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Demography, Clinical Characteristics, Psychological and Abuse Profiles, Treatment, and Long-Term Follow-up of Patients with Gastroparesis

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Abstract

Patients with gastroparesis frequently presentchallenging clinical, diagnostic, and therapeuticproblems. Data from 146 gastroparesis patients seen oversix years were analyzed. Patients were evaluated at the time of initial diagnosis and at themost recent follow-up in terms of gastric emptying andgastrointestinal symptomatology. The psychologicalstatus and physical and sexual abuse history in female idiopathic gastroparesis patients wereascertained and an association between those factors andgastrointestinal symptomatology was sought. Eightytwopercent of patients were females (mean age: 45 years old). The mean age for onset of gastroparesiswas 33.7 years. The etiologies in 146 patients are: 36%idiopathic, 29% diabetic, 13% postgastric surgery, 7.5%Parkinson's disease, 4.8% collagen vascular disorders, 4.1% intestinal pseudoobstruction,and 6% miscellaneous causes. Subgroups were identifiedwithin the idiopathic group: 12 patients (23%) had apresentation consistent with a viral etiology, 48% had very prominent abdominal pain. Othersubgroups were gastroesophageal reflux disease andnonulcer dyspepsia (19%), depression (23%), and onset ofsymptoms immediately after cholecystectomy (8%).Sixty-two percent of women with idiopathic gastroparesisreported a history of physical or sexual abuse, andphysical abuse was significantly associated withabdominal pain, somatization, depression, and lifetime surgeries. At the end of the follow-up period,74% required continuous prokinetic therapy, 22% wereable to stop prokinetics, 5% had undergone gastrectomy,6.2% went onto gastric electrical stimulation (pacing), and 7% had died. At some point 21%had required nutrition support with a feedingjejunostomy tube or periods of parenteral nutrition. Agood response to pharmacological agents can be expected in the viral and dyspeptic subgroups ofidiopathics, Parkinson's disease, and the majority ofdiabetics, whereas a poorer outcome to prokinetics canbe expected in postgastrectomy patients, those withconnective tissue disease, a subgroup of diabetics, andthe subset of idiopathic gastroparesis dominated byabdominal pain and history of physical and sexual abuse.Appreciation of the different etiologies andpsychological status of the patients may help predictresponse to prokinetic therapy.

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REFERENCES

  1. Malagelada J-R, Stanghelini V: Manometric evaluation of functional upper gut symptoms. Gastroenterology 88:1273- 1281, 1985

    Google Scholar 

  2. Minami H, McCallum RW: The physiology and pathophysiology of gastric emptying in humans. Gastroenterology 86:1592- 1610, 1984

    PubMed  Google Scholar 

  3. Abell TL, Malagelada J-R: Electrogastrography—current assessment and future perspectives. Dig Dis Sci 33:982-992, 1988

    PubMed  Google Scholar 

  4. Kendall BJ, McCallum RW: Gastroparesis and the current use of prokinetic drugs. Gastroenterologist 1:107-114, 1993

    PubMed  Google Scholar 

  5. McCallum RW: Motor function of the stomach in health and disease. InGastrointestinal Disease—Pathophysiology, Diagnosis and Management. MH Sleisinger and JS Fordtran (eds). Philadelphia, WB Saunders Co., 1989, pp 675-713

    Google Scholar 

  6. McCallum RW, Grill BB, Lange R, Planky M, Glass EE, Greenfield DG: Definition of a gastric emptying abnormality in patients with anorexia nervosa. Dig Dis Sci 30:713-722, 1985

    PubMed  Google Scholar 

  7. Soykan I, Sarosiek I, McCallum RW: The effect of chronic oral domperidone therapy on gastrointestinal symptoms, gastric emptying and quality of life in patients with gastroparesis. Am J Gastroenterol 92:976-980, 1997

    PubMed  Google Scholar 

  8. Butler RW, Satz P: Personality assessment of adults and children. InComprehensive Textbook of Psychiatry/VI. HI Kaplan, BJ Sadock (eds). Baltimore, Williams & Wilkins, 1995, pp 544-562

    Google Scholar 

  9. Canadian National Survey, Committee on Sexual Offenses Against Children and Youth: Sexual Offenses Against Children. Ottawa, Canadian Government Publishing Centre, 1984

    Google Scholar 

  10. Derogatis LR: SCL-90-R Administration, Scoring and Procedures. Manual II for the revised version. Towson, Maryland, Clinical Psychometric Research, 1983

    Google Scholar 

  11. Weber FH, McCallum RW: Gastric motor disorders. InConsultations in Gastroenterology. WJ Snape (ed). WB Saunders Co., Philadelphia, 1996, pp 247-259

