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
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
Primary complications of gastroparesis include:[3]
- Fluctuations in blood glucose due to unpredictable digestion times (in diabetic patients)
- General malnutrition due to the symptoms of the disease (which frequently include vomiting and reduced appetite) as well as the dietary changes necessary to manage it
- Severe fatigue and weight loss due to calorie deficit
- 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
Many treatments seem to provide only temporary benefit. The estimated 5-year survival for gastroparesis based on Gastroparesis study in Olmsted County, MN, as of January 1, 2007 was 67% with worse prognosis for diabetic gastroparesis.[1] Prognosis of diabetic gastroparesis mainly depends upon blood sugar level and duration of diabetes.
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.
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.
- ↑ 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.