ArticleNeurogastroenterology and motility2020
Autonomic function in gastroparesis and chronic unexplained nausea and vomiting: Relationship with etiology, gastric emptying, and symptom severity.
Article in Neurogastroenterology and motility, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 33 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Gastroparesis Registry 4 (GpR4): Improving the Understanding of Gastroparesis and Functional Dyspepsia
Evaluation of Incidence of Stomach Fullness in Elective Surgical Patients and Investigation of Associated Factors: Prospective Observational Study
Who cites it
33 citing papers in PubMed, 2 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- Spectrum of Interstitial Cell of Cajal Deficits in Chronic Gastroduodenal Disorders: Systematic Review and Meta-Analysis.The American journal of gastroenterology · 2026Pooled it
- European Guideline on Chronic Nausea and Vomiting-A UEG and ESNM Consensus for Clinical Management.United European gastroenterology journal · 2025Guideline
- Article
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- Abuse history as a modifier of symptom phenotype in endometriosis: Insights from a multidimensional retrospective cohort.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Diabetic gastroenteropathy: Associations between gastrointestinal symptoms, motility, and extraintestinal autonomic measures.Neurogastroenterology and motility · 2026Article
- Gastric electrical stimulation versus standard medical therapies for long-term symptom control and improved quality of life in drug-refractory gastroparesis patients.Annals of medicine and surgery (2012) · 2025Review
- Pyloric Dysfunction: A Review of the Mechanisms, Diagnosis, and Treatment.Gut and liver · 2025Review
- Current Concepts in Gastroparesis and Gastric Neuromuscular Disorders-Pathophysiology, Diagnosis, and Management.Diagnostics (Basel, Switzerland) · 2025Review
- Unmasking Gastroparesis in Diabetes During Ramadan: Challenges and Management Strategies.Journal of clinical medicine · 2025Review
- Endocannabinoid signaling in stress, nausea, and vomiting.Neurogastroenterology and motility · 2025Review
- Article
- A machine learning approach to stratify patients with hypermobile Ehlers-Danlos syndrome/hypermobility spectrum disorders according to disorders of gut brain interaction, comorbidities and quality of life.Neurogastroenterology and motility · 2025Article
- Evaluating the Associations Among Dysautonomia, Gastrointestinal Transit, and Clinical Phenotype in Patients With Systemic Sclerosis.Arthritis care & research · 2024Article
- Autonomic and Enteric Profiling May Help Predict Response to Diverse Obesity Therapies.Obesity surgery · 2024Article
- Low Vitamin D Levels in Patients with Symptoms of Gastroparesis: Relationships with Nausea and Vomiting, Gastric Emptying and Gastric Myoelectrical Activity.Digestive diseases and sciences · 2024Article
- Difference in Cyclic Versus Non-cyclic Symptom Patterns in Patients with the Symptoms of Gastroparesis Undergoing Bioelectric Therapy.Digestive diseases and sciences · 2024Article
- Postoperative delayed gastric emptying: may gut microbiota play a role?Frontiers in cellular and infection microbiology · 2024Review
- Age Differences in Upper Gastrointestinal Symptoms and Vagal Modulation in Women With Irritable Bowel Syndrome.Biological research for nursing · 2024Article
- The Gut-brain Connection and Episodic Migraine: an Update.Current pain and headache reports · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors at 11 institutions in 1 country.
Funding
Abstract
backgroundAutonomic dysfunction can be present in patients with idiopathic and diabetic gastroparesis. The role of autonomic dysfunction relating to gastric emptying and upper gastrointestinal symptoms in patients with gastroparesis and chronic unexplained nausea and vomiting (CUNV) remains unclear. The aim of our study is to evaluate autonomic function in patients with gastroparesis and CUNV with respect to etiology, gastric emptying and symptom severity.
methodsWe studied 242 patients with chronic gastroparetic symptoms recruited at eight centers. All patients had a gastric emptying scintigraphy within 6 months of the study. Symptom severity was assessed using the gastroparesis cardinal symptom index. Autonomic function testing was performed at baseline enrollment using the ANX 3.0 autonomic monitoring system which measures heart rate variability and respiratory activity measurements. KEY
resultsLow sympathetic response to challenge (Valsalva or standing) was the most common abnormality seen impacting 89% diabetic and 74% idiopathic patients. Diabetics compared to idiopathics, exhibited greater global hypofunction with sympathetic (OR = 4.7, 95% CI 2.2-10.3; P < .001) and parasympathetic (OR = 7.2, 95% CI 3.4-15.0; P < .001) dysfunction. Patients with delayed gastric emptying were more likely to have paradoxic parasympathetic excessive during sympathetic challenge [(Valsalva or standing) 40% vs. 26%, P = .05]. Patients with more severe symptoms exhibited greater parasympathetic dysfunction compared to those with mild-moderate symptoms: resting sympathovagal balance [LFa/RFa 1.8 (1.0-3.1) vs. 1.2 (0.6-2.3), P = .006)] and standing parasympathetic activity [0.4 (0.1-0.8) vs. 0.6 (0.2-1.7); P = .03].
conclusionsAutonomic dysfunction was common in patients with gastroparesis and CUNV. Parasympathetic dysfunction was associated with delayed gastric emptying and more severe upper gastrointestinal symptoms. Conversely, sympathetic hypofunction was associated with milder symptoms. INFERENCES: Gastroparesis and CUNV may be a manifestation of GI autonomic dysfunction or imbalance, such that sympathetic dysfunction occurs early on in the manifestation of chronic upper GI symptoms, while parasympathetic dysfunction results in more severe symptoms and delayed gastric emptying.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.