Gastroenterology

Gastroenterology

Volume 140, Issue 1, January 2011, Pages 101-115.e10
Gastroenterology

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

https://doi.org/10.1053/j.gastro.2010.10.015Get rights and content

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 National Institute of Diabetes and Digestive and Kidney Diseases 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 patients with IG 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%), an 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 and more severe loss of appetite and overall gastroparesis symptoms. Severe anxiety and depression were present in 36% and 18%, respectively. A total of 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.

Section snippets

Patients and Methods

The NIDDK Gastroparesis Clinical Research Consortium is a cooperative network of 7 clinical centers and one data coordinating center. The gastroparesis registry was implemented as an observational study of patients with gastroparesis (ClinicalTrials.gov identifier: NCT00398801). The registry consists of patients meeting specific entry criteria with symptoms of at least 12 weeks' duration, delayed gastric emptying on scintigraphy, and no abnormality causing obstruction on upper endoscopy.

Demographic Information

A total of 243 patients with IG were enrolled in the NIDDK registry at the time of data analysis (March 15, 2010). This represented 61% of the total number of patients with delayed gastric emptying enrolled (243 idiopathic, 131 diabetic, 27 other causes). Of the 243 patients with IG, 214 (88%) were female and 218 (90%) were white (Table 1). At the time of enrollment, the mean age was 41 ± 14 years; 30% were 30 years of age or younger. Mean body mass index (BMI) was 25.6 ± 6.9 kg/m2, with 8%

Discussion

This study highlights the clinical and physiologic features of patients with IG. The 243 patients in this multicenter report comprise the largest series of patients with IG. The study confirms that IG is a disease that particularly affects young women. Half of cases presented acutely, often in association with an initial infectious-like prodrome. The predominant symptom prompting evaluation was nausea in 34%, vomiting in 19%, and abdominal pain in 23%. Although the majority of patients were

Acknowledgments

Members of the Gastroparesis Clinical Research Consortium are listed in Supplementary Table 1.

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    Conflicts of interest The authors disclose no conflicts.

    Funding The Gastroparesis Clinical Research Consortium is supported by National Institute of Diabetes and Digestive and Kidney Diseases grants U01DK073983, U01DK073975, U01DK073985, U01DK074007, U01DK073974, and U01DK074008.

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