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Predictors of gastroparesis in out-patients with secondary and idiopathic upper gastrointestinal symptoms
V Stanghellini1, C Tosetti, M Horowitz
1Department of Internal Medicine, University of Bologna, St. Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy. vstang@med.unibo.it
Background:
Delayed gastric emptying occurs frequently in patients with upper gastrointestinal symptoms associated with functional or organic diseases.
Aims:
To evaluate whether: (i) the prevalence of delayed gastric emptying is influenced by the presence of organic disease; (ii) demographic or clinical factors predict modestly or markedly (gastroparesis) delayed emptying.
Patients:
A total of 327 consecutive out-patients with upper gastrointestinal symptoms.
Methods:
Routine diagnostic work-up and evaluation of demographic factors, gastrointestinal symptom evaluation and scintigraphic gastric emptying of solids were performed.
Results:
Organic diseases were detected in 227/327 (65%) patients: 33% had delayed emptying and 20% gastroparesis. Female gender (OR: 2.1; 95% C.I.: 1.3-3.4). overweight (0.5; 0.3-0.9), relevant postprandial fullness (1.8; 1.1-3.2) and relevant epigastric bloating (1.8; 1.1-2.9), but not the presence of organic diseases, were associated with delayed emptying. Female gender (3.9; 1.3-11.9) and relevant postprandial fullness (4.1; 1.7-10.2) were associated with gastroparesis.
Conclusions:
(i) There is a high prevalence of delayed gastric emptying and gastroparesis in out-patients with upper gastrointestinal symptoms, which is not influenced by the presence of organic disease; (ii) female gender, low body weight, relevant fullness and bloating are associated with delayed emptying; female gender and relevant postprandial fullness predict gastroparesis.
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