Epidemiology and outcomes of gastroparesis, as documented in general practice records, in the United Kingdom

Abstract

ObjectiveTo generate real-world evidence for the epidemiology of gastroparesis in the UK, we evaluated the prevalence, incidence, patient characteristics and outcomes of gastroparesis in the Clinical Practice Research Datalink (CPRD) database.DesignThis was a retrospective, cross-sectional study. Prevalence and incidence of gastroparesis were evaluated in the CPRD database, with linkage to Hospital Episodes Statistics Admitted Patient Care and Office for National Statistics mortality data. Prevalence and incidence were age and sex standardised to mid-2017 UK population estimates. Descriptive analyses of demographics, aetiologies, pharmacological therapies and mortality were conducted.ResultsStandardised prevalence of gastroparesis, as documented in general practice records, was 13.8 (95% CI 12.6 to 15.1) per 100 000 persons in 2016, and standardised incidence of gastroparesis rose from 1.5 (95% CI 1.1 to 1.8) per 100 000 person-years in 2004 to 1.9 (95% CI 1.4 to 2.3) per 100 000 person-years in 2016. The most common disease aetiologies were idiopathic (39.4%) and diabetic gastroparesis (37.5%), with a similar distribution of type 1 and type 2 diabetes among the 90% who had type of diabetes documented. Patients with diabetic gastroparesis had a significantly higher risk of mortality than those with idiopathic gastroparesis after diagnosis (adjusted HR 1.9, 95% CI 1.2 to 3.0). Of those with gastroparesis, 31.6% were not offered any recognised pharmacological therapy after diagnosis.ConclusionThis is, to our knowledge, the first population-based study providing data on epidemiology and outcomes of gastroparesis in Europe. Further research is required to fully understand the factors influencing outcomes and survival of patients with gastroparesis.

United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis

“…4,[8][9][10][11][12][13]16,17,20 Bloating is a common symptom of functional digestive disorders including FD and IBS, but its prevalence is high in gastroparesis patients. 24 In these cohorts, the idiopathic subgroup is the largest, but a high prevalence of gastroparesis is found among diabetic patients, with 25 and 38% of patients identified in the respective studies. 23,24 Gastroparesis occurs more frequently in type 1 diabetes compared to type 2.…”

“…126,127 In the analysis of the UK CPRD database, mortality risk was higher in diabetic compared to idiopathic gastroparesis patients (adjusted hazard ratio: 1.9, 95% CI: 1.2-3.0). 24 A population-based study compared the observed and expected mortality of patients with gastroparesis, demonstrating a significantly higher death rate in patients compared to age-and sexmatched controls, which was largely due to cardiovascular comorbidity in diabetic patients. 23…”

Direct optogenetic stimulation of smooth muscle cells to control gastric contractility

“…In fact, morphological and functional evidence suggests that it is by far most often the dysfunction of ICC and neurons that underlies impaired gastric emptying in the absence of mechanical obstruction, which is the clinical definition of gastroparesis 6 - 9 . Although estimates on the prevalence and burden of gastroparesis vary widely between studies, it is undoubtedly a frequent and disabling chronic medical condition 10 - 12 . Besides alleviating symptoms, most therapeutic strategies in gastroparesis intend to restore gastric emptying.…”

The efficacy and safety of acupoint injection for diabetic gastroparesis

“…Of those with gastroparesis, 37.5% were caused by diabetes statistically, while patients with DGP had an almost 2 fold mortality to those with idiopathic gastroparesis. [ 11 ] With the prevalence of diabetes increases year by year, the number of DGP keeps growing. DGP can lead to slump decline on productivity of individuals and heavy economic burdens on social healthcare resources.…”