Gastroparesis natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
The natural history of gastroparesis is largely unknown. Common complications include fluctuations in [[blood glucose]] due to unpredictable [[digestion]] times in [[Diabetes mellitus|diabetic]] patients, [[malnutrition]], [[weight loss]], [[malnutrition]] and [[vitamin]] and [[mineral]] deficiencies, [[Intestinal obstruction]] due to the formation of [[bezoar]]s and [[bacterial infection]] due to overgrowth in undigested food. Postviral gastroparesis has a good prognosis while prognosis for diabetic gastroparesis is poor. | |||
==Natural History== | ==Natural History== | ||
* The natural history of gastroparesis is largely unknown, especially there is minimal data on the natural history of diabetic gastroparesis.<ref name="pmid19249393">{{cite journal |vauthors=Jung HK, Choung RS, Locke GR, Schleck CD, Zinsmeister AR, Szarka LA, Mullan B, Talley NJ |title=The incidence, prevalence, and outcomes of patients with gastroparesis in Olmsted County, Minnesota, from 1996 to 2006 |journal=Gastroenterology |volume=136 |issue=4 |pages=1225–33 |year=2009 |pmid=19249393 |pmc=2705939 |doi=10.1053/j.gastro.2008.12.047 |url=}}</ref><ref name="pmid25667019">{{cite journal |vauthors=Bharucha AE |title=Epidemiology and natural history of gastroparesis |journal=Gastroenterol. Clin. North Am. |volume=44 |issue=1 |pages=9–19 |year=2015 |pmid=25667019 |pmc=4323583 |doi=10.1016/j.gtc.2014.11.002 |url=}}</ref> | * The natural history of gastroparesis is largely unknown, especially there is minimal data on the natural history of [[diabetic]] gastroparesis.<ref name="pmid19249393">{{cite journal |vauthors=Jung HK, Choung RS, Locke GR, Schleck CD, Zinsmeister AR, Szarka LA, Mullan B, Talley NJ |title=The incidence, prevalence, and outcomes of patients with gastroparesis in Olmsted County, Minnesota, from 1996 to 2006 |journal=Gastroenterology |volume=136 |issue=4 |pages=1225–33 |year=2009 |pmid=19249393 |pmc=2705939 |doi=10.1053/j.gastro.2008.12.047 |url=}}</ref><ref name="pmid25667019">{{cite journal |vauthors=Bharucha AE |title=Epidemiology and natural history of gastroparesis |journal=Gastroenterol. Clin. North Am. |volume=44 |issue=1 |pages=9–19 |year=2015 |pmid=25667019 |pmc=4323583 |doi=10.1016/j.gtc.2014.11.002 |url=}}</ref> | ||
* 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.<ref name="pmid25667019">{{cite journal |vauthors=Bharucha AE |title=Epidemiology and natural history of gastroparesis |journal=Gastroenterol. Clin. North Am. |volume=44 |issue=1 |pages=9–19 |year=2015 |pmid=25667019 |pmc=4323583 |doi=10.1016/j.gtc.2014.11.002 |url=}}</ref> | * 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.<ref name="pmid25667019">{{cite journal |vauthors=Bharucha AE |title=Epidemiology and natural history of gastroparesis |journal=Gastroenterol. Clin. North Am. |volume=44 |issue=1 |pages=9–19 |year=2015 |pmid=25667019 |pmc=4323583 |doi=10.1016/j.gtc.2014.11.002 |url=}}</ref> | ||
==Complications== | ==Complications== | ||
Common complications of gastroparesis include:<ref name="pmid16770141">{{cite journal |vauthors=Feigenbaum K |title=Update on gastroparesis |journal=Gastroenterol Nurs |volume=29 |issue=3 |pages=239–44; quiz 245–6 |year=2006 |pmid=16770141 |doi= |url=}}</ref><ref name="pmid25667022">{{cite journal |vauthors=Koch KL, Calles-Escandón J |title=Diabetic gastroparesis |journal=Gastroenterol. Clin. North Am. |volume=44 |issue=1 |pages=39–57 |year=2015 |pmid=25667022 |doi=10.1016/j.gtc.2014.11.005 |url=}}</ref><ref name="pmid21684286">{{cite journal |vauthors=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 |title=Dietary intake and nutritional deficiencies in patients with diabetic or idiopathic gastroparesis |journal=Gastroenterology |volume=141 |issue=2 |pages=486–98, 498.e1–7 |year=2011 |pmid=21684286 |doi=10.1053/j.gastro.2011.04.045 |url=}}</ref> | |||
