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Patients will undergo a SmartPill test to gain additional understanding of Fabry disease manifestation via motility abnormalities in order to improve symptom targeted therapy. An additional Endoscopic mucosal resection may be performed on further qualifying patients. Tissue analysis from this biopsy will include evaluation of abnormalities of cellular structure and morphology with correlation with gastrointestinal complaints for each patient and comparison against age matched non-Fabry patient tissue. The hypothesis is that patients with fabry disease will have abnormal motility which will correlate with the patients symptoms and quality of life as noted on the questionnaires.
Background: Gastrointestinal manifestations such as abdominal pain, diarrhea and nausea are prominent and, although typically non life-threatening, can frequently cause significant morbidity and burden in a patient with Fabry disease. Additional in depth understanding of gastrointestinal symptoms pathophysiology in Fabry disease is acutely needed in order to develop more specific evaluation of the symptoms and advance the treatment of these patients.
Hypothesis: Patients with gastrointestinal (GI) symptoms will have delayed motility on the SmartPill study, abnormal histologic findings on mucosal resection and symptoms that correlate with abnormal histologic and SmartPill findings. By gaining additional insight into the characterization of symptoms and the relationship to dysmotility, we anticipate improved and more focused adjunct therapies for the patients.
Methods: This study will consist of a screening visit, a SmartPill testing procedure visit, and a follow up visit for all subjects enrolled in the study. Fifteen of these patients, who clinically warranted sigmoidoscopy, will be asked to also complete an endoscopic mucosal resection (EMR) visit in addition to the other aspects of the study. Thus, each subject will report to the study site for at least 3 visits and up to 4 visits.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| SmartPill Test | Experimental | All subjects will be asked to complete a SmartPill test. The SmartPill capsule is pill-shaped and about an inch long and ½ inch wide, or about the size of a vitamin pill. The receiver unit is about the size of a paperback book. The receiver gets signals from the capsule and stores the signals on a computer chip. The capsule detects the level of acidity, temperature, and pressures in your stomach and intestines and sends the information by radio wave signals to the receiver. |
|
| Endoscopic Mucosal Resection | Experimental | An additional small group of subjects will also be asked to complete a Sigmoidoscopy (an exam used to evaluate the lower part of the large intestine) during which an Endoscopic Mucosal Resection (removal of a small amount of tissue from the outermost layer of gut wall) will be completed. In the Endoscopy Mucosal Resection (EMR) procedure we will use an instrument called an endoscope (a lighted, flexible tube) to take a tissue sample from the rectum. This is the same type of instrument used in a routine colonoscopy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Smartpill | Device | The SmartPill Test is approved by the U.S. Food and Drug Administration (FDA) to measure transit time in the GI tract. This procedure uses the SmartPill capsule, a receiver, and computer software. |
| Measure | Description | Time Frame |
|---|---|---|
| Gastric Emptying Transit Time Measured Via SmartPill Study | The primary outcome of dysmotility will be the measurement of gastric emptying transit time via a SmartPill study. Delayed GET are defined as longer than 5 hours. | Up to 5 hours |
| Small Bowel Transit Time Measured Via SmartPill Study | The primary outcome of dysmotility will be the measurement of small bowel transit time via a SmartPill study. Delayed SBTT are defined as longer than 6 hours. | Up to 6 hours |
| Colonic Transit Time Measured Via SmartPill Study | The primary outcome of dysmotility will be the measurement of colonic transit time via a SmartPill study. Delayed CTT is defined as longer than 59 hours. | Up to 67 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Gastrointestinal Symptom Assessment and Quality of Life, Work, and Productivity Via Questionnaires | Participants will complete several questionnaires during study participation regarding gastrointestinal symptoms (lower and upper GI). These results will be used to determine overall gastrointestinal involvement and will be correlated with transit time and histologic findings | Up to 4 weeks |
