Natural History of Patients with Gastroparesis

Gastroparesis is a syndrome characterized by delayed gastric emptying in the absence of mechanical obstruction of the stomach. The three most common etiologies of gastroparesis are diabetes, postsurgical, and idiopathic (i.e., of unknown cause). Symptoms associated with gastroparesis include nausea, vomiting, postprandial fullness, early satiety, bloating, and/or abdominal pain. Asymptomatic cases of delayed gastric emptying can be seen; particularly, in diabetic patients where difficult to control glucoses can be associated with the onset of delayed gastric emptying. The true prevalence of gastroparesis is difficult to estimate due to the relatively poor correlation of symptoms with gastric emptying and the need to apply a diagnostic test to diagnose this condition in a community setting. It is unclear if the majority of patients with gastroparesis seek health care or how often they are referred to gastroenterologists, and therefore the true prevalence of gastroparesis is not known. Community studies of the outcome of gastroparesis are few, and studies conducted in tertiary referral centers may not reflect findings encountered in the general population. Estimates for the prevalence of gastroparesis have been approximately 4%, based on the prevalence of functional dyspepsia in the community (20%) and the prevalence of delayed gastric emptying in patients with functional dyspepsia (20%). However, in a recent epidemiologic study of Olmsted County, Minnesota, the prevalence of gastroparesis was lower with the prevalence of definite gastroparesis (symptomatic individual with delayed gastric emptying) reported to be 9.6 per 100,000 for men and 37.8 per 100,000 for women.