Parkman H P, Schwartz S S
Arch Intern Med. 1987 Aug;147(8):1477-80.
The prevalence of associated gastrointestinal disorders with diabetic gastroparesis was studied retrospectively by reviewing all data on patients with diabetic gastroparesis who were admitted to the Hospital of the University of Pennsylvania, Philadelphia, over a four-year period. Twenty diabetic patients with intractable nausea and vomiting, thought to be secondary to diabetic gastroparesis, underwent upper gastrointestinal tract endoscopy after failure to respond to conventional therapy for gastroparesis within several days. Nine (45%) patients had normal upper endoscopic examination results. Eleven (55%) patients were discovered to have other gastrointestinal tract disorders that could explain their persistent symptoms of nausea and vomiting. Specifically, three patients had Candida esophagitis, four had erosive esophagitis, two had gastric ulcers, one had duodenal erosions, and one had bile reflux gastritis. These 11 patients improved when therapy was altered to treat their additional disorder. Management of diabetic gastroparesis is discussed with emphasis on early upper gastrointestinal tract endoscopy for patients who fail to respond to therapy initially.
通过回顾在四年期间入住费城宾夕法尼亚大学医院的糖尿病胃轻瘫患者的所有数据，对糖尿病胃轻瘫相关胃肠道疾病的患病率进行了回顾性研究。20例患有顽固性恶心和呕吐的糖尿病患者，被认为继发于糖尿病胃轻瘫，在对胃轻瘫的常规治疗数天内无反应后，接受了上消化道内镜检查。9例（45%）患者上消化道内镜检查结果正常。11例（55%）患者被发现患有其他胃肠道疾病，这些疾病可以解释他们持续的恶心和呕吐症状。具体而言，3例患者患有念珠菌食管炎，4例患有糜烂性食管炎，2例患有胃溃疡，1例患有十二指肠糜烂，1例患有胆汁反流性胃炎。当改变治疗方法以治疗其额外疾病时，这11例患者病情有所改善。讨论了糖尿病胃轻瘫的管理，重点是对初始治疗无反应的患者进行早期上消化道内镜检查。
