, Crohn disease, ulcerative colitis). The PedsQL 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, with an overall total gastrointestinal symptoms score. The gastrointestinal symptoms profile analysis identified significantly worse overall total gastrointestinal symptoms scores between pediatric patients with gastroparesis compared to all other gastrointestinal groups except for irritable bowel syndrome (most Ps < 0.001), with significant differences for stomach discomfort when eating compared to all 7 other gastrointestinal groups (most Ps < 0.001). Nausea and vomiting were significantly worse for gastroparesis compared to all other gastrointestinal groups except for functional dyspepsia (all Ps < 0.001).Pediatric patients with gastroparesis self reported significantly worse overall total gastrointestinal symptoms compared to all other gastrointestinal diagnostic groups except for irritable bowel syndrome, with stomach discomfort when eating and nausea and vomiting symptoms exhibiting the greatest differences compared to most gastrointestinal diagnostic groups.