    Google Scholar 

  12. Balaban DH, Chen J, Lin Z, Tribble CG, McCallum RW: Median arcuate ligament syndrome: A possible cause of idiopathic gastroparesis. Am J Gastroenterol 92:519-523, 1997

    PubMed  Google Scholar 

  13. Caras S, Laurie S, Cronk W, Tompkins W, Brashear R, McCallum RW: Pancreatic cancer presenting with paraneoplastic gastroparesis. Am J Med Sci 312:34-36, 1996

    PubMed  Google Scholar 

  14. Valenzuela G, Weber FH, Nance W, McCallum RW: Waardenburg syndrome and gastricstasis in adults. Va Med Q 122:279-280, 1995

    PubMed  Google Scholar 

  15. McCallum RW, Chen JDZ, Lin ZY, Schirmer BD, Williams RD, Ross R: Gastric pacing improves emptying and symptoms in patients with gastroparesis. Gastroenterology 114:456-461, 1998

    PubMed  Google Scholar 

  16. Hotokezaka M, Adams RB, Miller AD, McCallum RW, Schirmer BD: Laparoscopic percutaneous jejunostomy for long termenteral access. Surg Endosc 10:1008-1011, 1996

    Article  PubMed  Google Scholar 

  17. Oh JJ, Kim CH: Gastroparesis after a presumed viral illness: Clinical and laboratory features and natural history. Mayo Clin Proc 65:636-642, 1990

    PubMed  Google Scholar 

  18. Drossman DA, Leserman J, Nachman G, Li Z, Gluck H, Toomey TC, Mitchell CM: Sexual and physical abuse in women with functional or organic gastrointestinal disorders. Ann Intern Med 113:828-833, 1990

    PubMed  Google Scholar 

  19. Leserman J, Drossman DA, Li Z, Toomey TC, Nachman G, Glogau L: Sexual and physical abuse history in gastroente rology practice: How types of abuse impact health status. Psychosom Med 58:4-15, 1996

    PubMed  Google Scholar 

  20. McCallum RW, Berkowitz DM, Lerner E: Gastric emptying in patients with gastroesophageal reflux. Gastroenterology 80:285-291, 1981

    PubMed  Google Scholar 

  21. Klauser AG, Voderholzer WA, Knesewitsch PA, Schindlbeck NE, Muller-Lissner SA: What is behind dyspepsia? Dig Dis Sci 38:147-154, 1993

    PubMed  Google Scholar 

  22. Ibrarullah M, Mittal BR, Agarwal DK, Das BK, Kaushik SP: Gastric emptying in patients with gallstone disease with or without dyspepsia: Effect of cholecystectomy. Aust NZ J Surg 64:247-250, 1994

    Google Scholar 

  23. McCallum RW, Valenzuela G, Polepalle S, Spyker D: Subcutaneous metoclopramide in the treatment of symptomatic gastroparesis: Clinical efficacy and pharmacokinetics. J Pharmacol Exp Ther 258:136-142, 1991

    PubMed  Google Scholar 

  24. Kendall BJ, Chakravarti A, Kendall E, Soykan I, McCallum RW: The effect of intravenous erythromycin on solid meal gastric emptying in patients with chronic symptomatic postvagotomy -antrectomy gastroparesis. Aliment Pharmacol Ther 11:381-385, 1997

    Article  PubMed  Google Scholar 

  25. McCallum RW, Polepalle SC, Schirmer B: Completion gastrectomy for refractory gastroparesis following surgery for peptic ulcer disease—long-term follow-up with subjective and objective parameters. Dig Dis Sci 36:1556-1561, 1991

    PubMed  Google Scholar 

  26. Soykan I, Sarosiek I, Schifflett J, Wooten GF, McCallum RW: The effect of chronic oral domperidone therapy on gastrointestinal symptoms and gastric emptying in patients with Parkinson's disease. Mov Disord 12:952-957, 1997

    PubMed  Google Scholar 

  27. Silvers D, Kipnes M, Broadstone V, Patterson D, Quigley EM, McCallum R, Leidy NK, Farup C, Liu Y, Joslyn A, DOMUSA-5 Study Group: Domperidone in the management of symptoms of diabetic gastroparesis: Efficacy, tolerability, and quality-of-life outcomes in a multicenter controlled trial. Clin Ther 20(3):438-453, 1998

    Article  PubMed  Google Scholar 

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Soykan, I., Sivri, B., Sarosiek, I. et al. Demography, Clinical Characteristics, Psychological and Abuse Profiles, Treatment, and Long-Term Follow-up of Patients with Gastroparesis. Dig Dis Sci 43, 2398–2404 (1998). https://doi.org/10.1023/A:1026665728213

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