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Inclusion Criteria:
Exclusion Criteria:
Fabry disease with other concomitant gastrointestinal diagnosis (Example:
Inflammatory Bowel Disease, Celiac Disease)
Pregnancy
Endoscopic mucosal resection exclusions:
Exclusions for SmartPill:
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| Name | Affiliation | Role |
|---|---|---|
| Braden Kuo, MD | Massachusetts General Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Massachusetts General Hospital | Boston | Massachusetts | 02114 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37578052 | Derived | Bar N, Karaa A, Kiser K, Kuo B, Zar-Kessler C. Gastrointestinal Sensory Neuropathy and Dysmotility in Fabry Disease: Presentations and Effect on Patient's Quality of Life. Clin Transl Gastroenterol. 2023 Dec 1;14(12):e00633. doi: 10.14309/ctg.0000000000000633. |
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| ID | Title | Description |
|---|---|---|
| FG000 | SmartPill Test Only | All subjects will be asked to complete a SmartPill test. The SmartPill capsule is pill-shaped and about an inch long and ½ inch wide, or about the size of a vitamin pill. The receiver unit is about the size of a paperback book. The receiver gets signals from the capsule and stores the signals on a computer chip. The capsule detects the level of acidity, temperature, and pressures in your stomach and intestines and sends the information by radio wave signals to the receiver. Smartpill: The SmartPill Test is approved by the U.S. Food and Drug Administration (FDA) to measure transit time in the GI tract. This procedure uses the SmartPill capsule, a receiver, and computer software. |
| FG001 | SmartPill and Endoscopic Mucosal Resection | An additional small group of subjects will also be asked to complete a Sigmoidoscopy (an exam used to evaluate the lower part of the large intestine) during which an Endoscopic Mucosal Resection (removal of a small amount of tissue from the outermost layer of gut wall) will be completed. In the Endoscopy Mucosal Resection (EMR) procedure we will use an instrument called an endoscope (a lighted, flexible tube) to take a tissue sample from the rectum. This is the same type of instrument used in a routine colonoscopy Smartpill: The SmartPill Test is approved by the U.S. Food and Drug Administration (FDA) to measure transit time in the GI tract. This procedure uses the SmartPill capsule, a receiver, and computer software. Endoscopic Mucosal Resection: a Sigmoidoscopy is an exam used to evaluate the lower part of the large intestine) during which an Endoscopic Mucosal Resection (removal of a small amount of tissue from the outermost layer of gut wall) will be completed. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Smart Pill Test (1 Day) |
| |||||||||||||
| Endoscopic Mucosal Resection (1 Day) |
|
Reported demographics are separated by sex/gender.
Not provided
| ID | Title | Description |
|---|---|---|
| BG000 | Female | Demographics |
| BG001 | Male | Demographics |
| BG002 |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Self-Questionnaires |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Gastric Emptying Transit Time Measured Via SmartPill Study | The primary outcome of dysmotility will be the measurement of gastric emptying transit time via a SmartPill study. Delayed GET are defined as longer than 5 hours. | Demographics | Posted | Median | Inter-Quartile Range | Hours | Up to 5 hours |
|
|
Up to 4 days
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | SmartPill Test | All subjects will be asked to complete a SmartPill test. The SmartPill capsule is pill-shaped and about an inch long and ½ inch wide, or about the size of a vitamin pill. The receiver unit is about the size of a paperback book. The receiver gets signals from the capsule and stores the signals on a computer chip. The capsule detects the level of acidity, temperature, and pressures in your stomach and intestines and sends the information by radio wave signals to the receiver. Smartpill: The SmartPill Test is approved by the U.S. Food and Drug Administration (FDA) to measure transit time in the GI tract. This procedure uses the SmartPill capsule, a receiver, and computer software. |
Not provided
