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

Gastroenterology Section, Temple University, Philadelphia, Pennsylvania 19140, USA.
Gastroenterology (Impact Factor: 16.72). 10/2010; 140(1):101-15. DOI: 10.1053/j.gastro.2010.10.015
Source: PubMed


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.
Data from medical histories, symptom questionnaires, and 4-hour gastric emptying scintigraphy studies were obtained from patients with IG.
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.
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.

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    • "In line with this complex pathophysiology, the association between upper GI symptoms and gastric emptying is modest. Conversely, gastric emptying rate cannot explain the range of upper GI symptoms experienced, neither in DM patients nor in the case of idiopathic gastroparesis [11] [12] [13] [14]. Until now, the majority of studies in this field have focused on diabetes complications of the upper GI tract. "
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    • "In our study, regardless of the GNB3 genotype, females showed higher prevalence of FD than males after 5 years. It is well known that women have more severe nausea, satiety, constipation, and overall gastroparesis symptoms than men.30 Another study confirmed that prolonged gastric emptying in patients with FD is related to the female gender, while the abnormalities of the meal intragastric distribution appear to occur in dyspeptic males and females.31 "
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    • "acute fluctuations) glucose control, use of incretin-based medications, and psychosomatic factors [1]. Females generally have a slower solid and liquid GER than males [8-10]. The underlying mechanism for this phenomenon is not fully understood and may be related to estrogen levels. "
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