Development and psychometric evaluation of the patient assessment of upper gastrointestinal symptom severity index (PAGI-SYM) in patients with upper gastrointestinal disorders

Rentz, Anne M.; Kahrilas, Peter J.; Stanghellini, Vincenzo; Tack, Jan; Talley, Nicholas J.; Loge, Christine de la; Trudeau, Elyse; Dubois, Dominique; Revicki, Dennis A.

doi:10.1007/s11136-004-9567-x

Cited by 337 publications

(295 citation statements)

References 47 publications

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“…We have not found any significant association between predominant symptoms, etiology of gastroparesis and the severity of delayed gastric emptying, which somehow disagrees to other's reports (18,19) . This could be explained by one limitation of the present work: because ours is a retrospective study, symptoms were described in terms of type only, based on data from history taking.…”

Section: Characteristics Of Patients With Idiopathic Gastroparesiscontrasting

confidence: 99%

Clinical Features and Severity of Gastric Emptying Delay in Brazilian Patients With Gastroparesis

Borges

Secaf

Troncon

2013

Arq. Gastroenterol.

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-Context -Gastroparesis is defined by delayed gastric emptying without mechanical obstruction of the gastroduodenal junction, which has been increasingly investigated. Nevertheless, knowledge on the relationships between etiology, symptoms and degree of delayed gastric emptying is limited. Objectives -The demographic, clinical and etiological features of Brazilian patients with gastroparesis were studied and the relationships between these findings and the severity of gastric emptying were determined.Method -This is a retrospective study of medical records of 41 patients with symptoms suggestive of gastroparesis admitted between 1998 and 2011, who had evidence of abnormally delayed gastric emptying on abdominal scintigraphy. Cases with idiopathic gastroparesis were compared with those of patients with neurologic disorders or diabetes mellitus, in whom autonomic neuropathy is likely to occur. Results -The majority of the patients were women (75.6%) with a median age of 41 years and a long-term condition (median: 15 years). Twelve patients (29.3%) had a body mass index of less than 20 kg/m 2 . The most common presenting symptoms were dyspepsia (53.6%), nausea and vomiting (46.3%), weight loss (41.4%) and abdominal pain (24.3%). Regarding etiology, 16 patients had digestive disorders including idiopathic gastroparesis (n = 12), 12 had postoperative conditions, 11 had diseases of the nervous system, five had diabetes mellitus and in three cases gastroparesis was associated to a variety of conditions. In the majority of patients (65.8%) gastric emptying was severely delayed. There was no association between etiology of gastroparesis, type of presenting symptoms and the degree of delay in gastric emptying. Gastroparesis patients with proven (neurological conditions) or presumed (diabetes) nervous system involvements were significantly younger (P = 0.001), had more recent symptom onset (P = 0:03) and a trend towards more severe gastric empty (P = 0:06). There were no significant differences between this subgroup of patients and that comprising cases of idiopathic gastroparesis regarding any of the variables studied. Conclusions -The demographic, clinical and etiological characteristics of Brazilian patients with gastroparesis are quite varied, but there is a predominance of women with long-standing symptoms and marked delay in gastric emptying. The type of presenting symptoms and the degree of delay in gastric emptying do not predict the etiology of gastroparesis. However, severely delayed gastric emptying in younger patients with recent symptom onset should raise the suspicion of impaired neural control of gastro-duodenal motility. HEADINGS -Gastroparesis. Digestive signs and symptoms. Neuropathies. Diabetes mellitus.

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Section: Characteristics Of Patients With Idiopathic Gastroparesiscontrasting

confidence: 99%

Clinical Features and Severity of Gastric Emptying Delay in Brazilian Patients With Gastroparesis

Borges

Secaf

Troncon

2013

Arq. Gastroenterol.

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“…The patient assessment of gastrointestinal symptoms (PAGI-SYM) questionnaires included the gastroparesis cardinal symptom index (GCSI) scores as well as additional questions concerning abdominal pain, constipation, and diarrhea. 6,7 The GCSI evaluates the severity of nine symptoms over the past 2 weeks using a Likert scale from 0 (none) to 5 (very severe). 7 The symptoms include nausea, retching, vomiting, stomach fullness, inability to finish a standard meal, feeling excessively full after meals, loss of appetite, bloating, and a visibly larger stomach.…”

Section: Methodsmentioning

confidence: 99%

Granisetron Transdermal System for Treatment of Symptoms of Gastroparesis: A Prescription Registry Study

