Development and content validity of a gastroparesis cardinal symptom index daily diary

Revicki, Dennis A.; Camilleri, Michael; Kuo, Braden; Norton, Nancy J.; Murray, Lindsey; Palsgrove, Andrew; Parkman, Henry P.

doi:10.1111/j.1365-2036.2009.04078.x

Cited by 113 publications

(109 citation statements)

References 24 publications

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“…109 Quantification and stratification of symptoms can be assessed using a number of standardized questionnaires, such as the Gastroparesis Cardinal Symptom Index (GCSI) 110 or a modified version, termed the GCSI daily diary. 111 Complications of gastroparesis can include gastro-oesophageal reflux (probably in part as a result of reduced lower oesophageal sphincter pressure), bezoar formation and gastro-oesophageal haemorrhage from oesophagitis, as well as Mallory-Weiss tears and stasis gastric ulcers. 108 An increased risk of bacterial overgrowth in the small intestine has also been reported, with a prevalence of ~60% in some patient cohorts.…”

Section: Clinical Features Of Gastroparesismentioning

confidence: 99%

Gastric emptying and glycaemia in health and diabetes mellitus

et al. 2014

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The rate of gastric emptying is a critical determinant of postprandial glycaemia and, accordingly, is fundamental to maintaining blood glucose homeostasis. Disordered gastric emptying occurs frequently in patients with longstanding type 1 diabetes mellitus and type 2 diabetes mellitus (T2DM). A complex bidirectional relationship exists between gastric emptying and glycaemia--gastric emptying accounts for ∼35% of the variance in peak postprandial blood glucose concentrations in healthy individuals and in patients with diabetes mellitus, and the rate of emptying is itself modulated by acute changes in glycaemia. Clinical implementation of incretin-based therapies for the management of T2DM, which diminish postprandial glycaemia, in part by slowing gastric emptying, is widespread. Other therapies for patients with T2DM, which specifically target gastric emptying include pramlintide and dietary-based treatment approaches. A weak association exists between upper gastrointestinal symptoms and the rate of gastric emptying. In patients with severe diabetic gastroparesis, pathological changes are highly variable and are characterized by loss of interstitial cells of Cajal and an immune infiltrate. Management options for patients with symptomatic gastroparesis remain limited in their efficacy, which probably reflects the heterogeneous nature of the underlying pathophysiology.

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Section: Clinical Features Of Gastroparesismentioning

confidence: 99%

Gastric emptying and glycaemia in health and diabetes mellitus

et al. 2014

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“…A new variant designed to address this issue, the GCSI daily diary (GCSI DD), shows significant daytoday symptom variability in patients with gastroparesis; however mean GCSIDD scores correlate closely with GCSI scores from the 2week recall. 14 The Patient Assessment of Upper Gastrointestinal Disorders Quality of Life (PAGIQOL) provides numeri cal values for quality of life in patients with disordered gut motility. 15 By using these surveys, investigators can stratify patients with gastroparesis into subgroups on the Key points ■ Gastroparesis causes chronic symptoms of delayed gastric emptying; it can promote extraintestinal complications, and it leads to significant morbidity and health-care utilization ■ Diabetic, idiopathic and postsurgical gastroparesis are the most common etiologies of disease ■ Histopathology reveals defects in the morphology of enteric neurons, smooth muscle and interstitial cells of Cajal; in addition, the loss of neurotransmitters and increased levels of inflammatory cells suggests a heterogeneous pathogenesis of disease ■ Techniques to measure gastric emptying, including gastric emptying scintigraphy, wireless motility capsule monitoring and breath tests, are being validated for the diagnosis of gastroparesis but controversies persist ■ Treatments for gastroparesis include prokinetic and antiemetic drugs, endoscopic and surgical techniques, and nutritional and psychologic interventions; however, controlled testing is still needed to confirm their benefits ■ Ongoing research is defining the natural history of gastroparesis basis of severity of symptoms and predominant symp toms.…”

