Severe gastroparesis is associated with an increased incidence of slow‐transit constipation as measured by wireless motility capsule

Abstract

Background: Dysmotility in one region of the gastrointestinal tract has been found to predispose patients to developing motility disorders in other gastrointestinal segments. However, few studies have evaluated the relationship between gastroparesis and constipation.Methods: Retrospective review of 224 patients who completed 4-hour, solid-phase gastric emptying scintigraphy (GES), and wireless motility capsule (WMC) testing to evaluate for gastroparesis and slow-transit constipation, respectively. When available, anorectal manometry data were reviewed to evaluate for dyssynergic defecation.Patients were divided into two groups based on the results of the GES: 101 patients with normal gastric emptying and 123 patients with gastroparesis (stratified by severity). Differences in constipation rates were compared between the groups.Key results: Slow-transit constipation was more common in the gastroparesis group, but statistical significance was not reached (42.3% vs 34.7%, p = 0.304). Univariate logistical regression analysis found no association between slow-transit constipation and gastroparesis (OR 1.38, 95% CI 0.80-2.38, p = 0.245) nor dyssynergic defecation and gastroparesis (OR 0.88, 95% CI 0.29-2.70, p = 0.822). However, when stratifying gastroparesis based on severity, slow-transit constipation was found to be associated with severe gastroparesis (OR 2.45, 95% CI 1.20-5.00, p = 0.014). This association was strengthened with the exclusion of patients with diabetes mellitus (OR 3.5, 95% CI 1.39-8.83, p = 0.008) -a potential confounder. Conclusions & Inferences:Patients with severe gastroparesis (>35% gastric retention at the 4-hour mark on solid-phase GES) have an increased likelihood of having underlying slow-transit constipation. Dyssynergic defecation does not appear to be associated with gastroparesis (of any severity).

Gastrointestinal Symptoms Profile in Pediatric Patients With Gastroparesis Compared to Healthy Controls

“…It should be noted that the items in the Diarrhea Scale may also be measuring constipation with overflow fecal incontinence as previously reported (17). Though the pathophysiologic association between gastroparesis and constipation has not been fully elucidated, these findings regarding elevated constipation symptoms in pediatric patients with gastroparesis are consistent with recent findings in adults with gastroparesis (42,43). Our results appear to support the findings in adults that there is significant overlap in symptoms between pediatric patients with gastroparesis and those with gastroparesis‐like symptoms but normal gastric emptying; implying a spectrum of disease rather than two separate disorders (41).…”

Gastrointestinal Symptoms Profile in Gastroparesis Compared to Other Functional and Organic Gastrointestinal Diseases

“…Recent findings with adult patients have demonstrated significant symptoms overlap between gastroparesis and functional dyspepsia, suggesting a spectrum of disease rather than 2 separate disorders (6). The exception to this symptoms overlap is the finding that elevated constipation symptoms are present in adult patients with gastroparesis compared to those with functional dyspepsia (7,8). Notably, we also found in the present study that pediatric patients with gastroparesis reported significantly worse constipation symptoms than pediatric patients with functional dyspepsia.…”

“…In adults with gastroparesis, the patient‐reported gastrointestinal symptoms profile is similar to those of adult patients with functional dyspepsia with normal gastric emptying (4–6), except for more constipation symptoms in adult patients with gastroparesis compared to those with functional dyspepsia (7,8). Similarly, when comparing the gastrointestinal symptoms profiles of pediatric patients with gastroparesis to pediatric patients with gastroparesis‐like symptoms with normal gastric emptying, worse constipation and diarrhea/overflow fecal incontinence symptoms were reported by pediatric patients with gastroparesis using the PedsQL Gastrointestinal Symptoms Scales (9).…”

A global bibliometric and visualized analysis of the status and trends of gastroparesis research

“…In GESc, a gamma camera is used to detect the migration of radioisotopes, thereby reflecting the transport characteristics of substances in the gastrointestinal tract [ 44 ]. The use of GESc for the investigation of gastroparesis patients was first proposed in 1966 [ 45 ].…”