Gastroparesias: revisão de aspectos relacionados ao conceito, à etiopatogenia e ao manejo clínico

Troncon, Luiz Ernesto de Almeida

doi:10.1590/s0104-42301997000300011

Cited by 5 publications

(10 citation statements)

References 14 publications

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“…The delay in gastric emptying was classified as severe or very severe in seven (58.3%) cases. manifestations of its complications, such as severe forms of reflux esophagitis, the erratic absorption of drugs and the difficulty of metabolic control in diabetic patients (25,27) , which make estimation of incidence and prevalence more difficult.…”

Section: Characteristics Of Patients With Idiopathic Gastroparesismentioning

confidence: 99%

“…Occasional differences in the relative proportions of each of these groups are likely to be due to either referral bias or differences regarding prevalence of the underlying conditions in the populations from which the cases came from. This kind of influence can be exemplified by comparing the current and previous series (25) from the same center. In the former series, post-surgical cases accounted for less than 20% of the total and consisted mainly of patients who had underwent antrectomy for peptic ulcer diseases, whereas post-surgical gastroparesis in the patients herein presented corresponded to 29.3% and comprised many more patients submitted to fundoplication for the treatment of gastroesophageal reflux disease than those who had antrectomy (Table 2).…”

Section: Characteristics Of Patients With Idiopathic Gastroparesismentioning

confidence: 99%

“…Regarding etiology, gastroparesis is often associated with diabetes mellitus and post-surgical conditions, but, in substantial number of cases, etiology is not apparent and no underlying medical condition can be disclosed, thus comprising the so-called idiopathic gastroparesis (4,14) . In a previous review based on a large series of Brazilian patients, nearly 35% of the cases were of idiopathic gastroparesis (25) . Nowadays, there is a variety of non-invasive methods for gastric emptying assessment, including non-invasive breath tests employing a variety of substrates, ultrasonography, magnetic resonance imaging and scintigraphy (10) .…”

Section: Introductionmentioning

confidence: 99%

“…This study aimed at describing the local series of Brazilian patients with gastroparesis, in relation to a previous one, which stimulated a review on the subject published elsewhere (25) , focusing on the demographic, clinical, and etiological characteristics, as well as the severity of the delay in gastric emptying. It was also intended to detail the characteristics of patients who, after extensive clinical investigation, no presumed etiology was found, which allowed diagnosing them as idiopathic gastroparesis.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Features and Severity of Gastric Emptying Delay in Brazilian Patients With Gastroparesis

Borges

Secaf

Troncon

2013

Arq. Gastroenterol.

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-Context -Gastroparesis is defined by delayed gastric emptying without mechanical obstruction of the gastroduodenal junction, which has been increasingly investigated. Nevertheless, knowledge on the relationships between etiology, symptoms and degree of delayed gastric emptying is limited. Objectives -The demographic, clinical and etiological features of Brazilian patients with gastroparesis were studied and the relationships between these findings and the severity of gastric emptying were determined.Method -This is a retrospective study of medical records of 41 patients with symptoms suggestive of gastroparesis admitted between 1998 and 2011, who had evidence of abnormally delayed gastric emptying on abdominal scintigraphy. Cases with idiopathic gastroparesis were compared with those of patients with neurologic disorders or diabetes mellitus, in whom autonomic neuropathy is likely to occur. Results -The majority of the patients were women (75.6%) with a median age of 41 years and a long-term condition (median: 15 years). Twelve patients (29.3%) had a body mass index of less than 20 kg/m 2 . The most common presenting symptoms were dyspepsia (53.6%), nausea and vomiting (46.3%), weight loss (41.4%) and abdominal pain (24.3%). Regarding etiology, 16 patients had digestive disorders including idiopathic gastroparesis (n = 12), 12 had postoperative conditions, 11 had diseases of the nervous system, five had diabetes mellitus and in three cases gastroparesis was associated to a variety of conditions. In the majority of patients (65.8%) gastric emptying was severely delayed. There was no association between etiology of gastroparesis, type of presenting symptoms and the degree of delay in gastric emptying. Gastroparesis patients with proven (neurological conditions) or presumed (diabetes) nervous system involvements were significantly younger (P = 0.001), had more recent symptom onset (P = 0:03) and a trend towards more severe gastric empty (P = 0:06). There were no significant differences between this subgroup of patients and that comprising cases of idiopathic gastroparesis regarding any of the variables studied. Conclusions -The demographic, clinical and etiological characteristics of Brazilian patients with gastroparesis are quite varied, but there is a predominance of women with long-standing symptoms and marked delay in gastric emptying. The type of presenting symptoms and the degree of delay in gastric emptying do not predict the etiology of gastroparesis. However, severely delayed gastric emptying in younger patients with recent symptom onset should raise the suspicion of impaired neural control of gastro-duodenal motility. HEADINGS -Gastroparesis. Digestive signs and symptoms. Neuropathies. Diabetes mellitus.

