In up to 30% of patients with functional dyspepsia (FD), delayed gastric emptying (GE) is noted. Gastroparesis is diagnosed when delayed GE is observed; however, the relevance of delayed GE to the symptom pattern and severity appears to vary across different studies.

A study was designed which assessed the severity of 6 symptoms - postprandial fullness, epigastric pain and burning, bloating, nausea and belching- during a GE test, every 15 min, before meal-intake and 4h postprandially. The sum of individual symptom scores provided the meal-related symptoms score and the sum of all symptoms provided the overall meal-related symptom severity (OSS). Data were then compared for patients with normal and delayed GE (cut-off T_1/2 ≥ 109 min).

• A total of 504 patients with FD were included in the study. Of these, 382 patients (BMI 23.3±0.2 kg/m²) had normal GE, while 122 patients (BMI 23.2±0.6 kg/m²) had delayed GE.
• OSS appeared to be higher in patients with delayed GE (81.8±3.4 vs. 99.5±7.1, p=.05).
• Nausea was significantly higher in patients with delayed GE (11±0.8 vs. 16±1.6, p=.01).
• There was no correlation between GE rate and any of the symptoms (OSS: r=0.06, p=.2; nausea: r=0.06, p=.1).
• The symptom severity time course exhibited a significant difference for nausea only. The severity ratings increased 90 min after the meal (p<.01) in delayed GE patients vs. normal GE patients.

The severity of symptoms in FD and idiopathic gastroparesis, even when evaluated during the GE test meal, does not seem to be correlated to the rate of GE.

GE testing does not seem to be an adequate approach to explain the symptoms.

Source: Carbone F, De Buysscher R, Van den Houte K, et al. Relationship between Gastric Emptying Rate and Simultaneously Assessed Symptoms in Functional Dyspepsia. Clin Gastroenterol Hepatol. 2022 Mar;20(3):e429-e437.