- Fecal Incontinence
|Factors that contribute to the impairment of quality of life in gastroparesis
Neurogastroenterol Motil. 2021 Jan 25;e14087. doi: 10.1111/nmo.14087. Online ahead of print.
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
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.