P4056 - Diabetic and Idiopathic Etiologies of Gastroparesis Have Very Different Long-Term Prognosis

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

Introduction: Gastroparesis (GP) presents with symptoms of gastric retention without mechanical obstruction. Delayed gastric emptying (GE) >10% retention at 4 hours of the standard radio-isotope labeled meal is required. The two main etiologies of GP are diabetes mellitus (DM) and idiopathic (ID). There is a sparseness of published data about GP's long-term resolution and improvement. The goal is to compare the long-term objective and symptomatic outcomes of patients with DM or ID GP.

Methods: The patients were identified and treated over 4 years by a GI physician specializing in GI motility. A single nuclear medicine physician interpreted baseline and follow-up 4-hour (4-H) scintigraphy GE studies using the same test meal. Patients who received a Gastric Electrical Stimulation (GES) or pyloroplasty between follow-ups were excluded from this analysis.

Results: 22 patients were included in the DM GP group. 16 (73%) had Type 2, 5 (23%) had Type 1, and 1 patient had Type 3c DM. 82% were Hispanic and 82% were women. The baseline GE at 4-H was 44% and Hba1c of 9.3%. At the 1-year mark, 12 patients followed up and had an average delayed 4-H GE of 39% and mean Hba1c of 8.7%. 1 patient had a resolution of GP by 4-H GE criteria. At the 2-year mark, 11 patients followed up with a mean 4-H GE of 27% and a mean Hba1c of 10%. At the 3-year mark, 6 patients followed up with a mean 4-H GE of 30%, and a mean Hba1c of 8.2%. At the 4-year mark, 9 patients followed up and 4 patients had resolution of GP by 4-H GE criteria. The remaining 5 had a mean 4-H GE of 45% and a mean Hba1c of 7.3%. A total of 5 (23%) patients had a resolution of their DM GP.<br><br>17 patients were included in the ID GP group. 65% were Hispanic and 83% were women. Baseline 4-H GE was 30%. At the 1-year mark, 13 patients followed up and 5 patients had a resolution of GP by 4-H GE criteria while the remaining 8 patients had an average 4-H GE of 22%. At the 2-year mark, 7 patients followed up, 3 patients had a resolution of GP and the remaining 4 had an average delayed 4-H GE of 45%. At the 3-year mark, 2 patients followed up with an average delayed 4-H GE of 45%. At the 4-year mark, 1 patient followed up and had a resolution of GP. A total of 9 (53%) of patients had a resolution of their ID GP.

Discussion: This long-term 4-year follow-up study in GP patients contrasts the prognosis of the 2 major etiologies with diabetic GP patients representing a chronic and essentially non-resolving entity while ID GP patients often resolve over time.


Disclosures:


Jeff Angelo Taclob, MD¹, Jesus Diaz, MD², M Ammar Kalas, MD², Irene Sarosiek, MD³, Richard W. McCallum, MD⁴. P4056 - Diabetic and Idiopathic Etiologies of Gastroparesis Have Very Different Long-Term Prognosis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.