# Exploring Clinical Similarities and Distinctions Between Gastroparesis and Functional Dyspepsia: A Propensity‐Matched Cohort Study

## TL;DR

This study compares gastroparesis and functional dyspepsia, finding differences in symptoms and healthcare use that support distinct diagnoses and treatments.

## Contribution

The study provides the largest national cohort analysis of clinical distinctions between gastroparesis and functional dyspepsia using propensity score matching.

## Key findings

- Gastroparesis patients used more prokinetics and antiemetics and had higher healthcare utilization than functional dyspepsia patients.
- Nausea, vomiting, and distension were more common in gastroparesis, while epigastric pain was more common in functional dyspepsia.
- The findings support the need for mechanism-based, individualized management of these conditions.

## Abstract

Gastroparesis and functional dyspepsia often share overlapping upper gastrointestinal symptoms but may differ in symptom patterns, treatment, and health care utilization. We assessed their clinical similarities and distinctions in the largest national cohort study to date.

We performed a retrospective cohort study using the TriNetX database, identifying patients through administrative codes. Individuals with structural gastric or small bowel abnormalities or prior gastric surgery were excluded. Gastroparesis required a diagnosis within three months of a gastric emptying study, at least one typical symptom, and an upper endoscopy within 12 months prior. Functional dyspepsia required a diagnosis with prior endoscopy (1–12 months) and symptoms 6–12 months before diagnosis. Primary outcomes were medication use and healthcare utilization; secondary outcomes included symptom burden and coexisting disorders of gut–brain interaction. Propensity score matching (1:1) adjusted for demographics and comorbidities. Relative risks with 95% confidence intervals were calculated.

We identified 2488 patients with gastroparesis and 3676 with functional dyspepsia; after matching, 1914 per group remained. Gastroparesis showed greater use of prokinetics (52.7% vs. 19.6%; p < 0.0001) and antiemetics, and higher rates of endoscopy (41.4% vs. 21.2%), emergency visits (45.3% vs. 40.2%), and hospitalization (28.2% vs. 21.6%) (all p < 0.01). Nausea, vomiting, and distension were more frequent in gastroparesis, while epigastric pain predominated in functional dyspepsia (p < 0.0001).

Gastroparesis and functional dyspepsia show distinct symptom distributions and treatment patterns, with higher health care utilization in gastroparesis, supporting mechanism‐based individualized management.

Despite overlapping upper gastrointestinal symptoms, gastroparesis and functional dyspepsia demonstrate distinct population‐level symptom patterns, with nausea, vomiting, and bloating predominating in gastroparesis and epigastric pain in functional dyspepsia. Gastroparesis is also associated with greater use of prokinetics and antiemetics and higher healthcare utilization, supporting diagnostic distinction to enable targeted management.

Despite overlapping upper gastrointestinal symptoms, gastroparesis and functional dyspepsia demonstrate distinct population‐level symptom patterns, with nausea, vomiting, and bloating predominating in gastroparesis and epigastric pain in functional dyspepsia. Gastroparesis is also associated with greater use of prokinetics and antiemetics and higher health care utilization, supporting diagnostic distinction to enable targeted management.