Introduction:

The relationship between gastroparesis and gastroesophageal reflux (GERD) is complex, with delayed gastric emptying which potentially increases reflux risk. Studies that used multi-channel intraluminal impedance-pH (MII-pH) testing show that a delay in gastric emptying time (GET) increases post-prandial reflux events and proximal extension without having a significant impact on acid exposure time (AET). The main objective was to examine whether MII-pH outcomes were associated with gastric emptying studies.

Methods:

1. A total of 286 patients were included with 60% being females with a mean age of 58 years.
2. Patients who underwent MII-pH within a 1-year time frame were included in the study. Patients with prior esophageal or gastric surgery were excluded.
3. The patients were divided into 3 groups:
   1. GET <10%: 180 patients
   2. GET 10-30%: 60 patients
   3. GET >30%: 46 patients
4. The patents were of similar age, race, and BMI across groups.
5. Conclusive GERD diagnosis criteria included the following:
   1. Esophagitis/Barrett’s
   2. AET >6% off PPI
   3. AET >4% on PPI
6. Patients were categorised by GET (Gastric Emptying Time) into the following:
   1. Normal GET: GET <10%
   2. Mild/Moderate Delay: GET 10-30%
   3. Severe Delay: GET >30%

Results:

• It was found that reflux/heartburn was most common in GET <10% and GET 10-30% groups. PPI use is highest in GET >30% group (83%).
• There was no significant correlation between GET and AET (distal, supine, postprandial)

The following table shows the overall results:

Conclusion:

It was concluded that there was no significant link found between gastroparesis (or its severity) and GERD. Despite the previous assumptions, delayed gastric emptying did not correlate with reflux patterns which further suggested a more complex, non-causal relationship between gastroparesis and GERD.

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