Abstract
Introduction: Patients with suspected gastroparesis may also report intestinal symptoms such as constipation and/or show delayed colon transit on wireless motility capsules (WMC) testing. However, the impact of colonic dysfunction on gastroparesis and whether its treatment improves upper and lower GI symptoms and quality of life (QOL) in patients with delayed vs. normal colon transit is unknown. This prospective multicenter study determined if treatment decisions based on the results of WMC testing are associated with improvements in upper and lower GI symptoms and QOL in patients with suspected gastroparesis. Methods: 150 subjects with suspected gastroparesis underwent concurrent WMC and gastric emptying scintigraphy. Based on test results, investigators recommended treatment(s) (prokinetic, neuromodulator, constipation therapies). The clinical outcomes for various treatment modalities as assessed by symptoms (PAGI-SYM/GCSI) and QOL (PAGI-QOL) at 6 months were compared between the normal (NCT) and delayed colon transit (DCT)(>59 hours by WMC) groups. Results: 53 (35%) had delayed gastric transit; 45 (30%) subjects had DCT; 100 (67%) had NCT; 5 (3%) did not have colonic transit data. 50 subjects received prokinetics; 71 received neuromodulators; 54 received constipation therapies (linaclotide 22, lubiprostone 9, PEG 19, others 4). Overall PAGI-SYM scores improved on prokinetics and neuromodulators with both NCT and DCT, but improved on constipation therapies only with DCT (Table).PAGI-QOL scores improved on all 3 drug classes with DCT, but improved only on prokinetics with NCT. When comparing individual symptoms, constipation therapies were associated with reduced GCSI, fullness, and constipation scores and trends towards less bloating with DCT, but did not affect N/V, pain, or diarrhea (Figures A-B). Diarrhea (P=0.049) and upper abdominal pain (P=0.048) scores were higher on constipation therapies in DCT group. Conversely, constipation therapies were associated with trends to less fullness with NCT and no benefits for other symptoms. Conclusion: Delayed colon transit was found in 30% of patients with suspected gastroparesis and treatment with neuromodulators and constipation therapies was associated with selective overall improvements in gastroparetic and bowel symptoms and QOL in this group. By identifying colonic dysfunction, wireless motility capsule tests could provide improved overall treatment benefit(s) in patients with suspected gastroparesis.158_A Figure 1. Longitudinal Outcomes on Different Medication Classes in Normal vs. Delayed Colon Transit by Wireless Motility Capsule158_B Figure 2. Normal Colon Transit158_C Figure 3. Delayed Colon Transit
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
