P5056 - Changes in Nutritional Status of Patients With Drug Refractory Gastroparesis After Gastric Electrical Stimulation

Le Yu Naing, MD¹, Fares Kasem, DO², Prateek Mathur, MD¹, Lindsay McElmurray, PA-C¹, Carmelita Moppins, APRN¹, Michael Daniels, MS², Abigail Stocker, MD², Thomas Abell, MD², Endashaw Omer, MD^1
1University of Louisville, Louisville, KY; ²University of Louisville School of Medicine, Louisville, KY

Introduction: Patients with gastroparesis tend to live on a less nutritious high simple carbohydrate diet as it is better tolerated than regular diet with optimal composition of carbohydrate, protein, and fat. The effect of gastric electrical stimulation (GES) on the nutritional status of patients with drug-refractory gastroparesis (Gp) is unclear, even if they are receiving J-tube feedings.

Methods: Patients were profiled by GI Symptoms (0- none to 4- worse), nutritional status by subjective global assessment (SGA), and weight, and quality of life by a Medicare DRG-based system (IDIOMS) at baseline and after one year. Based on use of Tube Feeding (TF) or not, and their Sx from baseline (BL) to one-year follow-up (FU), using first, improvement in vomiting and/or nausea and second, a 0.5-point change in Average Total Symptom Score (TSS) from, categorized as Improved (IMP) or Not Improved (nIMP) and analyzed interactions across the four groups. For statistical analysis, using nonparametric methods of Kruskal-Wallis and Fisher’s Exact Test for independent comparisons, and Wilcoxon Signed-Rank and McNemar’s tests for follow-up data, using R software.

Results: Our findings indicate significant improvements in nutritional status of patients undergoing GES. Among J tube patients, 23/56 (41%) improved in vomiting and 38/56 (68%) improved in average upper GI Sx. Similarly, 108/248 (44%) of patients improved in vomiting and 175/255 (69%) of non-J tube f patients showed improvement in average upper GI Sx. At baseline and at one-year follow-up, the Tube Feeding (TF) groups (IMP & nIMP) had less t feeding use (average 44% with remaining J tube feedings) and had a significantly lower BMI than the non-TF groups (Baseline: 26.1 vs. 29.3, p=0.003; Follow-up: 26.9 vs. 30.0, p=0.003) [ Table and Figure]. Notably, the 'Not Improved Non-Tube Feeding ' group exhibited a significant increase in BMI at follow-up (p=0.005). Logistic regression indicated that within the TF groups, each one-unit increase in baseline BMI was associated with 9% (CI=2-16%, p=0.04) decrease in symptom improvement.

Discussion: From this large sample size of patients with Gp Symptoms, with and without J tube feedings, both groups had similar responses to the bio-electric therapy of GES. From this data, the J-tube is not a contraindication to GES; GES patients can maintain their weight with or without a J-tube. Further work with feeding tubes and GES is indicated.


Disclosures:


Le Yu Naing, MD¹, Fares Kasem, DO², Prateek Mathur, MD¹, Lindsay McElmurray, PA-C¹, Carmelita Moppins, APRN¹, Michael Daniels, MS², Abigail Stocker, MD², Thomas Abell, MD², Endashaw Omer, MD¹. P5056 - Changes in Nutritional Status of Patients With Drug Refractory Gastroparesis After Gastric Electrical Stimulation, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.