Gastroparesis natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Madhu Sigdel M.B.B.S.[2], Shaghayegh Habibi, M.D.[3]

Overview

The natural history of gastroparesis is largely unknown. Common complications include fluctuations in blood glucose due to unpredictable digestion times in diabetic patients, malnutrition, weight loss, malnutrition and vitamin and mineral deficiencies, Intestinal obstruction due to the formation of bezoars and bacterial infection due to overgrowth in undigested food. Postviral gastroparesis has a good prognosis while prognosis for diabetic gastroparesis is poor.

Natural History

  • The natural history of gastroparesis is largely unknown, especially there is minimal data on the natural history of diabetic gastroparesis.[1][2]
  • In the Olmsted County epidemiology study, of all the incident cases of gastroparesis, one third patients died and another one third required medications, hospitalization or tube feeding related to gastroparesis.[2]

Complications

Common complications of gastroparesis include:[3][4][5]

Prognosis

  • Prognosis of gastroparesis is uncertain even with appropriate treatment modalities, as majority of them seem to provide only temporary benefit.
  • The estimated 5-year survival for gastroparesis based on 'Gastroparesis study in Olmsted County', Minnesota from 1996 to 2006, was 67% with worse prognosis for diabetic gastroparesis.
  • Prognosis of diabetic gastroparesis mainly depends upon blood sugar level and duration of diabetes.[1][6]
  • Postviral gastroparesis has a good prognosis. 
  • The patients with autonomic dysfunction have slower resolution of their symptoms that may take several years and the prognosis is worse than in postviral gastroparesis without autonomic disorders.[7]

References

  1. 1.0 1.1 Jung HK, Choung RS, Locke GR, Schleck CD, Zinsmeister AR, Szarka LA, Mullan B, Talley NJ (2009). "The incidence, prevalence, and outcomes of patients with gastroparesis in Olmsted County, Minnesota, from 1996 to 2006". Gastroenterology. 136 (4): 1225–33. PMC 2705939Freely accessible. PMID 19249393. doi:10.1053/j.gastro.2008.12.047. 
  2. 2.0 2.1 Bharucha AE (2015). "Epidemiology and natural history of gastroparesis". Gastroenterol. Clin. North Am. 44 (1): 9–19. PMC 4323583Freely accessible. PMID 25667019. doi:10.1016/j.gtc.2014.11.002. 
  3. Feigenbaum K (2006). "Update on gastroparesis". Gastroenterol Nurs. 29 (3): 239–44; quiz 245–6. PMID 16770141. 
  4. Koch KL, Calles-Escandón J (2015). "Diabetic gastroparesis". Gastroenterol. Clin. North Am. 44 (1): 39–57. PMID 25667022. doi:10.1016/j.gtc.2014.11.005. 
  5. Parkman HP, Yates KP, Hasler WL, Nguyan L, Pasricha PJ, Snape WJ, Farrugia G, Calles J, Koch KL, Abell TL, McCallum RW, Petito D, Parrish CR, Duffy F, Lee L, Unalp-Arida A, Tonascia J, Hamilton F (2011). "Dietary intake and nutritional deficiencies in patients with diabetic or idiopathic gastroparesis". Gastroenterology. 141 (2): 486–98, 498.e1–7. PMID 21684286. doi:10.1053/j.gastro.2011.04.045. 
  6. Beyer HK, Uhlenbrock D, Anschütz HJ, Schlenkhoff D (1985). "[Value of nuclear magnetic resonance tomography in lung tumors]". Digitale Bilddiagn (in German). 5 (3): 129–34. PMID 2996823. 
  7. Tang DM, Friedenberg FK (2011). "Gastroparesis: approach, diagnostic evaluation, and management". Dis Mon. 57 (2): 74–101. PMID 21329779. doi:10.1016/j.disamonth.2010.12.007. 

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