Effect of Liquid and Solid Test Meals on Symptoms and Gastric Myoelectrical Activity in Patients with Gastroparesis and Functional Dyspepsia

Authors

Kenneth L Koch
Mark Van Natta
Henry P Parkman
Madhusudan Grover
Thomas L Abell
Richard W McCallum
Hossam A Shaltout
Irene Sarosiek
Gianrico Farrugia
Robert J Shulman
James Tonascia
Laura Miriel
Frank Hamilton
Pankaj J Pasricha
Gastroparesis Clinical Research Consortium

Publication Date

2-1-2023

Journal

Neurogastroenterology & Motility

DOI

10.1111/nmo.14376

PMID

35411675

PMCID

PMC9884454

PubMedCentral® Posted Date

4-11-2022

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Humans, Dyspepsia, Gastroparesis, Gastric Emptying, Meals, Water, functional dyspepsia, gastric dysrhythmias, gastroparesis, nutrient bar meal, postprandial distress syndrome, water load satiety test

Abstract

BACKGROUND: Patients with gastroparesis (GP) and functional dyspepsia (FD) have similar symptoms, but the pathophysiology of postprandial symptoms remains uncertain.

AIMS: To compare symptoms and gastric myoelectrical activity (GMA) after liquid and solid test meals in patients with GP and FD.

METHODS: Patients enrolled in the Gastroparesis Clinical Research Consortium Registry were studied. Clinical characteristics were measured with standard questionnaires. GP was determined by 4-h solid-phase gastric scintigraphy. GMA was measured using electrogastrography before and after ingestion of a water load or nutrient bar on separate days. Symptoms were measured on visual analog scales. GMA responses to the water load for individual patients were also determined.

RESULTS: 284 patients with GP and 113 with FD were identified who ingested both test meals. Patients with GP and FD had similar maximal tolerated volumes of water [mean (SD) 378 (218) ml vs. 402 (226) ml, p = 0.23] and reported similar intensity of fullness, nausea, bloating, and abdominal discomfort after the test meals. Twenty-six percent and 19% of the patients with GP and FD, respectively, ingested subthreshold (<238 >ml) volumes of water (p = 0.15). Gastric dysrhythmias were recorded in 66% of the GP and 65% of the FD patients after the water load. Symptoms and GMA were similar in both groups after ingestion of the nutrient bar.

CONCLUSION: The similarity in GMA responses and symptoms after ingestion of solid or liquid test meals suggests GP and FD are closely related gastric neuromuscular disorders.