S1373 Relationship of Symptomatology of Gastroparesis With Gastric Emptying Studies

INTRODUCTION: Gastroparesis is a debilitating disorder which includes several upper abdominal symptoms and documented slow gastric emptying (AJG 2013; 108:18). Past studies have shown heterogenous results of correlation between the symptoms and the gastric emptying study. We aim to study the association of symptoms with gastric emptying. METHODS: We performed retrospective review of the patients diagnosed with gastroparesis between September 30th, 2009 and January 31st, 2020. The 99mTc sulfur labeled food was used to diagnose gastroparesis. The test was performed in the patients with nausea, vomiting, abdominal pain, abdominal bloating/distention, postprandial fullness/ early satiety, diarrhea, constipation and weight loss. Gastric retention of ≥ 10% of solids at 4 hours and ≥ 5% of liquids at 1 hours were identified as delayed gastric emptying. We examined relationship of presence of symptoms with the rate of gastric emptying examined by various gastric emptying test. RESULTS: There were 320 patients (mean age 47.5 ± 16.4 years, 70% female, 71.3% white) with gastroparesis. The prevalence of abdominal symptoms and the percentage of gastric emptying was calculated by gastric scintigraphy test. We observed that nausea, vomiting and abdominal bloating/distention were significantly associated with degree of gastric emptying (Figure 1). Patients with nausea (55.7% vs 66.6%, P = 0.02) and vomiting (55.5% vs 63.7%, P = 0.04) had slower liquid gastric emptying, while the solid gastric emptying rate was prolonged in individuals without abdominal distension/ bloating (71.9% vs 82.3%, P = 0.004). Postprandial fullness/early satiety, abdominal pain, constipation, diarrhea and weight loss had no significant association with the degree of gastric emptying. CONCLUSION: In this cohort of objectively diagnosed gastroparesis, only a few symptoms correlated with delayed gastric emptying that include nausea, vomiting and abdominal distention. Symptoms alone may not be adequate to diagnose gastroparesis. Rapid gastric emptying and functional dyspepsia can also present with symptoms similar to gastroparesis, reported delayed gastric transit is important for the diagnosis of gastroparesis.Figure 1.: Comparison of percentages of gastric emptying in the presence or absence of nausea, vomiting and abdominal bloating/ distention (Average percentages written above bars).