{
  "abstract": "Introduction The association between upper gastrointestinal (GI) symptoms and delayed gastric emptying time (GET) is debated, with previous studies showing inconsistent findings. The Auckland Classification scheme was recently introduced to phenotype patients based on Body Surface Gastric Mapping (BSGM) together with validated time-of-test symptom profiling. We hypothesised that symptom associations with GET would differ according to Auckland Classification phenotypes.Methods A pooled analysis was performed on two prospective datasets (N=214) comprising patients with chronic upper GI symptoms. All patients underwent simultaneous BSGM (Gastric Alimetry, New Zealand) and gastric emptying testing (breath testing (GEBT) (n=143) or scintigraphy (GES) (n=71)). Patients were grouped into either normal or delayed GET (defined as t1/2 >109 minutes (GEBT) or >10% retention at 4 hours (GES)). Time-of-test symptom profiling occurred at 15-minute intervals (30-minutes preprandial to 4-hours postprandial) using the validated Gastric Alimetry App. Patients were classified into Auckland Classification phenotypes: ‘Spectral Abnormal’ (atypical gastric rhythm, frequency, amplitude), ‘Sensorimotor’ (gastric amplitude correlation with symptoms >0.5), ‘Continuous’ (continuous uncorrelated symptom profiles), or ‘NA’ (unclassified).Results Complete data were available for 194 patients (80% female, median age 38 years, median BMI 23.5 kg/m 2), of whom 24% had a delayed GET. Overall, patients with a delayed GET had a greater total symptom burden (15.6 vs. 8.8, p=0.006), specifically in symptoms of postprandial distress (excessive fullness (3.9 vs. 2.0, p=0.004), early satiation (6.0 vs. 1.0, p=0.015)). Auckland Classification phenotyping was undertaken on patients with adequate BSGM. Symptom associations with GET varied by phenotype. Patients with a ‘Sensorimotor’ phenotype showed symptom associations with GET, namely nausea (4.9 vs 1.0, p=0.027), with other symptoms showing similar trends, as illustrated by an increased total symptom burden (23.3 vs. 8.4, p=0.135). By contrast, patients with a ‘Continuous’ phenotype showed no symptom associations with GET, nor did other phenotypes (figure 1).Conclusions Delayed GET is associated with an increased burden of upper GI symptoms, specifically postprandial distress, when validated time-of-test symptom profiling is utilised. However, gastroduodenal disorders have heterogeneous pathophysiology, such that subgrouping by mechanistic phenotypes reveals this association to be relevant to patients with a ‘Sensorimotor’ phenotype, thus better guiding the use of gastric emptying tests and emptying-targeted therapies.Abstract P392 Figure 1Associations between gastric emptying and nausea symptoms (A) and total symptom burden (B) in a population subgrouped by the Auckland Classification scheme. Data presented as medians",
  "authors": [
    {
      "affiliations": [
        "Alimetry Ltd., Auckland, New Zealand",
        "Te Whatu Ora - Waitemata, Auckland, New Zealand"
      ],
      "name": "Charlotte Daker"
    },
    {
      "affiliations": [
        "The University of Auckland, Auckland, New Zealand"
      ],
      "name": "Jayden Kumar"
    },
    {
      "affiliations": [
        "The University of Auckland, Auckland, New Zealand"
      ],
      "name": "Chris Varghese"
    },
    {
      "affiliations": [
        "Tri-Service General Hospital, Taipei City, Taiwan"
      ],
      "name": "I-Hsuan Huang"
    },
    {
      "affiliations": [
        "Alimetry Ltd., Auckland, New Zealand",
        "The University of Auckland, Auckland, New Zealand"
      ],
      "name": "Stefan Calder"
    },
    {
      "affiliations": [
        "Alimetry Ltd., Auckland, New Zealand"
      ],
      "name": "Nicky Dachs"
    },
    {
      "affiliations": [
        "Alimetry Ltd., Auckland, New Zealand",
        "The University of Auckland, Auckland, New Zealand"
      ],
      "name": "Gabriel Schamberg"
    },
    {
      "affiliations": [
        "The University of Auckland, Auckland, New Zealand"
      ],
      "name": "Sam Simmonds"
    },
    {
      "affiliations": [
        "Alimetry Ltd., Auckland, New Zealand",
        "Tri-Service General Hospital, Taipei City, Taiwan"
      ],
      "name": "Daphne Foong"
    },
    {
      "affiliations": [
        "Alimetry Ltd., Auckland, New Zealand",
        "University of Calgary, Calgary, Canada"
      ],
      "name": "Christopher N Andrews"
    },
    {
      "affiliations": [
        "Alimetry Ltd., Auckland, New Zealand",
        "The University of Auckland, Auckland, New Zealand"
      ],
      "name": "Armen Gharibans"
    },
    {
      "affiliations": [
        "Katholieke Universiteit Leuven, Leuven, Belgium"
      ],
      "name": "Jan F Tack"
    },
    {
      "affiliations": [
        "Alimetry Ltd., Auckland, New Zealand",
        "The University of Auckland, Auckland, New Zealand"
      ],
      "name": "Greg O’Grady"
    }
  ],
  "title": "P392 Symptom associations with delayed gastric emptying: a subgroup analysis with body surface gastric mapping",
  "uid": "5d87d9c2-a7fd-572b-8006-2f927982a776"
}