J Neurogastroenterol Motil.
2023 Jan;29(1):65-71. 10.5056/jnm22013.
Nutrient Drink Test to Assess Gastric Accommodation in Cyclic Vomiting Syndrome: Single-blinded Parallel Grouped Prospective Study
- Affiliations
-
- 1Department of Gastroenterology and Hepatology, Stanford University School of Medicine, Redwood City, CA, USA
- 2Henry Ford Health System, Detroit, MI, USA
- 3Baylor College of Medicine, Houston, TX, USA
- 4Division of Gastroenterology, Washington University, St. Louis, MO, USA
- 5Cleveland Clinic Digestive Diseases Surgical Institute, Cleveland, OH, USA
- KMID: 2537941
- DOI: http://doi.org/10.5056/jnm22013
Abstract
- Background/Aims
Cyclic vomiting syndrome (CVS) is characterized by episodes of nausea and vomiting, separated by symptom-free intervals. The pathogenesis of CVS is poorly understood. Limited data exist on evaluating impaired gastric accommodation as a mechanistic means for symptoms. We aim to determine if CVS patients demonstrate impaired gastric accommodation applying a nutrient drink test (NDT) protocol.
Methods
Through this single-blinded pilot clinical trial, patients with CVS per Rome IV critera and healthy controls were assessed for presence of impaired gastric accommodation by administering an established NDT protocol. Statistical analysis was performed, with data presented as medians and interquartile range.
Results
Eleven CVS patients and 15 healthy controls participated in the study between January 2018 and October 2018. Median age was 42.0 years and 37.0 years; majority of subjects were female, 72.7% and 73.3%, respectively. Demographics were similar between CVS and healthy controls. Almost all healthy controls (93.3%) ingested the complete 500 mL protocol, whereas a smaller proportion (72.7%) were able to complete all 4 doses in the CVS group (P = 0.188). Post-prandial visual analogue scale scores of nausea and abdominal pain were found to be significantly higher in CVS patients compared to healthy controls.
Conclusions
To our knowledge, this is the first NDT protocol in CVS evaluating the role of impaired gastric accommodation and hypersensitivity as a possible pathophysiologic mechanism. Findings from this study suggest the presence of gastric hypersensitivity in a subset of CVS patients. These results provide the foundational data necessary for future larger testing of NDT and diagnostic accuracy in CVS.
