Prevalence of hidden gastroparesis in the community: the gastroparesis "iceberg".
ABSTRACT The prevalence of diagnosed gastroparesis is 24.2/100,000 inhabitants, but a large group of people with gastroparesis-like symptoms have never had a gastric emptying (GE) test. Some of them may have undiagnosed gastroparesis. Our aim was to estimate the prevalence of hidden gastroparesis in the community.
The study was conducted in 2 parts: (1) Patients referred for a scintigraphic GE test completed a validated questionnaire (Bowel Disease Questionnaire). Multiple linear regression models to predict 2 hours and 4 hours GE rates were developed. (2) A revised Bowel Disease Questionnaire was mailed to a random sample of 4,194 Olmsted County residents. GE rates were estimated with the models for each subject and delayed GE was considered when they were lower than normal values. Hidden gastroparesis was defined in community subjects with predicted delayed GE that had not been diagnosed with gastroparesis prior to the survey.
The regression models for GE rates were constructed using data from 450 patients. In addition to age and gender, the symptoms found significant were nausea/vomiting, early satiety, upper abdominal pain, bloating, loss of appetite and weight loss more than 7 pounds. 2,298 (55%) community subjects returned a questionnaire. Five subjects were excluded due to a prior diagnosis of gastroparesis. When models were applied to the community survey data, 42 (1.8%) subjects were estimated to have delayed GE.
Delayed GE was estimated to occur in 1.8% of community subjects. Since the prevalence of diagnosed gastroparesis is low (0.02%), many subjects with gastroparesis may remain undiagnosed.
Article: Prevalence of gastrointestinal symptoms associated with diabetes mellitus: a population-based survey of 15,000 adults.[show abstract] [hide abstract]
ABSTRACT: Gastrointestinal symptoms are reportedly common in diabetes, but a causal link is controversial and adequate population control data are lacking. To determine whether gastrointestinal symptoms are more frequent in persons with diabetes, particularly in those with poor glycemic control. Fifteen thousand adults were mailed a questionnaire (response rate, 60.0%) containing validated questions on the frequency of troublesome gastrointestinal symptoms within the past 3 months, diabetic status, and self-reported glycemic control. The prevalence of 16 symptoms and 5 symptom complexes, reported to occur often or very often, was compared using logistic regression analysis, adjusting for age and sex. Overall, 8657 eligible subjects responded; 423 (4.9%) reported having diabetes. Most (94.8%) had type 2 diabetes mellitus. Adjusting for age and sex, all 16 symptoms and the 5 symptom complexes were significantly more frequent in subjects with diabetes compared with controls. An increased prevalence rate of symptoms was significantly associated with poorer levels of glycemic control but not with duration of diabetes or type of diabetic treatment. Diabetes mellitus is associated with an increased prevalence of upper and lower gastrointestinal symptoms. This effect may be linked to poor glycemic control but not to duration of diabetes or type of treatment.Archives of Internal Medicine 10/2001; 161(16):1989-96. · 11.46 Impact Factor
Article: American Gastroenterological Association technical review on the diagnosis and treatment of gastroparesis.[show abstract] [hide abstract]
ABSTRACT: This literature review and the recommendations herein were prepared for the American Gastroenterological Association Clinical Practice Committee. The paper was approved by the Committee on May 16, 2004, and by the AGA Governing Board on September 23, 2004.Gastroenterology 12/2004; 127(5):1592-622. · 11.68 Impact Factor
Article: Gastroparesis-related hospitalizations in the United States: trends, characteristics, and outcomes, 1995-2004.[show abstract] [hide abstract]
ABSTRACT: Gastroparesis is an increasingly recognized disorder. Its prevalence in the United States is unknown. We examined the trends, characteristics, and outcomes of gastroparesis-related hospitalizations during 1995-2004. The publicly available Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) comprises a nationally representative sample of 5-8 million hospitalizations per year. Gastroparesis-related hospitalizations were identified using the International Classification of Diseases (ICD-9) code 536.3 and compared with other hospitalizations. Multivariate regressions were used to compare for differences in the outcomes including length of stay, total charges, and in-hospital deaths. Hospitalizations with gastroparesis as the primary diagnosis increased from 3,977 in 1995 to 10,252 in 2004 (+158%) and hospitalizations with gastroparesis as the secondary diagnosis increased from 56,726 to 134,146 (+136%). These compared to smaller changes in diabetes-related hospitalizations (+53%), all hospitalizations (+13%), and hospitalizations with gastroesophageal reflux disease (GERD), gastric ulcer, gastritis, or nonspecific nausea/vomiting as the primary diagnosis (-3% to +76%). Of the five upper gastrointestinal conditions studied as the primary diagnosis, gastroparesis had the longest length of stay (+15.4% to +66.2%, all P < 0.001) and the highest or second highest total charges (-7.2% to +60.6%, all P < 0.01) in 2004, with similar results in 1995. The number of gastroparesis-related hospitalizations has been increasing in the United States, suggesting an increasing prevalence of gastroparesis. The economic impact of gastroparesis-related hospitalizations is significant and increasing.The American Journal of Gastroenterology 03/2008; 103(2):313-22. · 7.28 Impact Factor