Atypical causes of gastroparesis seen in patients with delayed gastric emptying

Atypical causes of gastroparesis are present in some patients with delayed gastric emptying, a recent study has found. Moreover, patients with postsurgical or connective tissue gastroparesis experience significantly more delayed gastric emptying.

Postsurgical patients report having stomach fullness and early satiety, while those with connective tissue gastroparesis experience bloating and distension.

This study was conducted from 2018 and 2021 in gastroparesis patients being evaluated at a tertiary care centre. Participants completed a 4-hour gastric emptying scintigraphy and questionnaires assessing for gastrointestinal disorders, including patient assessment of upper gastrointestinal symptoms.

The investigators divided the patients into groups according to gastroparesis causes: diabetic, postsurgical, connective tissue, neurological, and idiopathic.

A total of 256 patients with delayed emptying on gastric emptying scintigraphy completed the questionnaires. Causes of gastroparesis included 149 (58.2 percent) idiopathic, 60 (23.4 percent) diabetic, 29 (11.3 percent) postsurgical, 13 (5.1 percent) connective tissue, and five (2.0 percent) neurological. Majority of the patients were female and White.

Significantly greater gastric retention at 4 hours was observed in patients with diabetic (39.3 percent; p<0.001), postsurgical (41.3 percent; p=0.002), and connective tissue gastroparesis (37.8 percent; p=0.049) compared with those with idiopathic causes (25.5 percent).

In patients with postsurgical, diabetic, and idiopathic causes, early satiety and postprandial fullness were the most common symptoms. In those with connective tissue gastroparesis, the predominant symptoms were bloating and abdominal distension. Additionally, patients with diabetes experienced more severe vomiting than those with idiopathic gastroparesis (2.9 vs 2.1; p=0.006).