Abdominal pain is a frequent symptom of gastroparesis

Background & aims: Although the most commonly recognized symptoms of gastroparesis (GP) are nausea and vomiting, patients also report abdominal pain. We aimed to define the prevalence, severity, and quality of abdominal pain in GP and to correlate abdominal pain with gastric emptying (GE) and quality of life.

Methods: Patients presumed to have GP underwent 4-hour GE scintigraphy and upper endoscopy examinations and completed the following: patient assessments of gastrointestinal symptoms (Patient Assessment of Upper Gastrointestinal Symptom Severity Index), abdominal pain questionnaires (Short-Form of the McGill Pain Questionnaire), and quality-of-life questionnaires.

Results: The study group consisted of 68 patients (58 female; 10 male) with delayed GE (18 diabetic gastroparesis [DG] and 50 idiopathic gastroparesis [IG]). Abdominal pain was present in 90% of patients (89% DG, 90% IG) and nausea was present in 96% (100% DG, 94% IG). Abdominal pain was epigastric in 43% and umbilical in 13%. Pain occurred daily in 43% and was constant in 38%. Pain often was induced by eating (72%), was nocturnal (74%), and interfered with sleep (66%). Severity ranking of symptoms based on the Patient Assessment of Upper Gastrointestinal Symptom Severity Index was as follows: abdominal fullness (3.8 +/- 0.2), bloating (3.6 +/- 0.2), nausea (3.6 +/- 0.2), upper abdominal discomfort (3.3 +/- 0.2), upper abdominal pain (3.0 +/- 0.2), and vomiting (2.2 +/- 0.2). Abdominal pain severity did not correlate with GE, but had moderate correlation with quality of life.

Conclusions: Abdominal pain is a frequent symptom in patients with GP, comparable with nausea and vomiting. Abdominal pain correlates with impaired quality of life but not with GE.