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Vomiting | Gastrointestinal disorders | Non-systematic Assessment |
Not provided
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Braden Kuo and Dr. Claire-Zar-Kessler | Massachusetts General Hospital | 617-724-6038 | bkuo@mgh.harvard.edu, czarkessler@mgh.harvard.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Aug 31, 2017 | Oct 28, 2022 | Prot_SAP_000.pdf |
Not provided
| ID | Term |
|---|---|
| D000795 | Fabry Disease |
| ID | Term |
|---|---|
| D013106 | Sphingolipidoses |
| D020140 | Lysosomal Storage Diseases, Nervous System |
| D020739 | Brain Diseases, Metabolic, Inborn |
| D001928 | Brain Diseases, Metabolic |
Not provided
Not provided
| ID | Term |
|---|---|
| D000069916 | Endoscopic Mucosal Resection |
| ID | Term |
|---|---|
| D016099 | Endoscopy, Gastrointestinal |
| D016145 | Endoscopy, Digestive System |
| D003938 | Diagnostic Techniques, Digestive System |
| D019937 | Diagnostic Techniques and Procedures |
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| Endoscopic Mucosal Resection | Procedure | a Sigmoidoscopy is an exam used to evaluate the lower part of the large intestine) during which an Endoscopic Mucosal Resection (removal of a small amount of tissue from the outermost layer of gut wall) will be completed. |
|
| Age of Symptom Start | Up to 4 weeks |
| Delayed Gastric Emptying Measured Via SmartPill Study | The secondary outcome of dysmotility will be the measurement of delayed gastric emptying measured via a SmartPill study. Delayed GET are defined as longer than 5 hours. | Up to 5 hours |
| Delayed Small Bowel Transit Measured Via SmartPill Study | The secondary outcome of dysmotility will be the measurement of delayed bowel transit time via a SmartPill study. Delayed SBTT are defined as longer than 6 hours. | Up to 6 hours |
| Delayed Colonic Transit Measured Via SmartPill Study | The secondary outcome of dysmotility will be the measurement of delayed colonic transit time via a SmartPill study. Delayed CTT is defined as longer than 59 hours. | Up to 67 hours |
| Symptom Severity Index | Patient reported severity of certain symptoms over the last 4 weeks on a scale of 0 to 10 (bloating, abdominal discomfort, incomplete evacuation, straining and urgency). Higher score would mean worse (more symptoms) outcome. | At 67 hours, data reported over the last 4 weeks |
| Symptom Frequency Assessment (SFA) | Patients reported the number of complete BMs they had during the last week (minimum could be 0 and the maximum could be any number greater than 0). Higher/lower scores could be the better or worse outcome (e.g., 0 bowel movements all week would be a worse outcome but over 10 bowel movements would be worse as well), it just depends on the extent. | At 67 hours, data reported over the last 7 days |
| Hamilton Anxiety Rating Scale (HAM-A) | The scale consists of 14 items, each defined by a series of symptoms, and measures both psychic anxiety (mental agitation and psychological distress) and somatic anxiety (physical complaints related to anxiety). Each item is scored on a scale of 0 (not present) to 4 (severe), with a total score range of 0-56, where <7 indicates no or minimal severity, 8-14 is mild anxiety, 15-23 is moderate anxiety and 24 and worse is severe anxiety 5. Moderate-severe anxiety was defined as a score of 15 and above. | At 4 weeks |
| Beck's Depression Inventory (BDI) | Beck's Depression Inventory (BDI): is a 21-item tool assessing the existence and severity of symptoms of depression, as defined by the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV; 1994). The items correspond to symptoms of depression and are a four-point scale for each item ranging from 0 to 3. They are summed to give a single BDI score between 0-63 (where higher results reflect more severe depression). Grades are 1-10: normal, 11-16: mild mood disturbance, 17-20: borderline clinical depression, 21-30: moderate depression, 31-40: severe depression, and >40 extreme depression 6. Moderate-severe depression was defined as a score of 21 and above. | At 4 weeks |
| Work Productivity and Activity Impairment (WPAI) | Work Productivity and Activity Impairment (WPAI): examines the effect of GI symptoms on loss of work time and loss of productivity. Patients indicated if they are unemployed. For employed patients, scores are presented as percentage of time lost during the last week (hours lost due to GI symptoms out of the hours that patient should have worked, excluding the time lost on participating in the study). Higher percentages indicate greater impairment. Work missed percentage, reduced productivity percentage, and work-productivity impairment percentage (combining the 2 scores) are calculated 7. We defined work/productivity impairment as either being unemployed or having lost 40% or more of work time or productivity. For employed patients, scores are presented as percentage of time lost during the last week (hours lost due to GI symptoms out of the hours that patient should have worked, excluding the time lost on participating in the study). | At 7 days |
| IBS Quality of Life (IBS QoL) and Sub-scores | Irritable bowel syndrome quality of life (IBS-QOL): Assesses bowel specific QOL. It consists of 34 items of a 5-point Likert scale. The total score is summed and then transformed to a 0-100 scale, where 0 is low QoL, and 100 is the best QoL. Different IBS-QOL items can also be categorized to eight subscale scores (Dysphoria, Interference with Activity, Body Image, Health Worry, Food Avoidance, Social Reaction, Sexual, Relationships). Note be made, that the IBS-QOL examines the effect of "bowel problems" on different aspect of QOL, and so was used to assess the effect of gut symptoms on the patients' QOL. Higher scores are better outcome. | At 4 weeks |
| Bristol Stool Scale | Bristol Stool Scale: patients indicate their last 7 days stool consistency on 1-7 visual scale. The Bristol stool scale correlates with colonic transit time. Higher scores do not indicate better or worse outcomes. It is a visual scale. | At 7 days |
| NOT COMPLETED |
|
| Total |
Total of all reporting groups |
| Inter-Quartile Range |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Count of Participants | Participants |
|
| Enzyme replacement therapy > 6 months | Count of Participants | Participants |
|
| Any neurologic involvement | Count of Participants | Participants |
|
| Peripheral nervous system involvement | Count of Participants | Participants |
|
| Central nervous system (serious) involvement - make clear this excludes CN | Count of Participants | Participants |
|
| Cardiac system involvement | Count of Participants | Participants |
|
| Renal systemic involvement | Count of Participants | Participants |
|
| Dermatology systemic involvement | Count of Participants | Participants |
|
| Ophthalmic systemic involvement | Count of Participants | Participants |
|
| Psychiatric systemic involvement | Count of Participants | Participants |
|
| Asthma systemic involvement | Count of Participants | Participants |
|
| Presenting age of any neurologic systemic involvement | Median | Inter-Quartile Range | years |
|
| Presenting age of cardiac systemic involvement | Median | Inter-Quartile Range | years |
|
| Presenting age of renal systemic involvement | Median | Inter-Quartile Range | years |
|
| Presenting age of ophthalmic systemic involvement | Median | Inter-Quartile Range | years |
|
| Presenting age of psychiatric systemic involvement | Median | Inter-Quartile Range | years |
|
| Presenting age of respiratory (asthma) systemic involvement | Median | Inter-Quartile Range | years |
|
| Counts |
|---|
| Participants |
|
|
| Primary | Small Bowel Transit Time Measured Via SmartPill Study | The primary outcome of dysmotility will be the measurement of small bowel transit time via a SmartPill study. Delayed SBTT are defined as longer than 6 hours. | Demographics | Posted | Median | Inter-Quartile Range | Hours | Up to 6 hours |
|
|
|
| Primary | Colonic Transit Time Measured Via SmartPill Study | The primary outcome of dysmotility will be the measurement of colonic transit time via a SmartPill study. Delayed CTT is defined as longer than 59 hours. | Demographics | Posted | Median | Inter-Quartile Range | Hours | Up to 67 hours |
|
|
|
| Secondary | Gastrointestinal Symptom Assessment and Quality of Life, Work, and Productivity Via Questionnaires | Participants will complete several questionnaires during study participation regarding gastrointestinal symptoms (lower and upper GI). These results will be used to determine overall gastrointestinal involvement and will be correlated with transit time and histologic findings | Posted | Count of Participants | Participants | Up to 4 weeks |
|
|
|
| Secondary | Age of Symptom Start | Posted | Median | Inter-Quartile Range | years | Up to 4 weeks |
|
|
|
