Nutritional deficiencies impact gastroparesis symptoms

SAN DIEGO — Patients with gastroparesis who have vitamin, mineral or protein deficiencies, which is about half of patients, are more prone to symptoms of nausea and vomiting, according to study results presented at Digestive Disease Week.

Asad Jehangir, MD, of Temple University Hospital, said that gastroparesis can lead to food aversion among patients because the symptoms worsen after eating. Approximately two-thirds of patients with gastroparesis report having inadequate caloric intake on dietary recall assessments.

“Patients with gastroparesis often have suboptimal intake of several important vitamins, minerals and proteins,” he said in his presentation. “Depletion of vitamins, minerals and proteins can cause numerous adverse health consequences, including effects on the GI tract.”

Jehangir and colleagues sought to determine the prevalence of nutritional deficiencies in patients with gastroparesis and to compare the severity of symptoms in patients with those deficiencies with patients with normal levels.

Researchers enrolled 201 patients with symptoms of gastroparesis seen from January to November 2018. Patients completed the Patient Assessment of Gastrointestinal Symptoms, Rome IV diagnostic questionnaires, and questionnaires on their medication use and past medical histories. Researchers collected vitamin, mineral and protein levels and performed 4-hour gastric emptying scintigraphy.

Jehangir and colleagues found that 53.1% patients with symptoms of gastroparesis had a deficiency of at least one vitamin, mineral or protein. The most common deficiencies were for vitamin D (23.2%), vitamin B2 (16.4%), vitamin C (12.9%) and iron (12.2%). There was no difference in prevalence of deficiencies among patients with delayed and normal gastric emptying.

Patients with deficiencies had a higher Gastroparesis Cardinal Symptom Index total score compared with patients with normal nutritional levels (3.2 ± 0.1 vs. 2.9 ± 0.1; P = .03). Patients with at least one deficiency had higher nausea and vomiting sub-scores compared with patients with normal levels (2.9 ± 0.1 vs. 2 ± 0.2; P < .01).

“These patients with deficiencies are more symptomatic particularly with nausea and vomiting without differences in gastric retention when compared to patients with normal levels,” Jehangir said. “Vitamin, mineral and protein deficiencies may impact on the clinical condition in patients with symptoms of gastroparesis.” – by Alex Young

Reference:

Jehangir A, et al. Abstract 998. Presented at: Digestive Disease Week; May 18-21, 2019; San Diego.

Disclosures: Jehangir reports no relevant financial disclosures. Please see the meeting disclosure index for all other authors’ relevant financial disclosures.