caa a22 4500 445796065 CHVBK 20180317145125.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s10620-010-1485-x doi (NATIONALLICENCE)springer-10.1007/s10620-010-1485-x Does Grading the Severity of Gastroparesis Based on Scintigraphic Gastric Emptying Predict the Treatment Outcome of Patients with Gastroparesis? [Elektronische Daten] [Reza Hejazi, Irene Sarosiek, Katherine Roeser, Richard McCallum] Objectives: The objectives of this study were as follows: (1) Whether gastric emptying is different between gastroparesis (GP) patients responding or not responding to standard medical therapy; (2) Identifying if mild, moderate, and severe degrees of gastroparesis based on the scintigraphic gastric emptying test (GET) can predict treatment responses for GP of diabetic (DM) and idiopathic (ID) origin. Methods: A total of 165 patients (119 F) diagnosed with GP [126 (76%) DM, 39 (24%) ID etiology] failed medical treatment and required the gastric electrical stimulation (GES) device (GES group). In addition, 112 patients (89 F) [37 (33%) DM, 75 (67%) ID] with GP who symptomatically responded to medical therapies are the comparison group (MED GP). All patients underwent a standardized scintigraphic GET consisting of low-fat (2%) isotope labeled egg beaters meal of 250kcal. We also analyzed the GET data to find cut-off points for different degrees of GP and identified mild (11-20% retention), moderate (21-35%), and severe gastroparesis (>35%) based on percent retention of isotope at 4h. Results: Overall gastric retention at 4h was significantly greater in the GES group (45±1.9%) than MED GP (30±2%) (p<0.001). The distribution severity of the GET was different in GES-treated patients than MED treated (p<0.001). In the diabetics, 57% of GES patients retained >35% after 4h (severe) similar to 43% in the DM MED group. However, 50% of the ID GES patients had retention>35% at 4h significantly more than only 17% of ID MED GP. Significantly more ID patients who responded to medical therapy had mild gastroparesis and significantly more requiring GES had severe GET (p<0.05). Conclusions: (1) GET in patients whose GP symptoms were refractory to standard medical therapy and required GES was significantly slower than in GP patients whose symptoms responded to medical therapy. (2) Stratifying GET into mild, moderate, and severe degrees of gastric retention does not predict whether a medical or surgical approach will be better to control the symptoms of diabetic GP but does correlate with treatment for the idiopathic GP subgroup. Springer Science+Business Media, LLC, 2010 Gastroparesis nationallicence Gastric emptying test nationallicence Severity nationallicence GP : Gastroparesis nationallicence DM : Diabetes mellitus nationallicence ID : Idiopathic nationallicence GET : Gastric emptying test nationallicence MED : Medical therapy nationallicence GES : Gastric electrical stimulation nationallicence Hejazi Reza Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Ave, 79905, El Paso, TX, USA aut Sarosiek Irene Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Ave, 79905, El Paso, TX, USA aut Roeser Katherine Division of Gastroenterology, Department of Medicine, Kansas University Medical Center, Kansas City, KS, USA aut McCallum Richard Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Ave, 79905, El Paso, TX, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/4(2011-04-01), 1147-1153 0163-2116 56:4<1147 2011 56 10620 https://doi.org/10.1007/s10620-010-1485-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-010-1485-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Hejazi Reza Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Ave, 79905, El Paso, TX, USA aut NATIONALLICENCE 700 1- Sarosiek Irene Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Ave, 79905, El Paso, TX, USA aut NATIONALLICENCE 700 1- Roeser Katherine Division of Gastroenterology, Department of Medicine, Kansas University Medical Center, Kansas City, KS, USA aut NATIONALLICENCE 700 1- McCallum Richard Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Ave, 79905, El Paso, TX, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/4(2011-04-01), 1147-1153 0163-2116 56:4<1147 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer