Impact of Constipation Therapies on Severity of Gastroparesis and Constipation Symptoms in Relation to Gastric and Colonic Transit

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Autori principali: Brian C. Surjanhata, Baharak Moshiree, Allen A. Lee, Richard W. McCallum, Irene Sarosiek, Linda A. Nguyen, Michael I. Schulman, John M. Wo, Henry P. Parkman, Braden Kuo, William L. Hasler, Satish S. C. Rao
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Pubblicazione: Wiley 2025
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author Brian C. Surjanhata
Baharak Moshiree
Allen A. Lee
Richard W. McCallum
Irene Sarosiek
Linda A. Nguyen
Michael I. Schulman
John M. Wo
Henry P. Parkman
Braden Kuo
William L. Hasler
Satish S. C. Rao
author_facet Brian C. Surjanhata
Baharak Moshiree
Allen A. Lee
Richard W. McCallum
Irene Sarosiek
Linda A. Nguyen
Michael I. Schulman
John M. Wo
Henry P. Parkman
Braden Kuo
William L. Hasler
Satish S. C. Rao
Brian C. Surjanhata
Baharak Moshiree
Allen A. Lee
Richard W. McCallum
Irene Sarosiek
Linda A. Nguyen
Michael I. Schulman
John M. Wo
Henry P. Parkman
Braden Kuo
William L. Hasler
Satish S. C. Rao
collection Wiley Open Access
contents Impact of Constipation Therapies on Severity of Gastroparesis and Constipation Symptoms in Relation to Gastric and Colonic Transit Brian C. Surjanhata Baharak Moshiree Allen A. Lee Richard W. McCallum Irene Sarosiek Linda A. Nguyen Michael I. Schulman John M. Wo Henry P. Parkman Braden Kuo William L. Hasler Satish S. C. Rao Neurogastroenterology & Motility ABSTRACTIntroductionStudies demonstrate an overlap of constipation with gastroparesis and functional dyspepsia, but the impact of treatments that target constipation on improving upper gastrointestinal (UGI) symptoms is unexplored. We quantified the effects of constipation medication therapies on UGI and constipation symptom severity in subjects presenting with symptoms of gastroparesis.MethodsFifty‐six subjects with symptoms of gastroparesis underwent concurrent wireless motility capsule and gastric emptying scintigraphy and were recommended to receive either a new medication therapy for constipation or a change in constipation therapy based on investigator interpretation of test results. Gastroparesis Cardinal Symptom Index (GCSI), upper abdominal pain, and constipation scores were compared between baseline and 6 months. Data were compared between delayed or non‐delayed gastric emptying and the presence or absence of slow colonic transit.Key ResultsSubjects with slow colonic transit had improvements in GCSI (p = 0.007) and constipation scores (p = 0.004) after treatment with a new or changed constipation medication, with the delayed emptying subgroup driving GCSI improvements (p = 0.004). Reductions in nausea/vomiting (p = 0.02) and early satiety/fullness subscores (p = 0.002) with trends to improved bloating/distention subscores (p = 0.06) were observed in this subgroup, but upper abdominal pain was unchanged. Subjects with normal colonic transit showed no improvement in GCSI scores regardless of gastric emptying status (p > 0.05).Conclusions and InferencesIdentifying and treating delayed colonic transit in gastroparetic (delayed gastric emptying) subjects improves global UGI symptoms as well as selected individual symptoms. Evaluation of whole gut motility as well as recognizing and managing extragastric delay may promote improved outcomes in these patients.Trial RegistrationClinicalTrials.gov: NCT02022826 10.1111/nmo.70013 http://onlinelibrary.wiley.com/termsAndConditions#vor
doi_str_mv 10.1111/nmo.70013
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spellingShingle Impact of Constipation Therapies on Severity of Gastroparesis and Constipation Symptoms in Relation to Gastric and Colonic Transit
Brian C. Surjanhata
Baharak Moshiree
Allen A. Lee
Richard W. McCallum
Irene Sarosiek
Linda A. Nguyen
Michael I. Schulman
John M. Wo
Henry P. Parkman
Braden Kuo
William L. Hasler
Satish S. C. Rao
Neurogastroenterology & Motility
Impact of Constipation Therapies on Severity of Gastroparesis and Constipation Symptoms in Relation to Gastric and Colonic Transit Brian C. Surjanhata Baharak Moshiree Allen A. Lee Richard W. McCallum Irene Sarosiek Linda A. Nguyen Michael I. Schulman John M. Wo Henry P. Parkman Braden Kuo William L. Hasler Satish S. C. Rao Neurogastroenterology & Motility ABSTRACTIntroductionStudies demonstrate an overlap of constipation with gastroparesis and functional dyspepsia, but the impact of treatments that target constipation on improving upper gastrointestinal (UGI) symptoms is unexplored. We quantified the effects of constipation medication therapies on UGI and constipation symptom severity in subjects presenting with symptoms of gastroparesis.MethodsFifty‐six subjects with symptoms of gastroparesis underwent concurrent wireless motility capsule and gastric emptying scintigraphy and were recommended to receive either a new medication therapy for constipation or a change in constipation therapy based on investigator interpretation of test results. Gastroparesis Cardinal Symptom Index (GCSI), upper abdominal pain, and constipation scores were compared between baseline and 6 months. Data were compared between delayed or non‐delayed gastric emptying and the presence or absence of slow colonic transit.Key ResultsSubjects with slow colonic transit had improvements in GCSI (p = 0.007) and constipation scores (p = 0.004) after treatment with a new or changed constipation medication, with the delayed emptying subgroup driving GCSI improvements (p = 0.004). Reductions in nausea/vomiting (p = 0.02) and early satiety/fullness subscores (p = 0.002) with trends to improved bloating/distention subscores (p = 0.06) were observed in this subgroup, but upper abdominal pain was unchanged. Subjects with normal colonic transit showed no improvement in GCSI scores regardless of gastric emptying status (p > 0.05).Conclusions and InferencesIdentifying and treating delayed colonic transit in gastroparetic (delayed gastric emptying) subjects improves global UGI symptoms as well as selected individual symptoms. Evaluation of whole gut motility as well as recognizing and managing extragastric delay may promote improved outcomes in these patients.Trial RegistrationClinicalTrials.gov: NCT02022826 10.1111/nmo.70013 http://onlinelibrary.wiley.com/termsAndConditions#vor
title Impact of Constipation Therapies on Severity of Gastroparesis and Constipation Symptoms in Relation to Gastric and Colonic Transit
topic Neurogastroenterology & Motility
url https://onlinelibrary.wiley.com/doi/10.1111/nmo.70013