Rapid Gastric Emptying Is More Common than Gastroparesis in Patients With Autonomic Dysfunction
Abstract
OBJECTIVES: Autonomic dysfunction is associated with a wide variety of gastrointestinal symptoms. It is unclear how many patients with autonomic dysfunction have slow or rapid gastric emptying. The aim of this study was to determine the prevalence of rapid and delayed solid phase gastric emptying in patients with autonomic dysfunction referred for evaluation of gastrointestinal symptoms and the association of emptying rate with clinical symptoms. METHODS: Retrospective review of all patients with autonomic dysfunction who had a gastric emptying test from January, 1996 to March, 2005. Demographic data, clinical symptoms, composite autonomic scoring scale (CASS) score, and gastric emptying parameters were analyzed. RESULTS: Sixty-one subjects (women 49, age 42 [16-74] yr) with autonomic dysfunction were reviewed. Patients had mild-to-moderate (mean CASS score 3) autonomic dysfunction. Twenty-seven, 17, and 17 patients had rapid, normal, and delayed gastric emptying t(1/2), respectively. In addition, 10 patients had initially rapid emptying in phase 1, with subsequent slowing in phase 2 to produce an overall normal or delayed t(1/2). There was no difference in demographic data or CASS score among the three groups. More patients with initial or overall rapid emptying had diarrhea (70%) compared to patients with normal (33%) or delayed (33%) emptying (P= 0.018). CONCLUSIONS: Unexpectedly, more patients with autonomic dysfunction have rapid rather than delayed gastric emptying. The presence of diarrhea in patients with autonomic symptoms should prompt consideration for the presence of rapid gastric emptying. Conversely, the finding of rapid gastric emptying in patients with gastrointestinal symptoms should prompt consideration for the presence of underlying autonomic dysfunction.
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Four studies of GI symptoms in POTS reported abnormal gastric motility, with rapid gastric emptying in 43% and delayed gastric emptying/gastroparesis in 20%.
“Four of these studies that describe the GI symptoms in POTS also reported evidence of abnormal gastric motility- either rapid gastric emptying (43%) or delayed gastric emptying (gastroparesis, 20%) [5, 36, 48, 67].”
From Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review (2018) · cites this paper as [36]
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- Authors
- Lawal, A., Barboi, A., Krasnow, A., Hellman, R., Jaradeh, S., & Massey, B. T.
- Affiliations
- Medical College of Wisconsin (US)
- Corresponding author
- Massey, Benson T
- Venue
- The American Journal of Gastroenterology
- Published
- 2007-03
- Volume
- 102
- Issue
- 3
- Pages
- 618-623
- ISSN
- 0002-9270 (ISSN-L)
- 1572-0241
- OpenAlex
- W1979479241
- Cited by
- 66
- References
- 39
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 3 · 2023: 3 · 2022: 1 · 2021: 3 · 2020: 6 · 2019: 4 · 2018: 5 · 2017: 3 · 2016: 2 · 2015: 5 · 2014: 2 · 2013: 1 · 2012: 2
- FWCI
- 3.37
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases (T-32-DK61923, T32DK061923)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Keywords
- autonomic dysfunction, rapid gastric emptying, delayed gastric emptying, gastroparesis, gastric emptying test, diarrhea, gastrointestinal symptoms, autonomic neuropathy
- MeSH terms
- Adolescent, Adult, Aged, Autonomic Nervous System Diseases, Female, Gastric Emptying, Humans, Male, Middle Aged, Prognosis, Retrospective Studies, Severity of Illness Index, Disease Progression, Gastroparesis
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