Low Vitamin D Levels in Patients with Symptoms of Gastroparesis: Relationships with Nausea and Vomiting, Gastric Emptying and Gastric Myoelectrical Activity

Authors

Kenneth L Koch
Henry P Parkman
Katherine P Yates
Mark L Van Natta
Madhusudan Grover
Gianrico Farrugia
Thomas L Abell
Richard W McCallum
Irene Sarosiek
Braden Kuo
Robert J Shulman
Laura Miriel
James Tonascia
Pankaj J Pasricha

Publication Date

8-1-2024

Journal

Digestive Diseases and Sciences

DOI

10.1007/s10620-024-08520-8

PMID

38877334

PMCID

PMC11341680

PubMedCentral® Posted Date

5-14-2024

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Humans, Gastroparesis, Gastric Emptying, Female, Male, Vomiting, Middle Aged, Adult, Vitamin D, Nausea, Vitamin D Deficiency, Stomach, Vitamin D deficiency, Nausea and vomiting, Gastroparesis, Gastric dysrhythmias, Functional dyspepsia

Abstract

Patients with gastroparesis (Gp) often have diets deficient in calories, electrolytes, and vitamins. Vitamin D levels have been reported to be low in some patients with Gp but has not been systematically studied.

AIMS: To determine vitamin D levels and relationships among symptoms, gastric emptying and gastric myoelectrical activity (GMA) in patients with symptoms of Gp.

METHODS: 25-hydroxy-vitamin D was measured in patients at enrollment in the Gastroparesis Clinical Consortium Registry. Gastroparesis Cardinal Symptoms Index (GCSI), gastric emptying, and GMA before and after water load satiety test (WLST) were measured. GMA, expressed as percentage distribution of activity in normal and dysrhythmic ranges, was recorded using electrogastrography.

RESULTS: Overall, vitamin D levels were low (< 30 ng/ml) in 288 of 513 (56.1%) patients with symptoms of Gp (206 of 376 (54.8%) patients with delayed gastric emptying (Gp) and 82 of 137 (59.9%) patients with symptoms of Gp and normal gastric emptying). Low vitamin D levels were associated with increased nausea and vomiting (P < 0.0001), but not with fullness or bloating subscores. Low vitamin D levels in patients with Gp were associated with greater meal retention at four hours (36% retention) compared with Gp patients with normal vitamin D levels (31% retention; P = 0.05). Low vitamin D in patients with normal gastric emptying was associated with decreased normal 3 cpm GMA before (P = 0.001) and increased tachygastria after WLST (P = 0.01).

CONCLUSIONS: Low vitamin D levels are present in half the patients with symptoms of gastroparesis and are associated with nausea and vomiting and gastric neuromuscular dysfunction.