P1436 - Virtual Reality Improves Symptoms of Functional Dyspepsia: Preliminary Analysis of a Prospective Study

Monday, October 25, 2021

10:30 AM – 4:15 PM PT

Location: Shoreline Exhibit Hall

Has Audio

Award: Presidential Poster Award

Presenting Author(s)

David J. Cangemi, MD

Mayo Clinic Health System
Jacksonville, FL, United States

Award: Presidential Poster Award

David J. Cangemi, MD¹, Marilia Montenegro, MD², Brennan Spiegel, MD, MSHS³, Brian E. Lacy, MD, PhD, FACG²
¹Mayo Clinic Health System, Jacksonville, FL; ²Mayo Clinic, Jacksonville, FL; ³Cedars-Sinai Medical Center, Los Angeles, CA

Introduction: Functional dyspepsia (FD) is a common functional GI disorder, characterized by symptoms of abdominal pain, nausea, and/or early satiety. Virtual reality (VR) is a promising intervention which has been shown to alleviate pain in various clinical settings. There are currently no studies assessing VR in the treatment of FD. The aim of this study was to investigate the effectiveness and safety of VR for the treatment of FD, by comparing changes in symptoms and quality of life (QoL), as measured by questionnaires.

Methods: This is a prospective, single-center, double-blinded study of adult patients with FD (Rome IV criteria). Patients’ symptoms were classified as epigastric pain syndrome (EPS), postprandial distress syndrome (PDS), or mixed subtypes of FD. Enrolled patients were randomized 2:1, experimental to control groups. Experimental patients were given a VR headset with software containing immersive audiovisual programs. Control patients were given an identical headset with 2-D nature videos. Patients were asked to use their headset at least daily and completed PAGI-SYM and Nepean Dyspepsia Index (NDI) questionnaires at the initial visit, after 1 week of use, and at the conclusion of the 2-week study. Paired sample t-tests were used to compare questionnaire scores.

Results: Given the limited number of control patients enrolled to date, we report a preliminary analysis of 20 experimental patients. Patients’ demographic data are shown in Table 1. Patients used the VR headset an average of 1.4 times/day for a mean 23.5 minutes/day. Total PAGI-SYM scores decreased from 2.55 (baseline) to 1.97 (week 1) to 1.87 (week 2); p=0.005 (baseline-week 1), p=0.006 (baseline-week 2). Further, PAGI-SYM subscales for early satiety, heartburn/regurgitation, and upper abdominal pain significantly decreased at week 2 (Figure 1). Among subtypes, statistically significant improvement only occurred in EPS patients [2.47 (baseline) to 1.37 (week 2), p=0.004]. Among experimental patients, QoL significantly improved, as the total NDI QoL score increased from 44.51 (baseline) to 58.24 (week 2), p=0.001. Nine (45%) patients reported adverse effects, with dizziness and headache being the most common (n=5, respectively); 1 patient withdrew due to migraines.

Discussion: In this preliminary analysis, VR was shown to be safe and result in statistically significant overall improvement in symptoms in FD patients, most pronounced in EPS patients, and QoL. Completion of the study will allow for comparison to a control group.

Figure: Figure 1. PAGI-SYM Scores Among FD Patients (n=20)

Mean Age	43.85 years (± 15.06)
Mean BMI	26.29 (± 7.82)
Sex Female Male	18 (90%) 2
FD subtype EPS PDS Mixed	9 (45%) 9 (45) 2 (10)
Anxiety	10 (50%)
Depression	6 (30%)
PTSD	2 (10%)
Fibromyalgia	2 (10%)
Prior H. pylori infection	4 (20%)
Medications PPI Antidepressants Gabapentin Opioids NSAIDs	11 (55%) 7 (35%) 4 (20%) 2 (10%) 0
Alcohol Use	3 (15%)
Marijuana Use	3 (15%)

Table: Table 1. FD Experimental Group Data

Disclosures:

David Cangemi indicated no relevant financial relationships.

Marilia Montenegro indicated no relevant financial relationships.

Brennan Spiegel indicated no relevant financial relationships.

Brian Lacy indicated no relevant financial relationships.

David J. Cangemi, MD¹, Marilia Montenegro, MD², Brennan Spiegel, MD, MSHS³, Brian E. Lacy, MD, PhD, FACG². P1436 - Virtual Reality Improves Symptoms of Functional Dyspepsia: Preliminary Analysis of a Prospective Study, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.