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Outcomes and Factors Associated With Reduced Symptoms in Patients With Gastroparesis
Open accessAbstract
Background & aims Gastroparesis is a chronic clinical syndrome characterized by delayed gastric emptying. However, little is known about patient outcomes or factors associated with reduction of symptoms. Methods We studied adult patients with gastroparesis (of diabetic or idiopathic type) enrolled in the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Clinical Research Consortium Gastroparesis Registry, seen every 16 weeks and treated according to the standard of care with prescribed medications or other therapies at 7 tertiary care centers. Characteristics associated with reduced symptoms, based on a decrease of 1 or more in the gastroparesis cardinal symptom index (GCSI) score after 48 weeks of care, were determined from logistic regression models. Data were collected from patients for up to 4 years (median, 2.1 y). Results Of 262 patients, 28% had reductions in GCSI scores of 1 or more at 48 weeks. However, there were no significant reductions in GCSI score from weeks 48 through 192. Factors independently associated with reduced symptoms at 48 weeks included male sex, age 50 years and older, initial infectious prodrome, antidepressant use, and 4-hour gastric retention greater than 20%. Factors associated with no reduction in symptoms included overweight or obesity, a history of smoking, use of pain modulators, moderate to severe abdominal pain, a severe gastroesophageal reflex, and moderate to severe depression. Conclusions Over a median follow-up period of 2.1 years, 28% of patients treated for gastroparesis at centers of expertise had reductions in GCSI scores of 1 or greater, regardless of diabetes. These findings indicate the chronic nature of gastroparesis. We identified factors associated with reduced symptoms that might be used to guide treatment. ClinicalTrials.gov no: NCT00398801.
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“Moreover, changes in symptom intensity do not always parallel objective GE measurements, highlighting the complex interplay between pathophysiological derangements and central processing of visceral signals [14, 21–23].”
From Diabetic gastroparesis: pathophysiology and impact on insulin timing choices (2026) · cites this paper as [21]
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“Factors associated with lack of improvement of symptoms included overweight or obesity, a history of smoking, the use of pain modulators, moderate to severe abdominal pain, severe gastroesophageal reflex, and moderate to severe depression.(122) Case series have also reported a higher likelihood of symptom resolution o…”
Background
Metadata
- Authors
- Pasricha, P. J., Yates, K. P., Nguyen, L., Clarke, J., Abell, T. L., Farrugia, G., Hasler, W. L., Koch, K. L., Snape, W. J., McCallum, R. W., Sarosiek, I., Tonascia, J., Miriel, L. A., Lee, L., Hamilton, F., & Parkman, H. P.
- Affiliations
- Johns Hopkins University (US)
- Stanford University (US)
- University of Louisville (US)
- Mayo Clinic (US)
- University of Michigan (US)
- Wake Forest University Health Sciences (US)
- California Pacific Medical Center (US)
- Texas Tech University (US)
- National Institute of Diabetes and Digestive and Kidney Diseases (US)
- Temple University (US)
- Corresponding author
- Pasricha, Pankaj J.
- ORCID
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2015-12
- Volume
- 149
- Issue
- 7
- Pages
- 1762-1774.e4
- ISSN
- 0016-5085 (ISSN-L)
- PMC
- PMC4663150
- OpenAlex
- W1188512702
- Cited by
- 143
- References
- 60
- Citations by year
- 2026: 12 · 2025: 7 · 2024: 13 · 2023: 13 · 2022: 12 · 2021: 13 · 2020: 18 · 2019: 18 · 2018: 14 · 2017: 9 · 2016: 11 · 2015: 3
- FWCI
- 11.69
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Association of Schools of Public Health (2007-2010, 2009-2011, 2009-2012)
- Johns Hopkins University
- National Institute of Diabetes and Digestive and Kidney Diseases
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Keywords
- gastroparesis, delayed gastric emptying, symptom improvement, Gastroparesis Cardinal Symptom Index, diabetic gastroparesis, idiopathic gastroparesis, gastric retention, abdominal pain, depression, obesity, smoking, antidepressants, gastroesophageal reflux, treatment outcomes
- MeSH terms
- Adult, Age Factors, Female, Gastric Emptying, Humans, Life Style, Male, Middle Aged, Predictive Value of Tests, Registries, Remission Induction, Risk Factors, Severity of Illness Index, Sex Factors, Time Factors, United States, Comorbidity, Linear Models, Logistic Models, Odds Ratio, Treatment Outcome, Gastroparesis, Recovery of Function
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