P0528 - Gastroparesis Is Here to Stay: Long-Term Outcomes of Gastric Emptying and Symptoms in Gastroparesis Patients Treated at a GI Motility Center

Jeff Angelo Taclob, MD¹, Jesus Diaz, MD², Ammar Kalas, MD³, Irene Sarosiek, MD³, Richard McCallum, MD^4
1Texas Tech University Health Sciences Center, El Paso, TX; ²Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX; ³Texas Tech, El Paso, TX; ⁴TTUHSC, El Paso, TX

Introduction: GP presents with symptoms of gastric retention in the setting of no mechanical obstruction and objective evidence of delayed gastric emptying (GE), >10% retention at 4 hours of the standard isotope labeled meal. The two main etiologies of GP are diabetes mellitus (DM) and idiopathic (ID). There is a paucity of published data about the long-term follow-up of patients with these different etiologies. Our goal was to investigate the outcomes of medically managed patients with GP due to DM or ID.

Methods: The database represents patients diagnosed and treated by one GI physician. They all had baseline and follow-up 4-hour scintigraphic GE studies using the same test meal and interpreted by the same nuclear medicine physician. GP symptoms were assessed utilizing the gastroparesis cardinal symptom index (GCSI). Follow-up GE and symptom assessments were conducted at 6 to 12-month intervals. Patients receiving Gastric Electrical Stimulation (GES) or who had pyloroplasty during follow-up were excluded from this analysis.

Results: There were 34 DM GP patients of a mean age 50 years, 86% female, 79% Hispanic, 69% Type 2 DM, as well as 13 ID GP patients with a mean age of 46 years, 85% female, 69% Hispanic, who met all these inclusion criteria. Of the 34 DM patients, 81% had persistently delayed gastric emptying – Initially 45% retention (range 11-97%) at 4 hours, and on the last follow-up which ranged from 6 months to 7 years, the mean retention was 34% (range 11-100%). The mean sum for the GCSI initially was 27.5 and on the last follow up was 26.9. Mean HbA1c of 8.5% remained unchanged on follow-up. The remaining 5 patients (15%) had a resolution of GP based on GE criteria.

Of the 13 ID GP patients, 62% had persistently delayed gastric emptying, with initial mean retention of 33% (range 14-74%), and on the last follow-up which ranged from 1 to 5 years, the mean retention was 25% (range 14-43%). The mean sum for the GCSI initially was 36 and on the last follow-up was 22. The remaining 5 patients (38%) had resolution of GP by GE criteria.

Discussion: 1. This study, the first to address the long-term outcomes in GP patients of DM and ID etiologies indicates that both causes have persistently delayed GE and accompanying ongoing symptoms despite receiving optimal medical treatment at a motility center for periods of 5 to 7 years duration.

2. This data emphasizes the limitations of current pharmacologic therapy for GP and open the door for the roles of GES and Pyloroplasty in the treatment algorithm.


Disclosures:


Jeff Angelo Taclob, MD¹, Jesus Diaz, MD², Ammar Kalas, MD³, Irene Sarosiek, MD³, Richard McCallum, MD⁴. P0528 - Gastroparesis Is Here to Stay: Long-Term Outcomes of Gastric Emptying and Symptoms in Gastroparesis Patients Treated at a GI Motility Center, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.