Clinical Features of Idiopathic Gastroparesis Vary With Sex, Body Mass, Symptom Onset, Delay in Gastric Emptying, and Gastroparesis Severity

Abstract

Background & Aims Idiopathic gastroparesis (IG) is a common but poorly understood condition with significant morbidity. We studied characteristics of patients with IG enrolled in the NIDDK Gastroparesis Clinical Research Consortium Registry. Methods Data from medical histories, symptom questionnaires, and 4-hour gastric emptying scintigraphy studies were obtained from patients with IG. Results The mean age of 243 IG patients studied was 41 years; 88% were female, 46% were overweight, 50% had acute onset of symptoms, and 19% reported an initial infectious prodrome. Severe delay in gastric emptying (>35% retention at 4 hours) was present in 28% of patients. Predominant presenting symptoms were nausea (34%), vomiting (19%), and abdominal pain (23%). Women had more severe nausea, satiety, constipation and overall gastroparesis symptoms. Patients who experienced acute onset IG had worse nausea than those with insidious onset. Overweight patients had more bloating and gastric retention at 2 hours, but less severe loss of appetite. Patients with severely delayed gastric emptying had worse vomiting, more severe loss of appetite and overall gastroparesis symptoms. Severe anxiety and depression was present in 36% and 18%, respectively. 86% met criteria for functional dyspepsia, primarily postprandial distress syndrome. Conclusions IG is a disorder that primarily affects young women, beginning acutely in 50% of cases; unexpectedly, many patients are overweight. Severe delay in gastric emptying was associated with more severe symptoms of vomiting and loss of appetite. IG is a diverse syndrome that varies by sex, body mass, symptom onset, and delay in gastric emptying.

Electroacupuncture combined with mosapride alleviates symptoms in diabetic patients with gastroparesis

“…Therefore, the patients enrolled in the present study cannot be assumed to have delayed gastric half-emptying times. Previous studies have demonstrated an insignificant correlation between the gastric emptying rate and upper gastrointestinal symptom severity or symptom alleviation in patients with diabetes (29,30), and the gastric emptying rate is reportedly also affected by plasma glucose levels and gender (31). In the present study, no statistically significant difference was detected in terms of gastric emptying rate prior to and following EA mono-treatment in all patients, which may be due to the small sample size of the study and the aforementioned factors.…”

Immunotherapy Prospects for Painful Small-fiber Sensory Neuropathies and Ganglionopathies

“…The cardiovascular symptoms include not only orthostatic hypotension and tachycardia, but also impaired cognitive function, headache, and exercise intolerance due to circulatory insufficiency [72][73][74]. Gastrointestinal symptoms can be upper or lower, and reflect dysmotility and inadequate splanchnic circulation [75,76]. SFPN cannot be detected by electromyography or standard nerve conduction studies, so special tests are needed for objective confirmation of diagnosis.…”

Functional Dyspepsia

“…17 There is also overlap between symptoms of functional dyspepsia and those of gastroparesis. More than one in four patients with functional dyspepsia have evidence of delayed gastric emptying, 18 and in one study 86% of the patients with gastroparesis met the criteria for functional dyspepsia, 19 which suggests that these conditions share similar pathophysiological features; the degree of overlap of symptoms also means that the capacity of diagnostic tests such as gastric scintigraphy to discriminate between functional dyspepsia and gastroparesis is limited. 20 The usefulness of ultrasonography in detecting relevant organic pancreatobiliary disease in pa- tients with dyspepsia who have normal results on upper gastrointestinal endoscopy was less than 5% in one primary care-based study.…”