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Section: Characteristics Of Patients With Idiopathic Gastroparesismentioning

confidence: 99%

Section: Characteristics Of Patients With Idiopathic Gastroparesismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Features and Severity of Gastric Emptying Delay in Brazilian Patients With Gastroparesis

Borges

Secaf

Troncon

2013

Arq. Gastroenterol.

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“…Recomenda-se que esse volume seja mensurado, antes de cada dieta, quando o método for intermitente e, a cada 4 horas, para o método contínuo, pois o acúmulo do conteúdo gástrico pode induzir a vômito e aspiração pulmonar (15) . Outros sinais de alto VRG são distensão abdominal, náusea e ausência de ruídos hidroaéreos (49) .…”

Section: Volume Residual Gástricounclassified

Complicações da Terapia Nutricional Enteral (TNE) e fatores associados em pacientes hospitalizados

Figueredo¹

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This observational and retrospective study aimed to describe the profile of patients and the characteristics of the Enteral Nutrition Therapy (ENT), as well as to analyze the complications of this therapy and the associated factors in hospitalized adult patients. The study consisted of a sample of 214 patients, hospitalized between 2008 and 2009 at a university hospital in the city of São Paulo. Data were collected from medical records and of nutritional assessment sheets, using a form developed for the study. Results showed that: 1 a-) in relation to patient profiles and enteral nutrition therapyparticipants were predominantly male (55.6%), with an average age of 64.8 years, hospitalized in semi-intensive and intensive care units (66.8%); b-) Concerning enteral nutrition therapy, the average days of enteral nutrition was 13.2 days, and 43.5% of the patients received it for up to one week. As for the route of enteral access, nasoenteric feeding tube (96.3%) and continuous feeding administration (67.3%) were the most common. 2-) regarding the complications of ENT and the observed events-of the 214 patients of the sample, 200 had complications during the use of enteral nutrition. There was occurrence of gastrointestinal (90.5%), metabolic (55.0%), mechanical (41.5%) and pulmonary (13.0%) complications. The most frequently observed events among gastrointestinal complication were: abdominal distention (33.4%), constipation (17.5%) and high gastric residual volume (GRV) (14.6%). Among the metabolic complication, hyperglycemia (55.0%) was observed, with average of 174.2 mg/dL. The predominant events resulting from mechanical complication were unexpected withdrawal of enteral feeding tube (70.5%), followed by obstruction of enteral feeding tube (19.0%). As for pulmonary complication, pulmonary aspiration (13.0%) was the observed event. 5-) Concerning the method of infusion, there was significant association of continuous infusion with the following events observed in gastrointestinal complication: high GRV (p=0.000), constipation (p=0.010) and abdominal distension (p=0.037). Among the mechanical complication, there was significant association with intermittent infusion at the following events: unexpected withdrawal of enteral feeding tube (p=0.005) and displacement of enteral feeding tube (p=0.040). 6-) Regarding drug therapy, there was significant association of metabolic complication (hyperglycemia) and use of sedatives/opioids (p=0.000) and vasoactive drugs (p=0.000). This study evidenced that complications concomitant with ENT are very prevalent in this population (93.5%). Moreover, it was found that there is a high occurrence of observed events (617), with complications (400) presenting significant intersections with other variables described above. Therefore, research on the clinical conditions, treatments and care to the use of enteral feeding tubes should be constantly indicated, particularly for nurses who are responsible for the administration and monitoring of enteral nutrition.

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Evaluation of gastric emptying by means of scintigra-phy using different test meals

Ojeda

Quintão²,

Marino³

et al. 2019

Braz. J. Rad. Sci.

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Gastroparesis is a disorder characterized by symptoms and evidence of delayed gastric emptying (GE) in the absence of mechanical obstruction. Scintigraphy has been considered a "gold standard" for measuring Gastric Emptying Time (GET) and retention percentage of radio-labeled food, after four hours of ingestion. To obtain the images, it is recommended, worldwide, the use of the Tougas diet (255 kcal) as a standard meal. The objective of this study was to compare the GET and the percentage of retention in the time of 4 h, obtained by scintigraphy using the Tougas diet (255 kcal) and the proposed diet (319 kcal). Thirty patients, both genders, aged 23 to 76 years, were selected, they presenting clinical symptoms suggestive of gastroparesis. These parameters were measured for the same patient, but in different days. The results showed that the diet fat content used to obtain GE of solid foods by scintigraphy did not influence the retention percentage results after 4 hours of ingestion of the radiolabeled food. However, the time of two hours is an important parameter to be observed in the result of this examination. In addition, the data suggest that the proposed diet may be more efficient for the classification of the severity of GE delay in patients with clinical signs suggestive of gastroparesis.

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Gastroparesias: revisão de aspectos relacionados ao conceito, à etiopatogenia e ao manejo clínico

Cited by 5 publications

References 14 publications

Clinical Features and Severity of Gastric Emptying Delay in Brazilian Patients With Gastroparesis

Clinical Features and Severity of Gastric Emptying Delay in Brazilian Patients With Gastroparesis

Complicações da Terapia Nutricional Enteral (TNE) e fatores associados em pacientes hospitalizados

Evaluation of gastric emptying by means of scintigra-phy using different test meals

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