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Relationship between symptom pattern, assessed by the PAGI-SYM questionnaire, and gastric sensorimotor dysfunction in
S Kindt1, D Dubois, L Van Oudenhove
1Department of Pathophysiology, Gastroenterology Division, University Hospital Gasthuisberg, University of Leuven, Leuven, Belgium.
Neurogastroenterology and Motility
|August 12, 2009
Summary
The Patient Assessment of Upper Gastrointestinal Symptom Severity Index (PAGI-SYM) effectively correlates with gastric emptying and sensitivity in functional dyspepsia (FD). This suggests its utility in evaluating treatments targeting these specific gastric functions.
Area of Science:
- Gastroenterology
- Functional Gastrointestinal Disorders
- Physiology
Background:
- Functional dyspepsia (FD) is a complex disorder with varied underlying mechanisms.
- The Patient Assessment of Upper Gastrointestinal Symptom Severity Index (PAGI-SYM) is a validated tool for assessing symptom severity in FD.
- The relationship between PAGI-SYM scores and specific pathophysiological factors in FD remains understudied.
Purpose of the Study:
- To investigate the correlation between PAGI-SYM subscale scores and key gastric functions in FD patients.
- Specifically, to assess the relationship with gastric emptying, gastric sensitivity, and gastric accommodation.
- To determine the potential of PAGI-SYM in evaluating therapeutic responsiveness based on pathophysiological mechanisms.
Main Methods:
- 161 consecutive FD patients completed the PAGI-SYM questionnaire.
- Gastric function was assessed through Helicobacter pylori testing, gastric barostat studies, and standardized gastric emptying tests (n=126).
- Statistical analyses included Pearson's correlation, multiple regression, chi-square, and Student's t-tests to evaluate relationships between symptom scores and gastric function parameters.
Main Results:
- PAGI-SYM scores for heartburn/regurgitation, nausea/vomiting, fullness/satiety, bloating, and lower abdominal pain significantly correlated with gastric emptying rate.
- Patients with delayed gastric emptying reported higher scores across these subscales.
- Gastric sensitivity (discomfort during distension) correlated with fullness/satiety, bloating, heartburn/regurgitation, and upper abdominal pain scores; hypersensitivity was linked to higher fullness/satiety scores.
Conclusions:
- PAGI-SYM scores demonstrate significant correlations with gastric emptying rate and gastric sensitivity in FD patients.
- The findings support the utility of the PAGI-SYM questionnaire for evaluating gastroprokinetic therapies.
- Its role in assessing drugs targeting gastric sensitivity requires further investigation.
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