* Fluctuations in [[blood glucose]] due to unpredictable digestion times | * Fluctuations in [[blood glucose]] levels and even [[ketoacidosis]] due to unpredictable digestion times especially in [[Diabetes mellitus|diabetic]] patients | ||
* | * [[Malnutrition]] | ||
* | * [[Weight loss]] | ||
* [[Intestinal obstruction]] due to the formation of [[bezoar]]s (solid masses of undigested food) | * [[Intestinal obstruction]] due to the formation of [[bezoar]]s (solid masses of undigested food) | ||
* [[Bacterial infection]] due to overgrowth in undigested food | * [[Bacterial infection]] due to overgrowth in undigested food | ||
* [[Dehydration]] | * [[Dehydration]] | ||
* [[Electrolyte]] | * [[Electrolyte imbalance|Electrolyte imbalances]] | ||
==Prognosis== | ==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. | |||
Postviral gastroparesis has a good prognosis. | * Prognosis of [[diabetic]] gastroparesis mainly depends upon [[blood sugar]] level and duration of [[diabetes]].<ref name="pmid19249393">{{cite journal| author=Jung HK, Choung RS, Locke GR, Schleck CD, Zinsmeister AR, Szarka LA et al.| title=The incidence, prevalence, and outcomes of patients with gastroparesis in Olmsted County, Minnesota, from 1996 to 2006. | journal=Gastroenterology | year= 2009 | volume= 136 | issue= 4 | pages= 1225-33 | pmid=19249393 | doi=10.1053/j.gastro.2008.12.047 | pmc=2705939 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19249393 }}</ref><ref name="pmid2996823">{{cite journal |vauthors=Beyer HK, Uhlenbrock D, Anschütz HJ, Schlenkhoff D |title=[Value of nuclear magnetic resonance tomography in lung tumors] |language=German |journal=Digitale Bilddiagn |volume=5 |issue=3 |pages=129–34 |year=1985 |pmid=2996823 |doi= |url=}}</ref> | ||
* 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 dysfunction|autonomic disorders]].<ref name="pmid21329779">{{cite journal |vauthors=Tang DM, Friedenberg FK |title=Gastroparesis: approach, diagnostic evaluation, and management |journal=Dis Mon |volume=57 |issue=2 |pages=74–101 |year=2011 |pmid=21329779 |doi=10.1016/j.disamonth.2010.12.007 |url=}}</ref> | |||
==References== | ==References== | ||
Latest revision as of 15:55, 20 February 2018
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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]
- Fluctuations in blood glucose levels and even ketoacidosis due to unpredictable digestion times especially in diabetic patients
- Malnutrition
- Weight loss
- Intestinal obstruction due to the formation of bezoars (solid masses of undigested food)
- Bacterial infection due to overgrowth in undigested food
- Dehydration
- Electrolyte imbalances
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
- ↑ 1.0 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. doi:10.1053/j.gastro.2008.12.047. PMC 2705939. PMID 19249393.
- ↑ 2.0 2.1 Bharucha AE (2015). "Epidemiology and natural history of gastroparesis". Gastroenterol. Clin. North Am. 44 (1): 9–19. doi:10.1016/j.gtc.2014.11.002. PMC 4323583. PMID 25667019.
- ↑ Feigenbaum K (2006). "Update on gastroparesis". Gastroenterol Nurs. 29 (3): 239–44, quiz 245–6. PMID 16770141.
- ↑ Koch KL, Calles-Escandón J (2015). "Diabetic gastroparesis". Gastroenterol. Clin. North Am. 44 (1): 39–57. doi:10.1016/j.gtc.2014.11.005. PMID 25667022.
- ↑ 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. doi:10.1053/j.gastro.2011.04.045. PMID 21684286.
- ↑ 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.
- ↑ Tang DM, Friedenberg FK (2011). "Gastroparesis: approach, diagnostic evaluation, and management". Dis Mon. 57 (2): 74–101. doi:10.1016/j.disamonth.2010.12.007. PMID 21329779.