| Secondary | Delayed Gastric Emptying Measured Via SmartPill Study | The secondary outcome of dysmotility will be the measurement of delayed gastric emptying measured via a SmartPill study. Delayed GET are defined as longer than 5 hours. | Demographics | Posted | Count of Participants | Participants | Up to 5 hours |
|
|
|
| Secondary | Delayed Small Bowel Transit Measured Via SmartPill Study | The secondary outcome of dysmotility will be the measurement of delayed bowel transit time via a SmartPill study. Delayed SBTT are defined as longer than 6 hours. | Posted | Count of Participants | Participants | Up to 6 hours |
|
|
|
| Secondary | Delayed Colonic Transit Measured Via SmartPill Study | The secondary outcome of dysmotility will be the measurement of delayed colonic transit time via a SmartPill study. Delayed CTT is defined as longer than 59 hours. | Demographics | Posted | Count of Participants | Participants | Up to 67 hours |
|
|
|
| Secondary | Symptom Severity Index | Patient reported severity of certain symptoms over the last 4 weeks on a scale of 0 to 10 (bloating, abdominal discomfort, incomplete evacuation, straining and urgency). Higher score would mean worse (more symptoms) outcome. | Posted | Median | Inter-Quartile Range | score on a scale | At 67 hours, data reported over the last 4 weeks |
|
|
|
| Secondary | Symptom Frequency Assessment (SFA) | Patients reported the number of complete BMs they had during the last week (minimum could be 0 and the maximum could be any number greater than 0). Higher/lower scores could be the better or worse outcome (e.g., 0 bowel movements all week would be a worse outcome but over 10 bowel movements would be worse as well), it just depends on the extent. | Posted | Median | Inter-Quartile Range | units on a scale | At 67 hours, data reported over the last 7 days |
|
|
|
| Secondary | Hamilton Anxiety Rating Scale (HAM-A) | The scale consists of 14 items, each defined by a series of symptoms, and measures both psychic anxiety (mental agitation and psychological distress) and somatic anxiety (physical complaints related to anxiety). Each item is scored on a scale of 0 (not present) to 4 (severe), with a total score range of 0-56, where <7 indicates no or minimal severity, 8-14 is mild anxiety, 15-23 is moderate anxiety and 24 and worse is severe anxiety 5. Moderate-severe anxiety was defined as a score of 15 and above. | Posted | Median | Inter-Quartile Range | score on a scale | At 4 weeks |
|
|
|
| Secondary | Beck's Depression Inventory (BDI) | Beck's Depression Inventory (BDI): is a 21-item tool assessing the existence and severity of symptoms of depression, as defined by the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV; 1994). The items correspond to symptoms of depression and are a four-point scale for each item ranging from 0 to 3. They are summed to give a single BDI score between 0-63 (where higher results reflect more severe depression). Grades are 1-10: normal, 11-16: mild mood disturbance, 17-20: borderline clinical depression, 21-30: moderate depression, 31-40: severe depression, and >40 extreme depression 6. Moderate-severe depression was defined as a score of 21 and above. | Posted | Median | Inter-Quartile Range | score on a scale | At 4 weeks |
|
|
|
| Secondary | Work Productivity and Activity Impairment (WPAI) | Work Productivity and Activity Impairment (WPAI): examines the effect of GI symptoms on loss of work time and loss of productivity. Patients indicated if they are unemployed. For employed patients, scores are presented as percentage of time lost during the last week (hours lost due to GI symptoms out of the hours that patient should have worked, excluding the time lost on participating in the study). Higher percentages indicate greater impairment. Work missed percentage, reduced productivity percentage, and work-productivity impairment percentage (combining the 2 scores) are calculated 7. We defined work/productivity impairment as either being unemployed or having lost 40% or more of work time or productivity. For employed patients, scores are presented as percentage of time lost during the last week (hours lost due to GI symptoms out of the hours that patient should have worked, excluding the time lost on participating in the study). | Posted | Median | Inter-Quartile Range | percentage of time lost during the last | At 7 days |
|
|
|
