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Identifying and managing delayed colonic transit in gastroparesis can significantly improve overall upper gastrointestinal symptoms. A whole-gut motility assessment and extragastric delay management are vital to optimize treatment outcomes.
A recent study led by Brian C Surjanhata et al. highlighted the overlooked link between constipation and upper gastrointestinal (UGI) symptoms in patients with gastroparesis. Researchers found that adjusting constipation treatments led to remarkable symptom relief—but primarily in patients with delayed colonic transit.
The study involved 56 individuals experiencing symptoms of gastroparesis who underwent comprehensive gastrointestinal motility testing, including wireless motility capsule and gastric emptying scintigraphy. Based on these results, the enrolled volunteers were either started on or had their constipation medications adjusted. Symptoms were reassessed 6 months later using validated measures, including the Gastroparesis Cardinal Symptom Index (GCSI), upper abdominal pain scores, and constipation severity scores.
At 6 months, those with slow colonic transit reported remarkable improvements in their GCSI scores (p = 0.007), including reductions in nausea and vomiting (p = 0.02) and early satiety/fullness (p = 0.002). A trend toward improvement in bloating/distention was also witnessed (p = 0.06). Interestingly, upper abdominal pain remained unchanged. These benefits were driven by patients with both delayed colonic transit and delayed gastric emptying.
Conversely, those with normal colonic transit exhibited no meaningful improvement in UGI symptoms, regardless of their gastric emptying status. These findings underscore the importance of monitoring the entire gastrointestinal tract—not just gastric emptying—in those with gastroparesis-like symptoms. Identifying and addressing delayed colonic transit could represent a novel strategy to boost outcomes in this complex population.
Neurogastroenterology & Motility
Impact of Constipation Therapies on Severity of Gastroparesis and Constipation Symptoms in Relation to Gastric and Colonic Transit
Brian C Surjanhata et al.
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