Symptom variability throughout the day in patients with gastroparesis
Symptom variability throughout the day in patients with gastroparesis
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DOI：
10.1111/nmo.13740
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发表时间：
2020-02-01
影响因子：
3.5
通讯作者：
Parkman, Henry P.
中科院分区：
文献类型：
--
作者：
Shahsavari, Dariush;Yu, Daohai;Parkman, Henry P.
背景胃轻瘫(GP)的症状会在一天中的不同时间波动。我们的目标是(1)表征GP症状在一天中和与饮食有关的变异性，以及(2)比较GP-糖尿病胃轻瘫(DGP)和特发性胃轻瘫(IGP)亚型的日常症状变异性。方法GP患者填写胃肠道症状自评量表(PAGI-SYM)，每日7次(GCSI-全天；餐前、餐后、睡前)完成GCSI-DD，持续2周。关键结果44例患者(86%为女性)，其中IGP 29例(66%)，DGP 13例(30%)，术后GP 2例(4%)。使用GCSI-TTD，GP患者报告餐后总体症状严重程度显著恶化，以及恶心、早饱、胃胀和腹痛的严重程度。患者的总体症状严重程度也在白天逐渐恶化，早饱、胃胀和腹痛；然而，恶心的严重程度在白天没有不同。呕吐和呕吐发作的次数在餐后或白天没有显着变化。与DGP患者相比，IGP患者全天症状严重程度更高，餐后症状增加更多。结论和推断，GP患者的总体症状严重程度在餐后恶化，恶心、早饱、胃胀和腹痛的严重程度也是如此。除了全天持续的严重恶心外，这些症状在白天也会逐渐恶化。了解GP患者全天和餐后症状的变异性可能有助于GP患者的治疗。
Background Symptoms of gastroparesis (Gp) can fluctuate at different times of the day. Our aims are (1) To characterize Gp symptom variability throughout the day and in relation to meals and (2) to compare the daily symptom variability in subtypes of Gp-diabetic gastroparesis (DGp) and idiopathic gastroparesis (IGp). Methods Patients with Gp filled Patient Assessment of Gastrointestinal Symptoms (PAGI-SYM) and completed a modified GCSI-DD seven times a day (GCSI-Throughout the Day [GCSI-TTD]; before and after meals, and before going to bed) over a 2-week period. Key Results A total of 44 patients participated (86% females), including 29 (66%) with IGp, 13 (30%) with DGp, and 2 (4%) with postsurgical Gp. Using the GCSI-TTD, patients with Gp reported significant postprandial worsening of overall symptom severity, as well as severities of nausea, early satiety, stomach fullness, and abdominal pain. Patients also had progressive worsening of the overall symptom severity, early satiety, stomach fullness, and abdominal pain during the day; however, nausea severity did not differ during the day. Number of vomiting and retching episodes did not show significant variations postprandially or during the day. Patients with IGp had greater symptom severity throughout the day and greater postprandial increase in symptoms compared to patients with DGp. Conclusions and Inferences Patients with Gp experience postprandial worsening of overall symptom severity, as well as severities of nausea, early satiety, stomach fullness, and abdominal pain. These symptoms also progressively worsen during the day, except for the severity of nausea which persists throughout the day. Understanding the symptom variability in patients with Gp throughout the day and postprandially may be useful in treatment of patients with Gp.