Bekkelund Mattis, Sangnes Dag A, Søfteland Eirik, Aabakken Lars, Biermann Martin, Steinsvik Elisabeth K, Hausken Trygve, Dimcevski Georg, Hatlebakk Jan Gunnar
Department of Clinical Medicine, University of Oslo, Oslo, Norway.
Norwegian Competence Centre for Functional Gastrointestinal Disorders, Department of Medicine, Haukeland University Hospital, Bergen, Norway.
Clin Exp Gastroenterol. 2021 Apr 28;14:133-144. doi: 10.2147/CEG.S304854. eCollection 2021.
Gastric emptying measurements are mandatory in gastroparesis diagnostics, but the association between delayed emptying and symptoms is questionable. It is imperative to find biomarkers better correlated to symptom generation. Hence, we examined the association between symptom severity and gastrointestinal motility measured by wireless motility capsule.
In this prospective single-centre study, patients with gastroparesis symptoms were simultaneously investigated with gastric emptying scintigraphy and wireless motility capsule, measuring regional transit times and contractility parameters. Symptom severity was assessed with the Patient Assessment of Upper Gastrointestinal Symptom Severity Index (PAGI-SYM), including the Gastroparesis Cardinal Symptom Index (GCSI).
We included 107 patients (70% women). In the whole patient group, nausea correlated with the gastric ( = -0.31, = 0.007), small bowel ( = -0.41, < 0.001) and colonic ( = -0.33, = 0.012) motility indices. In patients with idiopathic etiology, nausea correlated with small bowel motility index ( = -0.81, < 0.001) and mean stomach pressure ( = -0.64, = 0.013). We also found negative correlations between total GCSI score and maximum pressure of the small bowel ( = -0.77, < 0.001) and colon ( = -0.74, = 0.002). In diabetes patients, total PAGI-SYM score correlated with colonic motility index ( = -0.34, = 0.012), and mean pressure of the colon correlated with upper abdominal pain ( = -0.37, = 0.007). We found no association between symptoms, gastric emptying nor any other transit times.
In patients with gastroparesis symptoms, we found that symptom severity was associated with intestinal hypomotility. Based on these results, gastroparesis diagnostics should also include an evaluation of the small bowel and colon.
胃排空测量在胃轻瘫诊断中必不可少，但排空延迟与症状之间的关联存在疑问。找到与症状产生相关性更强的生物标志物势在必行。因此，我们研究了症状严重程度与通过无线动力胶囊测量的胃肠动力之间的关联。
在这项前瞻性单中心研究中，对有胃轻瘫症状的患者同时进行胃排空闪烁扫描和无线动力胶囊检查，测量区域转运时间和收缩性参数。使用上消化道症状严重程度患者评估指数（PAGI-SYM）评估症状严重程度，其中包括胃轻瘫主要症状指数（GCSI）。
我们纳入了107例患者（70%为女性）。在整个患者组中，恶心与胃动力指数（=-0.31，=0.007）、小肠动力指数（=-0.41，<0.001）和结肠动力指数（=-0.33，=0.012）相关。在特发性病因患者中，恶心与小肠动力指数（=-0.81，<0.001）和平均胃内压（=-0.64，=0.013）相关。我们还发现GCSI总分与小肠最大压力（=-0.77，<0.001）和结肠最大压力（=-0.74，=0.002）之间存在负相关。在糖尿病患者中，PAGI-SYM总分与结肠动力指数（=-0.34，=0.012）相关，结肠平均压力与上腹部疼痛（=-0.37，=0.007）相关。我们未发现症状、胃排空及任何其他转运时间之间存在关联。
在有胃轻瘫症状的患者中，我们发现症状严重程度与肠道动力不足相关。基于这些结果，胃轻瘫诊断还应包括对小肠和结肠的评估。
