P3692 - Outcomes of GPOEM for Gastroparesis: A Single Center Study to Evaluate the Association Between GCSI, GERD HRQL , and RSI Scores: GPOEM Can Improve GERD Symptoms More Than Gastroparesis Symptoms

Daniyal Raza, MD¹, Syed Musa Raza, MD¹, Elizabeth Armstrong, BA¹, Victoria Andrus, ¹, Grace McCurdy, ¹, Michelle Neice, MD¹, Maryam Mubashir, MD¹, Shazia Rashid, MD¹, Nazar Hafiz, MD¹, Mohammad Alfrad Nobel Bhuiyan, PhD², Qiang Cai, MD^1
1LSU Health Sciences Center, Shreveport, LA; ²Louisiana State University Health Sciences Center, Shreveport, LA

Introduction: This study aims to evaluate the effectiveness of G-POEM (Gastric Peroral Endoscopic Myotomy) in improving gastroesophageal reflux disease (GERD) symptoms in patients with gastroparesis. With only limited studies done previously the primary objective is to assess the efficacy of G-POEM in alleviating GERD symptoms in these patients and to assess the degree of correlation between improvement in Gastroparesis cardinal symptoms index (GCSI), Reflux symptoms index (RSI) and GERD-health related quality of life (GERD HRQL) score after the G-POEM procedure.

Methods: 23 patients in our tertiary care center who underwent G-POEM from 7/2021 to 10/2022 were included in the study. All patients provided signed consent before the study and completed the GCSI, GERD HRQL, and RSI questionnaire before and after the G-POEM procedure. Pearson correlation coefficients were calculated to test the association between the scoring systems. The grouped bar plot was used to compare the patient-wise percentage of changes in each score.






Results: 23 patients mean GCSI pre and post GPOEM were 3.5 and 1.5, respectively. We conducted a Welch Two Sample t-test and found a significant decrease in the mean GERD HRQL score from 16.5 to 6.5 and a significant decrease in mean RSI score from 15.3 to 5.2 after G-POEM with p-value < 0.05. There was a significant positive correlation between the differences in GCSI score, RSI score, and GERD HRQL score before and after the GPOEM procedure. With one unit decrease in the difference of GCSI, there was 0.58 times decrease in GERD_HRQL score with a p-value of 0.04 (p< 0.05). With one unit decrease in GCSI score difference, the RSI scores decreased by 0.46 times. (p < 0.05). 5 out of 23 patients did not have significant improvement in their GCSI scores, decreasing by 1 point. Among those patients, three out of five had an improvement of the Gerd HRQL score of more than 50 %, and four out of five had an improvement of more than 25 % in the RSI scores.

Discussion: The association between gastroparesis and GERD is influenced by several factors. Delayed gastric emptying in gastroparesis can lead to prolonged food retention in the stomach, increasing the likelihood of reflux. Given that gastroparesis can contribute to refractory GERD, it is hypothesized, that improvements in gastroparesis severity may alleviate reflux-related symptoms in individuals with both conditions. Results show a significant positive correlation of decrease in GCSI score with decrease in RSI and GERD HRQL score.








Disclosures:


Daniyal Raza, MD¹, Syed Musa Raza, MD¹, Elizabeth Armstrong, BA¹, Victoria Andrus, ¹, Grace McCurdy, ¹, Michelle Neice, MD¹, Maryam Mubashir, MD¹, Shazia Rashid, MD¹, Nazar Hafiz, MD¹, Mohammad Alfrad Nobel Bhuiyan, PhD², Qiang Cai, MD¹. P3692 - Outcomes of GPOEM for Gastroparesis: A Single Center Study to Evaluate the Association Between GCSI, GERD HRQL , and RSI Scores: GPOEM Can Improve GERD Symptoms More Than Gastroparesis Symptoms, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.