Relating gastric scintigraphy and symptoms to motility capsule transit and pressure findings in suspected gastroparesis. Issue 2 (5th September 2017)

• Record Type: Journal Article
• Authors: Hasler, W. L.; May, K. P.; Wilson, L. A.; Van Natta, M.; Parkman, H. P.; Pasricha, P. J.; Koch, K. L.; Abell, T. L.; McCallum, R. W.; Nguyen, L. A.; Snape, W. J.; Sarosiek, I.; Clarke, J. O.; Farrugia, G.; Calles‐Escandon, J.; Grover, M.; Tonascia, J.; Lee, L. A.; Miriel, L.; Hamilton, F. A.
• Other Names: Kim Yale investigator.; Ullah Nighat investigator.; DeVole Nata investigator.; Greene Mary investigator.; Lee Candice investigator.; Ponsetto Courtney investigator.; Shetler Katerina investigator.; Kantor Steven investigator.; Lytes Vanessa investigator.; Palit Amiya investigator.; Simmons Kellie investigator.; Hejazi Reza investigator.; Roeser Kathy investigator.; Vasquez Denise investigator.; Vega Natalia investigator.; Beatty Karen investigator.; Hatter Lisa investigator.; Howard Ronna investigator.; Nowotny Lindsay investigator.; Tang Shou investigator.; Amin Om S investigator.; Henry Olivia investigator.; Kedar Archana investigator.; McNair Valerie investigator.; Pruett Susanne investigator.; Smith Margaret investigator.; Spree Danielle investigator.; Castle Michelle investigator.; Coleski Radoslav investigator.; Wootten Sophanara investigator.; Baxter Lynn investigator.; Brown Anya investigator.; Culler Samantha investigator.; Hooker Judy investigator.; Stuart Paula investigator.; Bernard Cheryl investigator.; Lurken Matthew investigator.; Serrano Jose investigator.; James Steven investigator.; Torrance Rebecca investigator.; Van Raaphorst Rebekah investigator.; Belt Patricia investigator.; Hallinan Erin Corless investigator.; Colvin Ryan investigator.; Donithan Michele investigator.; Green Mika investigator.; Isaacson Milana investigator.; Kim Wana investigator.; Sternberg Alice investigator.; Vaughn Ivana investigator.; Yates Katherine investigator.;
• Is Part Of: Neurogastroenterology & motility. Volume 30:Issue 2(2018)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2017-09-05
• Subjects: contractility -- gastric emptying -- scintigraphy -- small bowel and colon transit; Gastrointestinal system -- Motility -- Periodicals; Gastrointestinal system -- Innervation -- Periodicals; 616.33
• DOI: 10.1111/nmo.13196
• Languages: English
• ISSNs: 1350-1925

Abstract

Abstract: Background: Wireless motility capsule (WMC) findings are incompletely defined in suspected gastroparesis. We aimed to characterize regional WMC transit and contractility in relation to scintigraphy, etiology, and symptoms in patients undergoing gastric emptying testing. Methods: A total of 209 patients with gastroparesis symptoms at NIDDK Gastroparesis Consortium centers underwent gastric scintigraphy and WMCs on separate days to measure regional transit and contractility. Validated questionnaires quantified symptoms. Key Results: Solid scintigraphy and liquid scintigraphy were delayed in 68.8% and 34.8% of patients; WMC gastric emptying times (GET) were delayed in 40.3% and showed 52.8% agreement with scintigraphy; 15.5% and 33.5% had delayed small bowel (SBTT) and colon transit (CTT) times. Transit was delayed in ≥2 regions in 23.3%. Rapid transit was rarely observed. Diabetics had slower GET but more rapid SBTT versus idiopathics ( P ≤ .02). GET delays related to greater scintigraphic retention, slower SBTT, and fewer gastric contractions ( P ≤ .04). Overall gastroparesis symptoms and nausea/vomiting, early satiety/fullness, bloating/distention, and upper abdominal pain subscores showed no relation to WMC transit. Upper and lower abdominal pain scores ( P ≤ .03) were greater with increased colon contractions. Constipation correlated with slower CTT and higher colon contractions ( P = .03). Diarrhea scores were higher with delayed SBTT and CTT ( P ≤ .04). Conclusions & Inferences: Wireless motility capsules define gastric emptying delays similar but not identical to scintigraphy that are more severe in diabetics and relate to reduced gastric contractility. Extragastric transit delays occur in >40% with suspected gastroparesis. Gastroparesis symptoms show little association with WMC profiles, although lower symptoms relate to small bowel or colon abnormalities. Abstract : Wireless motility capsule (WMC) findings in suspected gastroparesis and relations to symptoms have been poorly defined. Evaluation of patients with gastroparesis symptoms revealed gastric emptying delays with WMCs that were similar to scintigraphy, were related to reduced contractility, and were often associated with extragastric or generalized transit delays; symptoms correlated poorly with WMC profiles. These findings provide insight into motor abnormalities in gastroparesis pathogenesis and form a basis for future investigations studying the impact of WMC testing on clinical care.