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Background: Gastroparesis (Gp) is a poorly understood chronic gastrointestinal medical condition for which patient reported outcomes (PRO) are lacking. Previously developed symptoms scoring has been used for several decades. Using symptoms scores as a basis for documentation, 12 years of support/focus group patient feedback from the nearly 1000 attendees were integrated with medical care and recommendations for treatment were developed. Early attenders of the support group were compared with non-attendees for illness acuity, disability, and duration and number of office phone calls. Methods: Patients cared for in an academic medical practice were assessed for patient-derived PRO symptoms, coupled with standardized Health Related Quality of Life (HRQOL) measures. Based on factors identified by the patients via support/focus groups, a diagnostic and prognostic tool was developed. Results: The new tool utilized PRO symptoms and included provider assessments of medical illnesses as well as resource utilization. This 'post PRO' tool has been applied in a variety of settings for patients with the symptoms of Gp over the last two decades. The 'pre-PRO' factors from the support/focus groups were compared to the PRO measures as well as the 'post-PRO' scale to assess their usefulness. Using methods that combine chart data, including electronic medical records (EMR), with PRO symptoms may have design implications for PRO assessment. The resultant scales, as part of a new tool, can allow for sharing of PRO derived scores in a chronic gastrointestinal (GI), illness with different practitioners. Conclusions: These newly-derived scales offer a potentially useful tool for clinical decision-making, tailoring treatment to patient subgroups and engaging both patients and their families and caregivers in more active partnerships with providers to improve health outcomes. [ABSTRACT FROM AUTHOR]

Introduction: This study evaluates the modeling of gastric electrophysiology tracings during long-term gastric electrical stimulation for gastroparesis. We hypothesized that serosal electrogastrogram may change over time representing gastric remodeling from gastric stimulation. Patients: Sixty-five patients with gastroparesis underwent placement of gastric stimulator for refractory symptoms. Mean age at initial stimulator placement was 44 years (range, 8-76), current mean age was 49, and the majority of the subjects were female ( n = 51, 78 %). Only a minority had diabetes-induced gastroparesis ( n = 16, 25 %); the remainder were either idiopathic or postsurgical. Methods: At the time of stimulator placement, electrogastrogram was performed after the gastric leads were placed but before stimulation was begun. Patients underwent continuous stimulation until pacer batteries depleted. At the time of replacement, before the new pacemaker was attached, electrogastrogram was again performed. Results: After a mean of 3.9 years of stimulation therapy, the mean of baseline frequency before stimulation therapy was 5.06 cycles/min and declined to 3.66 after replacement ( p = 0.0000002). The mean amplitude was 0.33 mV before stimulation therapy and decreased to 0.31 mV ( p = 0.73). The frequency/amplitude ratio was 38.4 before stimulation therapy and decreased to 21.9 ( p = 0.001). Conclusion: Long-term gastric electrical stimulation causes improvement in basal unstimulated gastric frequency to near normal. [ABSTRACT FROM AUTHOR]

Background: Migraine is a disabling neurological disorder often complicated by gastrointestinal conditions such as gastricstasis. The association between migraine and gastric stasis has received very little attention in the literature, but theexisting evidence suggests that they may share a common etiology. Results: Patients with migraine and those with gastric stasis exhibit abnormal autonomic nervous system function.Furthermore, empirical studies demonstrate that migraineurs experience significant delays in gastric emptying, bothduring and outside of attacks, when compared to non-migrainous controls.Conclusion: More research is needed to establish the relationship between gastric stasis and migraine burden and todetermine the impact of gastric stasis on migraine treatment. [ABSTRACT FROM AUTHOR]