Section: Presentationmentioning

confidence: 99%

Gastroparesis: pathogenesis, diagnosis and management

Hasler

2011

Nat Rev Gastroenterol Hepatol

110

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Gastroparesis is a prevalent condition that produces symptoms of delayed gastric emptying in the absence of physical blockage. The most common etiologies of gastroparesis are idiopathic, diabetic, and postsurgical disease, although some cases stem from autoimmune, paraneoplastic, neurologic or other conditions. Histologic examination of gastric tissues from patients with severe gastroparesis reveals heterogeneous and inconsistent defects in the morphology of enteric neurons, smooth muscle and interstitial cells of Cajal, and increased levels of inflammatory cells. Diagnosis is most commonly made by gastric emptying scintigraphy; however, wireless motility capsules and nonradioactive isotope breath tests have also been validated. A range of treatments have been used for gastroparesis including dietary modifications and nutritional supplements, gastric motor stimulatory or antiemetic medications, endoscopic or surgical procedures, and psychological interventions. Most treatments have not been subjected to controlled testing in patients with gastroparesis. The natural history of this condition is poorly understood. Active ongoing research is providing important insights into the pathogenesis, diagnosis, treatment and outcomes of this disease.

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“…Non-radioactive-based gastric emptying techniques are one option, as is the use of patient-reported outcome measures such as the Diabetes Bowel Symptom Questionnaire, a useful measure of gastrointestinal symptoms and glycaemic control in patients with both type 1 and type 2 diabetes,90 and the Gastroparesis Cardinal Symptom index (GCSI), a patient-reported outcome measure of symptoms of gastroparesis consisting of nine commonly reported symptoms 91. A further modification of the initial questionnaire, the GCSI-DD, has been developed, where patients record symptoms every day, allowing clinicians to capture the daily variability of patient symptoms 92. Validation of the GCSI to meet approval agencies' requirements is currently underway.…”

Section: Diagnosismentioning

confidence: 99%

Diabetic gastroparesis: what we have learned and had to unlearn in the past 5 years: Figure 1

Kashyap

Farrugia

2010

Gut

161

127

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Diabetic gastroparesis is a disorder that occurs in both type 1 and type 2 diabetes. It is associated with considerable morbidity among these patients and resultant economic burden on the health system. It is primarily a disease seen in middle aged women though the increased predisposition in women still remains unexplained. Patients often present with nausea, vomiting, bloating, early satiety, and abdominal pain. The pathogenesis of this complex disorder is still not well understood but involves abnormalities in multiple interacting cell types including the extrinsic nervous system, enteric nervous system, Interstitial Cells of Cajal (ICC), smooth muscles and immune cells. The primary diagnostic test remains gastric scintigraphy though other modalities such as breath test, capsule, ultrasound, MRI and SPECT imaging show promise as alternative diagnostic modalities. The mainstay of treatment for diabetic gastroparesis has been antiemetics, prokinetics, nutritional support and pain control. In recent years, gastric stimulation has been used in refractory cases with nausea and vomiting. As we better understand the pathophysiology, newer treatment modalities are emerging which aim to correct the underlying defect. In this review we highlight what has been learned about diabetic gastroparesis in the past 5 years. We review the epidemiology, pathogenesis, diagnosis and treatment of diabetic gastroparesis focusing on the areas that are still controversial and those that require more studies. We also focus on advances in our understanding of the cellular changes that underlie development of diabetic gastroparesis highlighting new opportunities for targeted therapy. Keywords

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Development and content validity of a gastroparesis cardinal symptom index daily diary

Abstract: SUMMARY BackgroundThe Gastroparesis Cardinal Symptom Index (GCSI) is a patient-reported outcome for gastroparesis using a two-week recall period. To minimize potential patient recall effects, a daily diary version of the GCSI (GCSI-DD) was developed.

Cited by 113 publications

References 24 publications

Gastric emptying and glycaemia in health and diabetes mellitus

Gastric emptying and glycaemia in health and diabetes mellitus

Gastroparesis: pathogenesis, diagnosis and management

Diabetic gastroparesis: what we have learned and had to unlearn in the past 5 years: Figure 1

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