Constipation in Patients With Symptoms of Gastroparesis: Analysis of Symptoms and Gastrointestinal Transit

Authors

Henry P Parkman
Emily Sharkey
Richard W McCallum
William L Hasler
Kenneth L Koch
Irene Sarosiek
Thomas L Abell
Braden Kuo
Robert J Shulman
Madhusudan Grover
Gianrico Farrugia
Ron Schey
James Tonascia
Frank Hamilton
Pankaj J Pasricha
NIH/NIDDK Gastroparesis Consortium

Publication Date

3-1-2022

Journal

Clinical Gastroenterology and Hepatology

DOI

10.1016/j.cgh.2020.10.045

PMID

33130007

PMCID

PMC8079462

PubMedCentral® Posted Date

3-1-2023

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Constipation, Gastric Emptying, Gastrointestinal Transit, Gastroparesis, Humans, Intestine, Small, Radionuclide Imaging, gastroparesis, constipation, delayed colonic transit, delayed gastric emptying, irritable bowel syndrome

Abstract

BACKGROUND & AIMS: Constipation can be an important symptom in some patients with gastroparesis. The aims were to: 1) Determine prevalence of constipation and delayed colonic transit in patients with symptoms of gastroparesis; 2) Correlate severity of constipation to severity of symptoms of gastroparesis; and 3) Relate severity of constipation to GI transit delays assessed by gastric emptying scintigraphy (GES) and wireless motility capsule (WMC).

METHODS: Patients with symptoms of gastroparesis underwent gastric emptying scintigraphy (GES), wireless motility capsule (WMC) assessing gastric emptying, small bowel transit, and colonic transit, and questionnaires assessing symptoms using a modified Patient Assessment of Upper GI Symptoms [PAGI-SYM] and Rome III functional GI disorder questionnaire.

RESULTS: Of 338 patients with symptoms of gastroparesis, 242 (71.5%) had delayed gastric emptying by scintigraphy; 298 (88.2%) also met criteria for functional dyspepsia. Severity of constipation was severe/very severe in 34% patients, moderate in 24%, and none/very mild/mild in 42%. Increasing severity of constipation was associated with increasing symptoms of gastroparesis and presence of irritable bowel syndrome (IBS). Severity of constipation was not associated with gastric retention on GES or WMC. Delayed colonic transit was present in 108 patients (32% of patients). Increasing severity of constipation was associated with increasing small bowel transit time, colonic transit time, and whole gut transit time.

CONCLUSIONS: Severe/very severe constipation and delayed colon transit occurs in a third of patients with symptoms of gastroparesis. The severity of constipation is associated with severity of gastroparesis symptoms, presence of IBS, small bowel and colon transit delay, but not delay in gastric emptying. ClinicalTrials.gov Identifier: NCT01696747