Sarah Marowski, Yiwei Xu, Luke M Funk, Jacob A Greenberg, Anne O Lidor, Amber L Shada. University of Wisconsin School of Medicine and Public Health
Gastroparesis (GP) causes nausea, vomiting, and reflux. These symptoms are also associated with gastroesophageal reflux disease (GERD), and it is often difficult to distinguish between the two. Currently, gastric emptying scans (GES) and the Gastroparesis Cardinal Symptom Index (GCSI) are used to evaluate gastroparesis. The GCSI has been validated for use in diabetic gastroparesis patients but not in other patient populations, such as patients with GERD. This study aims to evaluate the usefulness of GCSI in identifying GP in patients with a primary diagnosis of GERD who presented to our clinic for anti-reflux surgery.
Retrospective review of an institutional foregut surgery database was performed to identify adult patients with GES. Diabetic or idiopathic gastroparesis patients with no history of foregut surgery were excluded. The rest were sorted by normal (GERD) or abnormal (GERD-DGE) GES. GERD-Health Related Quality of Life (HQRL) and GCSI scores including subcategory scores in fullness, bloating and nausea/vomiting were calculated and compared between groups. A Wilcoxon RankSum was used to compare scores between groups.
There were 137 total patients identified. Thirty-four of these with diabetic or idiopathic gastroparesis were excluded. The remaining patients included 67 with GERD and 36 with GERD-DGE. GERD-DGE patients were more likely to be female and diabetic compared to GERD patients (p= 0.03 and 0.02 respectively). The GERD-DGE group had significantly higher gastric emptying halftime compared to the GERD group (p=<0.001). Reflux was the primary reason for evaluation for both GERD and GERD-DGE groups. Mean HRQL score was 23 in the GERD group and 16 in the GERD-DGE (p=NS). Mean GCSI was 24 for both groups (p=NS). There was no difference between the GERD and GERD-DGE groups in any of the GCSI subcategory scores.
In terms of symptom scoring, patients with GERD and GERD-DGE do not have significantly different scores. The GCSI is not a good predictor of DGE in patients who present with GERD. A GES is still the best test to evaluate gastroparesis in this patient demographic. Our clinical practice is to perform GES on all patients who present with GERD and clinical concern for DGE.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95161
Program Number: P444
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster
sages_adbutler_leaderboard