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PTSD Is Associated With Severity of Upper GI Symptoms in Patients With Gastroparesis
Madison Simons1, Elise Hokr1, Jack Loesch1,2
1Department of Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic Foundation, Digestive Disease Institute, Cleveland, USA.
Background:
Posttraumatic stress disorder may contribute to chronic overactivation of the sympathetic nervous system and exacerbate GI symptoms. The purpose of this study was to evaluate the impacts of PTSD on GI symptom severity and psychological functioning in patients with gastroparesis.
Methods:
We conducted a cross-sectional analysis of gastroparesis patients at a tertiary care center. Patients completed questionnaires at the initial evaluation. Objective markers of gastric function were extracted from the medical record. Patients were determined to have probable PTSD based on a total score greater than 33 on the Patient Checklist for DSM-5 (PCL-5).
Key Results:
Of the 207 patients with gastroparesis included in the final analysis (mean age = 45.5 years, 93% female, 93% White), 128 (61.8%) endorsed having ever experienced a traumatic event and 58 (28%) screened positive for PTSD. There were no significant differences in severity of gastric delay (p = 0.2) or impaired gastric accommodation (p = 0.48) between those with and without PTSD, but those with PTSD had reduced myoelectric activity on electrogastrography (p = 0.01). Patients with PTSD reported worse symptoms on most outcomes measured, including GI symptom severity. Regression analysis demonstrated age, anorectal dysfunction, and depression/anxiety to be the strongest predictors of PTSD severity.
Conclusion And Inferences:
PTSD was not associated with greater delay in gastric emptying or impairments in gastric accommodation but was associated with more severe symptoms and psychosocial impairment. Further exploration should assess the effects of undergoing trauma-focused therapy in improving symptoms.
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