Worldwide prevalence and burden of gastroparesis‐like symptoms as defined by the United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis

Abstract

Background/Objectives The global epidemiology of gastroparesis is unknown. The European UEG and European Society for Neurogastroenterology and motility consensus defines Gastroparesis as a condition characterized by delayed gastric emptying in the absence of mechanical obstruction, with a symptom pattern of nausea and/or vomiting and overlapping postprandial distress syndrome (PDS). Real‐world evidence of this gastroparesis‐like symptom pattern is a crucial step in understanding the epidemiology of gastroparesis. Methods In the Rome Foundation Global Epidemiology Study, 54,127 respondents from 26 countries completed the Rome IV Diagnostic Questionnaire and variables associated with disorders of gut‐brain interaction via Internet. We selected subjects with gastroparesis‐like symptoms (GPLS) (nausea and/or vomiting ≥1 day/week and simultaneous PDS). Patients reporting organic gastrointestinal disease, or fulfilling criteria for self‐induced vomiting, cyclic vomiting or cannabinoid hyperemesis syndrome were excluded. We determined prevalence, associated comorbidities, quality of life (QoL) (PROMIS Global‐10), symptoms of anxiety and depression (PHQ‐4), somatic symptoms (PHQ‐12), and healthcare utilization. Results The global prevalence of GPLS was 0.9% overall and 1.3% among diabetic individuals. Subjects with GPLS showed frequent overlapping of epigastric pain syndrome and irritable bowel syndrome. Subjects with GPLS had significantly lower body mass index, QoL, more non‐gastrointestinal somatic complaints, symptoms of anxiety and depression, higher medication usage and doctor visits in the overall and diabetic population, compared to subjects without these symptoms. Conclusions GPLS are common worldwide and more common in diabetic patients. The symptom complex is associated with multiple aspects of illness and an increased healthcare consumption.

Prevalence of delayed gastric emptying in patients with gastroparesis‐like symptoms

“…In order to establish the epidemiology of GP, the prevalence of subjects with the appropriate symptom pattern needs to be known, as well as the proportion of those in whom delayed GE can be confirmed. A recent study from the Rome IV Global Epidemiology survey showed symptoms suggestive of GP affected 0.9% of the adult population worldwide 25 . In the current study, we used a database of subjects who underwent a GE study and filled out symptom questionnaires, allowing us to evaluate the prevalence of delayed emptying in those with GPLS according to the European consensus, in comparison to patients who underwent GE testing and who did not fulfil these symptom criteria.…”

Gastric sensorimotor function and its clinical measurement

“…Several disorders can be associated with gastroparesis, but the predominant types are idiopathic and diabetic. The estimated global prevalence is 0.9%, with a higher prevalence of 1.3% in diabetic subjects 13 …”

“…The estimated global prevalence is 0.9%, with a higher prevalence of 1.3% in diabetic subjects. 13 While nausea and vomiting are cardinal gastroparesis symptoms, most patients with these symptoms will not show delayed gastric emptying. They are categorized according to the Rome IV consensus as having chronic nausea and vomiting syndrome, cyclic vomiting syndrome or cannabinoid hyperemesis syndrome.…”

Gastric emptying rate and relevance for symptoms

“…Anyhow, from the same Rome Foundation Global Epidemiology Study database, a specific symptom pattern was used as the definition of gastroparesis, such as nausea and/or vomiting ≥1 day/week and simultaneous postprandial distress syndrome, and this was reported by 0.9% of adults. 4 The high prevalence of both the gastroduodenal and gastroparesis‐like symptom clusters and the associated effects they have on health outcomes, including increased healthcare consumption, indicate the need for effective treatment options to reduce symptoms. The recent United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility consensus on gastroparesis 5 that was based on a Delphi process of agreement on evidence‐based statements disappointingly showed that only the dopamine‐2 antagonists and 5‐HT4 agonists are recommended for usage.…”