| Secondary | IBS Quality of Life (IBS QoL) and Sub-scores | Irritable bowel syndrome quality of life (IBS-QOL): Assesses bowel specific QOL. It consists of 34 items of a 5-point Likert scale. The total score is summed and then transformed to a 0-100 scale, where 0 is low QoL, and 100 is the best QoL. Different IBS-QOL items can also be categorized to eight subscale scores (Dysphoria, Interference with Activity, Body Image, Health Worry, Food Avoidance, Social Reaction, Sexual, Relationships). Note be made, that the IBS-QOL examines the effect of "bowel problems" on different aspect of QOL, and so was used to assess the effect of gut symptoms on the patients' QOL. Higher scores are better outcome. | Posted | Median | Inter-Quartile Range | score on a scale | At 4 weeks |
|
|
|
| Secondary | Bristol Stool Scale | Bristol Stool Scale: patients indicate their last 7 days stool consistency on 1-7 visual scale. The Bristol stool scale correlates with colonic transit time. Higher scores do not indicate better or worse outcomes. It is a visual scale. | Posted | Median | Inter-Quartile Range | score on a scale | At 7 days |
|
|
|
| 0 |
| 48 |
| 0 |
| 48 |
| 1 |
| 48 |
| EG001 | Endoscopic Mucosal Resection | An additional small group of subjects will also be asked to complete a Sigmoidoscopy (an exam used to evaluate the lower part of the large intestine) during which an Endoscopic Mucosal Resection (removal of a small amount of tissue from the outermost layer of gut wall) will be completed. In the Endoscopy Mucosal Resection (EMR) procedure we will use an instrument called an endoscope (a lighted, flexible tube) to take a tissue sample from the rectum. This is the same type of instrument used in a routine colonoscopy Smartpill: The SmartPill Test is approved by the U.S. Food and Drug Administration (FDA) to measure transit time in the GI tract. This procedure uses the SmartPill capsule, a receiver, and computer software. Endoscopic Mucosal Resection: a Sigmoidoscopy is an exam used to evaluate the lower part of the large intestine) during which an Endoscopic Mucosal Resection (removal of a small amount of tissue from the outermost layer of gut wall) will be completed. | 0 | 13 | 0 | 13 | 1 | 13 |
| diarrhea | Gastrointestinal disorders | Non-systematic Assessment | 06/27/2017 |
|
| syncope | Gastrointestinal disorders | Non-systematic Assessment | 06/27/2017 |
|
| ER visit | Gastrointestinal disorders | Non-systematic Assessment | 06/27/2017 |
|
| Fever | Gastrointestinal disorders | Non-systematic Assessment | 07/17/2019 |
|
| Rectal Pain | Gastrointestinal disorders | Non-systematic Assessment | 07/16/2019 |
|
Not provided
Not provided
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D059345 | Cerebral Small Vessel Diseases |
| D002561 | Cerebrovascular Disorders |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D040181 | Genetic Diseases, X-Linked |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D008661 | Metabolism, Inborn Errors |
| D008064 | Lipidoses |
| D008052 | Lipid Metabolism, Inborn Errors |
| D016464 | Lysosomal Storage Diseases |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D052439 | Lipid Metabolism Disorders |
| D003933 | Diagnosis |
| D004724 | Endoscopy |
| D003949 | Diagnostic Techniques, Surgical |
| D013505 | Digestive System Surgical Procedures |
| D013514 | Surgical Procedures, Operative |
| D019060 | Minimally Invasive Surgical Procedures |
| Reporting chronic constipation |
|
| Reporting only diarrhea |
|
| Reporting only constipation |
|
| Chronic abdominal pain |
|
| Symptoms compatible with IBS |
|
| Bloating |
|
| Functional dyspepsia |
|
| Dysphagia |
|
| nausea and vomiting |
|
| Gastroesophageal reflux disease symptoms |
|
| Moderate severe depression |
|
| Moderate severe anxiety |
|
| Unemployed by Work Productivity and Activity Impairment |
|
| Work loss- 40% and more by Work Productivity and Activity Impairment |
|
| Reduced productivity 40% and more by Work Productivity and Activity Impairment |
|
| Work/productivity impairment by Work Productivity and Activity Impairment |
|
| Age of Diarrhea symptom start |
|
| Age of constipation symptom start |
|
| Age of nausea symptom start |
|
| Age of vomiting symptom start |
|
| Sense of incomplete evacuation |
|
| Straining while defecating |
|
| Bowel urgency |
|
| work productivity impairment (%) |
|
| Body Image sub-score |
|
| Health Worry sub-score |
|
| Food avoidance sub-score |
|
| Social reaction sub-score |
|
| Sexual sub-score |
|
| Relationships sub-score |
|
| IBS-QOL |
|