Gastrointestinal symptoms, electrogastrography, inflammatory markers, and PG-SGA in patients with advanced cancer

Electrogastrography (EGG) is a technique used to record gastric myoelectrical activity (GMA). Our aim is to investigate the (1) prevalent patterns of GMA, (2) most frequent gastrointestinal (GI) symptoms reported on the Dyspepsia Symptom Severity Index (DSSI), and (3) EGG diagnosis and correlations with GI symptoms, ghrelin, and inflammatory markers.

An EGG was performed 10 min preprandial and 30 min postprandial after ingestion of 500 ml water. EGG measurements were recorded by electrodes positioned externally on the abdominal wall. C-reactive protein (CRP), ghrelin, and albumin were included at baseline.

There were 53 patients enrolled, with a median age of 60 years (range, 18-82 years) and EGG diagnoses of mixed dysrhythmia (n = 25), tachygastria (n = 15), bradygastria (n = 6), gastric outlet obstruction (n = 1), and normal (n = 6). Forty-seven patients with an abnormal EGG had high median CRP, low median albumin, and high median ghrelin levels when compared to 6 patients with a normal EGG, with CRP [12 (8-22) vs. 6 (5-8)]; albumin [35 (26-40) vs. 38.5 (34-42)]; ghrelin [4 (2-10) vs. 2.5 (2-9)]. According to the DSSI, the most frequent dysmotility-like symptoms were (1) frequent burping and belching [73.6%], (2) bloating [60.4%], (3) feeling full after meals [69.8%], (4) inability to finish normal-sized meal [66%], (5) abdominal distention [51%], and (6) nausea after meals [50.9%]. The most frequent reflux- and ulcer-like symptoms were (1) regurgitation of bitter fluid [43.4%] and abdominal pain before meals [39.6%]. The most frequent nutrition impact symptoms as recorded on the Patient-Generated Subjective Global Assessment in patients with an abnormal EGG diagnosis were no appetite or did not feel like eating, nausea, vomiting, and feeling full quickly.

Abnormal EGG diagnosis, ghrelin, albumin, and CRP levels are found in the majority of patients with advanced cancer. Further studies are needed to better understand the correlation of these abnormal serum levels and their interaction with the pathogenesis of abnormal electrogastrographic rhythms.