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. 2021 Aug;33(8):e14087.
doi: 10.1111/nmo.14087. Epub 2021 Jan 25.

Factors that contribute to the impairment of quality of life in gastroparesis

Henry P Parkman  1 , Laura A Wilson  2 , Katherine P Yates  2 , Kenneth L Koch  3 , Thomas L Abell  4 , Richard W McCallum  5 , Irene Sarosiek  5 , Braden Kuo  6 , Zubair Malik  1 , Ron Schey  1 , Robert J Shulman  7 , Madhusudan Grover  8 , Gianrico Farrugia  8 , Laura Miriel  2 , James Tonascia  2 , Frank Hamilton  9 , Pankaj J Pasricha  2 ; NIDDK/NIH Clinical Gastroparesis Consortium
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Factors that contribute to the impairment of quality of life in gastroparesis

Henry P Parkman et al. Neurogastroenterol Motil. 2021 Aug.

Abstract

Background: Understanding factors that impair quality of life (QOL) in gastroparesis is important for clinical management.

Aims: (a) Determine QOL in patients with gastroparesis; (b) Determine factors that impair QOL.

Methods: Gastroparetic patientsAQ6 underwent history and questionnaires assessing symptoms (PAGI-SYM and Rome III), QOL (SF-36v2 and PAGI-QOL), depression (Beck Depression Inventory [BDI]), and anxiety (State Trait Anxiety InventoryAQ7).

Key results: 715 gastroparesis patients (256 diabetic (DG), 459 idiopathic (IG)) were evaluated. SF-36 physical component (PC) score averaged 33.3 ± 10.5; 41% had impaired score <30. SF-36 PC scores were similar between diabetic and idiopathic gastroparesis. Impaired SF-36 PC associated with increased nausea/vomiting and upper abdominal pain subscores, acute onset of symptoms, higher number of comorbidities, use of narcotic pain medications, and irritable bowel syndrome (IBS). SF-36 mental component (MC) score averaged 38.9 ± 13.0; 26% had impaired score <30. Poor SF-36 MC associated with diabetic etiology, higher Beck depression inventory, and state anxiety scores. PAGI-QOL score averaged 2.6 ± 1.1; 50% had a score of <2.6. Low PAGI-QOL associated with higher fullness, bloating, and upper abdominal pain subscores, more depression and Trait anxiety, smoking cigarettes, need for nutritional support, progressively worsening symptoms and periodic exacerbations.

Conclusions & inferences: Multiple measures show poor QOL present in gastroparesis. Several areas impacted on reduced QOL: (a) Symptoms of nausea, vomiting, and abdominal pain, as well as IBS; (b) Etiology and acute onset and progressively worsening symptoms; (c) Comorbidities and psychological factors such as anxiety and depression; (d) Patient-related factors such as smoking. Targeting the modifiable factors may improve patient outcomes in gastroparesis.

Trial registration: ClinicalTrials.gov NCT00398801 NCT01696747.

Keywords: diabetic gastroparesis; gastroparesis; health-related quality of life; idiopathic gastroparesis; quality of life.

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Conflict of interest statement

Competing Interests: the authors have no competing interests.

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