LAUSR

OBJECTIVES Gastroparesis is a common complication of systemic sclerosis (SSc). We sought to determine the degree of overlap between gastroparesis and dysmotility in other areas of the gut, correlate our findings with GI symptoms, and examine associations between gastroparesis and SSc features. METHODS Whole gut scintigraphy was performed on SSc patients who were enrolled in the Johns Hopkins Scleroderma Cohort, where detailed longitudinal clinical and serologic data are collected. A subset of patients completed the UCLA GIT 2.0 to quantify GI symptoms. We examined associations between the presence and severity of gastroparesis, GI symptoms, and SSc clinical features. RESULTS Ninety-seven SSc patients with and without GI symptoms underwent whole gut scintigraphy and completed the gastric emptying study. 34/97 (35%) met criteria for gastroparesis. Of the measures assessed, delayed liquid emptying captured more patients with delayed gastric transit compared with delayed solid emptying (74% vs 55%) and percent liquid emptying correlated best with GIT Reflux (ρ= -0.33, p= 0.01) and Distension (ρ=-0.30, p= 0.03) scores. 30/33 (91%) patients with gastroparesis had abnormal transit in other areas of the GI tract. Higher anti-CENP-B titers correlated with slower gastric emptying (ρ= -0.26, p= 0.03), but no specific clinical features of SSc associated with gastroparesis. CONCLUSIONS Gastric emptying of liquids when given alongside solids may be more sensitive and provide a more clinically relevant measure of gastroparesis in SSc. SSc patients with gastroparesis frequently have dysmotility in other areas of the GI tract, underscoring the need for whole-gut scintigraphy to evaluate the entire gut.