Midani

Parkman

2016

J Neurogastroenterol Motil

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Background/AimsSerotonin receptor (eg, antagonists are used to treat nausea and vomiting from a variety of causes. Granisetron transdermal system (GTS) is an appealing delivery system for patients with gastroparesis. To assess if GTS improves nausea and vomiting and other gastroparesis symptoms in patients with gastroparesis. MethodsPatients with gastroparesis and symptoms of nausea and vomiting refractory to conventional treatment were treated with GTS. Symptoms of gastroparesis were assessed using a modified Gastroparesis Cardinal Symptom Index (GCSI). Following 2 weeks of treatment, patients were asked to assess their symptoms and indicate their therapeutic response using the Clinical Patient Grading Assessment Scale (CPGAS) reporting if symptoms of nausea and vomiting improved on a scale: 0 = no change to +7 = completely better. ResultsFifty-one patients received GTS by prescription: average age was 40 ± 17 years, 44 female, 11 diabetics, 23 ± 20% retention at 4 hours on gastric emptying scintigraphy. Thirty-nine of the 51 (76%) patients stated improvement with GTS. There was significant improvement in nausea and vomiting as assessed with CPGAS at 2 weeks (2.28 ± 2.53; P < 0.05). Symptoms of nausea and vomiting significantly improved. Other symptoms including postprandial fullness, loss of appetite, upper abdominal pain, and early satiety improved. Side effects reported included redness at the site of the patch in 7 patients, pruritus in 5, and constipation in 5. ConclusionsGTS was moderately effective in reducing nausea and/or vomiting in 76% of gastroparesis patients. In addition to nausea and vomiting, symptoms of postprandial fullness, loss of appetite, upper abdominal pain, and early satiety also improved.

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“…In addition, all patients answered the patient assessment of upper gastrointestinal disorders-symptom severity index (PAGI-SYM) questionnaire at each of the above assessment times. PAGI-SYM questionnaire is a well-accepted, validated tool to reliably quantify symptom burden in patients with UGI disorders 13 ( Figure I in the Data Supplement).…”

Section: Vn Functional Assessmentmentioning

confidence: 99%

“…13 It includes a series of questions (20-item) relating to multiple UGI symptoms. Patients rate their symptoms on a subjective scale of 0 to 5, where 0 represents no symptoms and 5 represents the worst severity of that symptom ( Figure I in the Data Supplement).…”

Section: Pagi-sym Ugi Symptom Questionnairementioning

confidence: 99%

Effect of Atrial Fibrillation Ablation on Gastric Motility

Lakkireddy

Reddy

Atkins

et al. 2015

Circ: Arrhythmia and Electrophysiology

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Background-Collateral damage to the vagal nerve and the upper gastrointestinal (UGI) system during atrial fibrillation ablation has not been systematically evaluated. Methods and Results-We performed a prospective, observational study assessing the effect of atrial fibrillation ablation on the function of the vagus nerve/UGI system. All patients underwent esophageal manometry, gastric emptying study, and sham-feeding test (corresponding to esophageal, gastric, and small intestinal function evaluation, respectively) before ablation (baseline) and subsequently at 24 hours, 90 days, and 180 days after the procedure. In addition, UGI symptom assessment using the patient assessment of upper gastrointestinal disorders-symptom severity index (PAGI-SYM) questionnaire was performed at baseline and during each of the subsequent evaluations. Of the 27 patients enrolled in the study, 9 (33%) patients had abnormal UGI function at baseline; defined as at least one of the 3 abnormal tests. At 24 hours after the radiofrequency catheter ablation, 20 (74%) patients had at least 1 new abnormality on the UGI function tests (P<0.001). New onset esophageal dysmotility, delayed gastric emptying time, and abnormal sham-feeding tests were observed in 13 (48%), 13 (48%), and 9 (33%) patients, respectively. Mean PAGI-SYM scores increased from 7.78±6.6 at baseline to 15.56±13.4 (P=0.002) at 24 hours. New onset abnormalities persisted in 9 (33%) patients at 3 months and normalized in all patients at 6 months. Conclusions-Atrial fibrillation ablation results in functional impairment of the UGI system, including the esophagus, stomach, and small intestine. This impairment is transient and is probably mediated by the injury to the components of the vagal nerve. Clinical Trial Registration-URL: http://clinicaltrials.gov. Unique Identifier: NCT01396356.

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Development and psychometric evaluation of the patient assessment of upper gastrointestinal symptom severity index (PAGI-SYM) in patients with upper gastrointestinal disorders

Abstract: Results suggest the PAGI-SYM, a brief symptom severity instrument, has good reliability and evidence supporting construct validity in subjects with GERD, dyspepsia, or gastroparesis.

Cited by 337 publications

References 47 publications

Clinical Features and Severity of Gastric Emptying Delay in Brazilian Patients With Gastroparesis

Clinical Features and Severity of Gastric Emptying Delay in Brazilian Patients With Gastroparesis

Granisetron Transdermal System for Treatment of Symptoms of Gastroparesis: A Prescription Registry Study

Effect of Atrial Fibrillation Ablation on Gastric Motility

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