From the Department of Pediatrics, University of Miami, Miami, FL.
the Department of Pediatrics, Baylor College of Medicine, Houston, TX.
J Pediatr Gastroenterol Nutr. 2022 Aug 1;75(2):151-158. doi: 10.1097/MPG.0000000000003484. Epub 2022 Jun 1.
The primary objective was to compare the patient-reported gastrointestinal symptoms profiles of pediatric patients with gastroparesis to matched healthy controls using the Pediatric Quality of Life Inventory™ (PedsQL™) Gastrointestinal Symptoms Scales. The secondary objectives were to compare pediatric patients with gastroparesis to pediatric patients with gastroparesis-like symptoms and normal gastric emptying and to compare pediatric patients with gastroparesis-like symptoms and normal gastric emptying to matched healthy controls.
The PedsQL™ Gastrointestinal Symptoms Scales were completed by 64 pediatric patients with gastroparesis, 59 pediatric patients with gastroparesis-like symptoms and normal gastric emptying, and 200 age, gender, and race/ethnicity matched healthy controls. The PedsQL™ Gastrointestinal Symptoms Scales encompass 10 individual multi-item scales which measure stomach pain, stomach discomfort when eating, food and drink limits, trouble swallowing, heartburn and reflux, nausea and vomiting, gas and bloating, constipation, blood in poop, and diarrhea/fecal incontinence. Based on gastric emptying scintigraphy testing, those with abnormal gastric retention were classified as having gastroparesis.
The gastrointestinal symptoms profile analysis identified large differences between those with gastroparesis compared to healthy controls (most P <0.001), with the largest effect sizes for upper gastrointestinal symptoms including stomach pain, stomach discomfort when eating, food and drink limits, nausea, and vomiting. Those with gastroparesis self-reported similar gastrointestinal symptoms to those with normal gastric emptying, except for increased constipation.
Pediatric patients with gastroparesis self-reported broad multidimensional gastrointestinal symptoms profiles in comparison to healthy controls with large differences, indicating the critical need for more highly efficacious interventions to bring patient functioning within the normal range of healthy functioning.
本研究旨在使用儿童生活质量量表(PedsQL)胃肠道症状量表比较胃轻瘫患儿与匹配健康对照者的胃肠道症状特征。次要目的是比较胃轻瘫患儿与胃排空正常的胃轻瘫样症状患儿以及胃排空正常的胃轻瘫样症状患儿与匹配健康对照者之间的差异。
共有 64 例胃轻瘫患儿、59 例胃排空正常的胃轻瘫样症状患儿和 200 例年龄、性别和种族匹配的健康对照者完成了 PedsQL 胃肠道症状量表。PedsQL 胃肠道症状量表包括 10 个单项多项目量表,用于评估腹痛、进食时胃部不适、饮食限制、吞咽困难、烧心和反流、恶心和呕吐、气胀和腹胀、便秘、粪便带血和腹泻/大便失禁。根据胃排空闪烁扫描检查结果,胃排空异常的患儿被归类为胃轻瘫。
胃轻瘫患儿与健康对照者的胃肠道症状特征分析存在显著差异(多数 P<0.001),最大的效应量出现在上胃肠道症状,包括腹痛、进食时胃部不适、饮食限制、恶心和呕吐。与胃排空正常的胃轻瘫样症状患儿相比,胃轻瘫患儿报告的胃肠道症状相似,除了便秘症状更为严重。
与健康对照者相比,胃轻瘫患儿报告的胃肠道症状具有广泛的多维症状特征,差异较大,这表明迫切需要更有效的干预措施,使患者的功能恢复到健康功能的正常范围。