Clinical Predictors of Rapid Gastric Emptying in Patients Presenting with Dyspeptic Symptoms

Cifuentes, Juan D. Gomez; Radetic, Mark; López, Rocío; Gabbard, Scott

doi:10.1007/s10620-019-05620-8

Cited by 16 publications

(13 citation statements)

References 43 publications

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“…Nearly, two‐thirds of patients with rapid GE had one or more extra‐intestinal complication of DM. Reaffirming earlier observations, in this study (a) weight loss was associated with a lower risk of rapid versus normal GE, (b) the phenotype (ie, type of DM, prevalence of complications) did not discriminate between patients with normal and rapid GE, and (c) insulin therapy was associated with a lower risk of rapid (versus normal GE) . Insulin reverses the reduced expression of neuronal nitric oxide synthase (nNOS), which should improve gastric accommodation and gastric emptying, in diabetic mice .…”

Section: Discussionsupporting

confidence: 81%

“…In this large cohort of 2798 patients, 8% had rapid GE. Although we used more stringent criteria to define rapid GE and excluded patients who had prior gastric surgery, this proportion is comparable to the prevalence (ie, 10% of 750 patients, 9% of 545 patients, and 9% of 2907 patients) in earlier reports that included patients who had gastric surgery . In another study, 28% of 642 patients undergoing scintigraphy had rapid GE, perhaps because a less stringent criterion was used to define rapid GE (ie, gastric half‐emptying time less than 70 minutes) …”

Section: Discussionmentioning

confidence: 67%

“…Initially described in patients with dumping syndrome after gastric surgery, iatrogenic dumping syndrome (ie, after gastric bypass surgery and fundoplication) is among the most common causes of rapid gastric emptying (GE). Other diseases (eg, diabetes mellitus (DM), autonomic neuropathy or postural orthostatic tachycardia syndrome [POTS]) and functional gastrointestinal disorders (eg, diarrhea, non‐ulcer dyspepsia, and cyclic vomiting syndrome) are also associated with rapid gastric emptying (GE) . Indeed, among patients with DM and upper gastrointestinal symptoms who undergo scintigraphy, approximately one in five have rapid GE .…”

Section: Introductionmentioning

confidence: 99%

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Clinical features and disturbances of gastrointestinal transit in patients with rapid gastric emptying

Kuwelker

Muthyala

O’Connor

et al. 2020

Neurogastroenterology Motil

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Aims Some patients with upper gastrointestinal symptoms have rapid gastric emptying (GE). We aimed to compare patients with normal and rapid GE and to identify phenotypes among patients with rapid GE. Methods Among 2798 patients who underwent GE scintigraphy, we compared patients with normal and rapid GE and separately, patients with rapid GE at 1 hour (GE1), 2 hours (GE2), or both (GE12). Results In 2798 patients, GE was normal (74%), delayed (18%), or rapid (8%). Among 211 patients with rapid GE, patterns were rapid GE1 (48%), 2 hours (17%), or 1 and 2 hours (35%); 42 (20%) had diseases that explain rapid GE. A combination of upper and lower gastrointestinal symptoms (54%) was more common that isolated upper (17%) or lower (28%) gastrointestinal symptoms (P < .001). Constipation was more prevalent in patients with rapid GE 2 (72%) than rapid GE 1 (47%) or rapid GE12 hours (67%) (P < .05). Among 179 diabetes mellitus (DM) patients, 15% had rapid GE, which was not associated with the DM phenotype. By multivariable analysis, insulin therapy (odds ratio [OR], 0.36; 95% confidence interval [CI], 0.15‐0.88), and weight loss (OR, 0.10; 95% CI, 0.01‐0.78) were associated with a lower risk of rapid than normal GE in DM. Conclusions Eight percent of patients undergoing scintigraphy had rapid GE, which is most frequently associated with upper and lower gastrointestinal symptoms; constipation is common. Insulin therapy and weight loss were associated with a lower risk of rapid than normal GE in DM patients.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

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Clinical features and disturbances of gastrointestinal transit in patients with rapid gastric emptying

Kuwelker

Muthyala

O’Connor

et al. 2020

Neurogastroenterology Motil

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“…The pathophysiological mechanisms underlying FD are heterogeneous. Theoretic causes include impaired gastric accommodation, altered gastric emptying, and increased gastric hypersensitivity [13,[22][23][24]. Previous studies have demonstrated that patients presenting with post-fundoplication dyspepsia have significantly reduced gastric accommodation compared to controls, presumably due to surgical alteration of the gastric fundus [11,12].…”

Section: Discussionmentioning

confidence: 99%

Role of Neuromodulators for the Management of Post-Gastric-Fundoplication Dyspepsia: A Retrospective Series

Singh¹,

Ford²,

McMichael³

et al. 2021

Cureus

Self Cite

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Post-fundoplication dyspepsia is a common complication of gastric fundoplication surgeries. This can be attributable to the loss of fundal relaxation, decreased gastric accommodation, and/or alterations in gastric motility and sensitivity following fundoplication. The role of neuromodulators in the management of such symptoms is unknown. We retrospectively assessed the efficacy of neuromodulators such as tricyclic antidepressants, buspirone, and mirtazapine for the management of post-fundoplication dyspepsia.

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“…In this issue of Digestive Diseases and Sciences, Cifuentes et al determined the clinical predictors of RGE in symptomatic patients, with the purpose of defining a distinct population more likely to develop RGE [4]. The authors retrospectively analyzed characteristics of patients with RGE, correlating them with dyspeptic symptoms in comparison with symptomatic patients with normal gastric emptying.…”

mentioning

confidence: 99%

Concise Commentary: Significance of Rapid Gastric Emptying in Dyspepsia—Is the Stomach 30% Empty or 30% Full?

Verma

Rezaie

2019

Dig Dis Sci

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Clinical Predictors of Rapid Gastric Emptying in Patients Presenting with Dyspeptic Symptoms

Cited by 16 publications

References 43 publications

Clinical features and disturbances of gastrointestinal transit in patients with rapid gastric emptying

Clinical features and disturbances of gastrointestinal transit in patients with rapid gastric emptying

Role of Neuromodulators for the Management of Post-Gastric-Fundoplication Dyspepsia: A Retrospective Series

Concise Commentary: Significance of Rapid Gastric Emptying in Dyspepsia—Is the Stomach 30% Empty or 30% Full?

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