Fatigue: a prevalent symptom in gastroparesis.
BACKGROUND
Fatigue is seen in many medical conditions. Patients with gastroparesis may complain of fatigue.


OBJECTIVE
The aim of this work is to first assess the prevalence and severity of fatigue in patients with gastroparesis, and secondly to correlate fatigue with symptoms, quality of life, and factors that may contribute to fatigue.


METHODS
One hundred and fifty-six patients with gastroparesis filled out questionnaires including the fatigue assessment instrument (FAI), patient assessment of upper gastrointestinal symptom severity index, patient assessment of upper gastrointestinal disorders-quality of life and hospital anxiety, and depression scale to evaluate for fatigue, symptoms, quality of life, and depression. Gastric emptying test and laboratory studies for hemoglobin, glycosylated hemoglobin, thyroid function (TSH), and inflammatory markers (CRP and ESR) were obtained.


RESULTS
Fatigue was reported by 93 % of patients. The mean total FAI score was 3.71 ± 0.2, with 51 % of patients having a score above 4, indicating severe fatigue. There were moderate correlations between fatigue and many symptoms of gastroparesis: upper abdominal discomfort (r = 0.446), upper abdominal pain (r = 0.422), loss of appetite (r = 0.329), bloating (r = 0.297), and abdominal distention (r = 0.265). Fatigue in patients using metoclopramide (3.5 ± 0.4) was similar to patients using domperidone (3.7 ± 0.5) or neither medicine (3.8 ± 0.3). Fatigue severity correlated with a decreased quality of life (r = -0.694, p < 0.001), increased depression (r = 0.339, p = 0.009), lower anxiety (r = -0.441, p < 0.001), and lower hemoglobin levels (r = -0.258, p = 0.005), but not to glycosylated hemoglobin, ESR, CRP, TSH, or gastric emptying.


CONCLUSIONS
Fatigue is an important significant symptom in patients with gastroparesis with a high prevalence and severity. Fatigue is correlated with many symptoms of gastroparesis, low hemoglobin, depression, inflammation, decreased quality of life, but not to severity of delayed gastric emptying or to medication use.
Department of Medicine, Temple University School of Medicine, Philadelphia, PA, USA.
Dinu
D
Cherian
Susmita
S
Paladugu
Murali
M
Pathikonda
Henry P
HP
Parkman
D000328:Adult; D059026:Diagnostic Self Evaluation; D004294:Domperidone / Q000627:therapeutic use; D018492:Dopamine Antagonists / Q000627:therapeutic use; D004415:Dyspepsia / Q000150:complications; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D018589:Gastroparesis / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008787:Metoclopramide / Q000627:therapeutic use; D015143:Philadelphia / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life; D011795:Surveys and Questionnaires
D018492:Dopamine Antagonists; D004294:Domperidone; D008787:Metoclopramide