Association Between Symptoms, Quality of Life, and Gastric Emptying in Dyspeptic Patients

Abstract

Background/Aims Association between symptoms, quality of life and gastric emptying in dyspepsia is inconsistent in the literature. The aim of our study is to investigate if gastric emptying is associated with specific symptoms and quality of life in dyspeptic patients. Methods We reviewed retrospectively gastric emptying measured by 13 C-labelled octanoate breath testing for more than 6 hours in 198 consecutive patients with dyspepsia complaints. Gastrointestinal symptoms were assessed using a 5-points Likert scale and by a symptomatic composite score, whereas quality of life was measured by the GIQLI. Results In our cohort, 90 patients (45%) had a delayed gastric emptying (half emptying time above 166 minutes when assessed over 6-8 hours). There was no difference in symptoms or quality of life between patients with or without delayed gastric emptying. However, patients with severely delayed gastric emptying (half emptying time above 200 minutes) had increased postprandial fullness (P = 0.012), abdominal pain (P = 0.026), bloating (P = 0.044), early satiety (P = 0.018), symptomatic composite score (P = 0.005), and a lower quality of life (P = 0.018). This association was no longer observed if the calculation of gastric emptying was limited to the first 4-hour samples. Conclusions There is no association between symptoms, quality of life and gastric emptying in an overall dyspeptic population. However, there is an association between symptoms, quality of life of delayed gastric emptying in the subgroup of patients with severely delayed gastric emptying. An 8-hour measurement of gastric emptying should be recommended.

The use of impedance planimetry (Endoscopic Functional Lumen Imaging Probe, EndoFLIP®) in the gastrointestinal tract: A systematic review

“…In addition, pyloric distensibility correlated negatively with gastroparesis symptoms, including nausea, 75,79 gastric fullness, 75,77 early satiety, 75,77 and quality of life 75,77 . This contrasts with gastric emptying measurement which is poorly correlated with symptoms or quality of life 71‐73 (LE 3). This suggests therefore that pyloric distensibility may be a clinically relevant tool in a subset of gastroparetic patients to better identify precisely one of the underlying mechanisms involved in gastric retention 17,80 …”

“…Clinical diagnosis of gastroparesis may be challenging as symptoms patterns and severity are poorly correlated with gastric emptying 71‐73 . Historically, the role of pylorus in gastric emptying delay and symptom generation has been highlighted.…”

Can Ultrasonographic Measurements of Gastric Motility Identify Pathophysiological Abnormalities of Functional Dyspepsia and Irritable Bowel Syndrome?

“…6,16 However, other studies revealed no or little difference in symptoms between patients with or without delayed gastric emptying. 5,17,18 Also, FD subgroups are not differentially related to abnormalities of stomach motor function. 19 Although SPECT can quantify the amount of remaining material in the stomach, it cannot distinguish a patient with FD from that with idiopathic gastroparesis.…”

The Associations Among Symptoms, Quality of Life, and Gastric Emptying: An Unresolved Issue

“…In this issue of Journal of Neurogastroenterology and Motility, Wuestenberghs et al 15 assessed association between symptoms and gastric emptying in 198 patients with dyspepsia. The main findings were that there was no association between symptoms, quality of life, and gastric emptying in their population.…”

“…Specifically, a populationbased study applying the Rome III showed FD overlap both with IBS and GERD had a significant impact on bodily pain. 14 In addition, Wuestenberghs et al 15 reported that patients with IBS present poorer quality of life (GIQLI scores of 71.9 points compared to 83.6 without overlap with IBS, P = 0.002). As mentioned above, these factors may be confounders that distort the association among gastric emptying, symptoms and HRQOL.…”