Department of Internal Medicine, Temple University Hospital.
Section of Gastroenterology, Department of Medicine, Temple University School of Medicine, Philadelphia, PA.
J Clin Gastroenterol. 2023 Oct 1;57(9):895-900. doi: 10.1097/MCG.0000000000001786.
Gastroparesis is commonly attributed to idiopathic or diabetic causes.
We aimed to describe atypical causes of gastroparesis and examine the clinical features and severity of delayed gastric emptying compared with idiopathic and diabetic causes.
Between 2018 and 2021, gastroparesis patients being evaluated at our tertiary care center completed a 4-hour gastric emptying scintigraphy and questionnaires assessing for gastrointestinal disorders, including patient assessment of upper gastrointestinal symptoms. Patients were divided into groups relating to gastroparesis cause: diabetic, postsurgical (PSGp), connective tissue (CTGp), neurological and idiopathic.
Two hundred fifty-six patients with delayed emptying on gastric emptying scintigraphy completed the questionnaires. Gastroparesis causes included 149 (58.2%) idiopathic, 60 (23.4%) diabetic, 29 (11.3%) postsurgical, 13 (5.1%) connective tissue, and 5 (2.0%) neurological. In each group, most patients were female and White. Gastric retention at 4 hours was significantly greater in patients with diabetic (39.3±25.7% P <0.001), postsurgical (41.3±24.0% P =0.002), and connective tissue gastroparesis (37.8±20.0% P =0.049) compared with patients with idiopathic gastroparesis (25.5±17.6%). In PSGp, diabetic and idiopathic causes, the main symptoms were early satiety and postprandial fullness, whereas in CTGp, bloating and abdominal distension were the predominant symptoms. Vomiting severity was significantly greater in patients with diabetes compared with idiopathic gastroparesis (2.9±1.9 vs. 2.1±1.8 P =0.006).
Atypical causes contributed to gastroparesis in 47 of 256 (18.4%) patients with delayed gastric emptying. Gastric emptying was significantly more delayed in PSGp and CTGp patients. PSGp patients mainly experienced stomach fullness and early satiety, whereas CTGp patients had predominantly bloating and distension.
胃轻瘫通常归因于特发性或糖尿病原因。
我们旨在描述胃轻瘫的非典型原因，并检查与特发性和糖尿病原因相比，延迟胃排空的临床特征和严重程度。
在 2018 年至 2021 年间，在我们的三级保健中心接受评估的胃轻瘫患者完成了 4 小时胃排空闪烁扫描，并完成了评估胃肠道疾病的问卷，包括患者对上消化道症状的评估。患者根据胃轻瘫的病因分为以下几组：糖尿病、手术后（PSGp）、结缔组织（CTGp）、神经和特发性。
256 例胃排空闪烁扫描显示排空延迟的患者完成了问卷。胃轻瘫的病因包括 149 例（58.2%）特发性、60 例（23.4%）糖尿病、29 例（11.3%）手术后、13 例（5.1%）结缔组织和 5 例（2.0%）神经。在每个组中，大多数患者为女性和白人。糖尿病（39.3±25.7%，P<0.001）、手术后（41.3±24.0%，P=0.002）和结缔组织性胃轻瘫（37.8±20.0%，P=0.049）患者的胃潴留显著大于特发性胃轻瘫患者（25.5±17.6%）。在 PSGp 中，糖尿病和特发性病因的主要症状是早饱和餐后饱胀，而在 CTGp 中，腹胀和腹部膨隆是主要症状。与特发性胃轻瘫相比，糖尿病患者的呕吐严重程度显著更高（2.9±1.9 vs. 2.1±1.8，P=0.006）。
在 256 例延迟胃排空的患者中，47 例（18.4%）为非典型病因。PSGp 和 CTGp 患者的胃排空明显延迟。PSGp 患者主要经历胃部饱胀和早饱，而 CTGp 患者主要出现腹胀和腹部膨隆。
