Abdominal Pain in Patients with Gastroparesis: Associations with Gastroparesis Symptoms, Etiology of Gastroparesis, Gastric Emptying, Somatization, and Quality of Life

Henry P. Parkman, Laura Wilson, William L. Hasler, Richard W. McCallum, Irene Sarosiek, Kenneth L. Koch, Thomas L. Abell, Ron Schey, Braden Kuo, William J. Snape, Linda Nguyen, Gianrico Farrugia, Mandhusudan Grover, John Clarke, Laura Miriel, James A Tonascia, Frank Hamilton, Pankaj Jay Pasricha

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Abstract

Abstract: Abdominal pain can be an important symptom in some patients with gastroparesis (Gp). Aims: (1) To describe characteristics of abdominal pain in Gp; (2) describe Gp patients reporting abdominal pain. Methods: Patients with idiopathic gastroparesis (IG) and diabetic gastroparesis (DG) were studied with gastric emptying scintigraphy, water load test, wireless motility capsule, and questionnaires assessing symptoms [Patient Assessment of Upper GI Symptoms (PAGI-SYM) including Gastroparesis Cardinal Symptom Index (GCSI)], quality of life (PAGI-QOL, SF-36), psychological state [Beck Depression Inventory (BDI), State-Trait Anxiety Index (STAI), PHQ-15 somatization scale]. Results: In total, 346 Gp patients included 212 IG and 134 DG. Ninety percentage of Gp patients reported abdominal pain (89% DG and 91% IG). Pain was primarily in upper or central midline abdomen, described as cramping or sickening. Upper abdominal pain was severe or very severe on PAGI-SYM by 116/346 (34%) patients, more often by females than by males, but similarly in IG and DG. Increased upper abdominal pain severity was associated with increased severity of the nine GCSI symptoms, depression on BDI, anxiety on STAI, somatization on PHQ-15, the use of opiate medications, decreased SF-36 physical component, and PAGI-QOL, but not related to severity of delayed gastric emptying or water load ingestion. Using logistic regression, severe/very severe upper abdominal pain associated with increased GCSI scores, opiate medication use, and PHQ-15 somatic symptom scores. Conclusions: Abdominal pain is common in patients with Gp, both IG and DG. Severe/very severe upper abdominal pain occurred in 34% of Gp patients and associated with other Gp symptoms, somatization, and opiate medication use. ClinicalTrials.gov Identifier: NCT01696747.

Original languageEnglish (US)
JournalDigestive Diseases and Sciences
DOIs
StatePublished - Jan 1 2019

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Keywords

  • Abdominal pain
  • Diabetic gastroparesis
  • Gastroparesis
  • Idiopathic gastroparesis

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

Cite this

Parkman, H. P., Wilson, L., Hasler, W. L., McCallum, R. W., Sarosiek, I., Koch, K. L., Abell, T. L., Schey, R., Kuo, B., Snape, W. J., Nguyen, L., Farrugia, G., Grover, M., Clarke, J., Miriel, L., Tonascia, J. A., Hamilton, F., & Pasricha, P. J. (2019). Abdominal Pain in Patients with Gastroparesis: Associations with Gastroparesis Symptoms, Etiology of Gastroparesis, Gastric Emptying, Somatization, and Quality of Life. Digestive Diseases and Sciences. https://doi.org/10.1007/s10620-019-05522-9