Factors contributing to hospitalization for gastroparesis exacerbations

Sesha S. Uppalapati, Zeeshan Ramzan, Robert S. Fisher, Henry P. Parkman

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: The clinical course of patients with gastroparesis is characterized by symptomatic exacerbations often necessitating hospitalization. Aims: To investigate precipitating factors leading to hospitalization for exacerbation of symptoms in patients with gastroparesis. Methods: This was a retrospective review of 103 admissions (63 patients) for gastroparesis exacerbation. Results: Etiologic categories for gastroparetic patients were diabetic (43%), idiopathic (39%), and post surgical (8%). Poor glycemic control was present in 36%, infection in 19% (12 urinary tract infections and two bacteremia), and noncompliance with or intolerance of, medications in six and 5% of patients, respectively. Fasting morning cortisol concentrations were <3 mcg/dl in 9%. Elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were seen in 34 of 65 (52%) and 11 of 50 patients (22%), respectively. No identifiable infection was found in 74 and 45% of patients with elevated ESR and elevated CRP, respectively. ESR and CRP were higher when patients were symptomatic necessitating hospitalization (26.2 ± 6.6 mm/h and 1.6 ± 1.0 mg/l) compared with when they were seen in outpatient follow-up and less symptomatic (10.3 ± 2.9 mm/h and 0.3 ± 0.1 mg/l; P = 0.0001 and P = 0.211, respectively). Conclusions: Poor glycemic control, infection, noncompliance with/intolerance of medications, and, perhaps, adrenal insufficiency were contributory factors leading to hospitalizations of gastroparetic patients. Hospitalized patients with gastroparesis exacerbations had elevated ESR and CRP levels. Although many patients with elevated inflammatory markers had evidence of infection, some did not. Assessment of inflammatory markers may help indicate those gastroparetic patients in whom a search for infection should be undertaken.

Original languageEnglish (US)
Pages (from-to)2404-2409
Number of pages6
JournalDigestive Diseases and Sciences
Volume54
Issue number11
DOIs
StatePublished - Nov 2009

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Gastroparesis
Hospitalization
Blood Sedimentation
C-Reactive Protein
Infection
Precipitating Factors
Adrenal Insufficiency
Patient Admission
Infection Control
Bacteremia
Urinary Tract Infections
Hydrocortisone
Fasting
Outpatients

Keywords

  • Gastroparesis
  • Inflammation
  • Nausea
  • Vomiting

ASJC Scopus subject areas

  • Gastroenterology
  • Physiology

Cite this

Factors contributing to hospitalization for gastroparesis exacerbations. / Uppalapati, Sesha S.; Ramzan, Zeeshan; Fisher, Robert S.; Parkman, Henry P.

In: Digestive Diseases and Sciences, Vol. 54, No. 11, 11.2009, p. 2404-2409.

Research output: Contribution to journalArticle

Uppalapati, SS, Ramzan, Z, Fisher, RS & Parkman, HP 2009, 'Factors contributing to hospitalization for gastroparesis exacerbations', Digestive Diseases and Sciences, vol. 54, no. 11, pp. 2404-2409. https://doi.org/10.1007/s10620-009-0975-1
Uppalapati, Sesha S. ; Ramzan, Zeeshan ; Fisher, Robert S. ; Parkman, Henry P. / Factors contributing to hospitalization for gastroparesis exacerbations. In: Digestive Diseases and Sciences. 2009 ; Vol. 54, No. 11. pp. 2404-2409.
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N2 - Background: The clinical course of patients with gastroparesis is characterized by symptomatic exacerbations often necessitating hospitalization. Aims: To investigate precipitating factors leading to hospitalization for exacerbation of symptoms in patients with gastroparesis. Methods: This was a retrospective review of 103 admissions (63 patients) for gastroparesis exacerbation. Results: Etiologic categories for gastroparetic patients were diabetic (43%), idiopathic (39%), and post surgical (8%). Poor glycemic control was present in 36%, infection in 19% (12 urinary tract infections and two bacteremia), and noncompliance with or intolerance of, medications in six and 5% of patients, respectively. Fasting morning cortisol concentrations were <3 mcg/dl in 9%. Elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were seen in 34 of 65 (52%) and 11 of 50 patients (22%), respectively. No identifiable infection was found in 74 and 45% of patients with elevated ESR and elevated CRP, respectively. ESR and CRP were higher when patients were symptomatic necessitating hospitalization (26.2 ± 6.6 mm/h and 1.6 ± 1.0 mg/l) compared with when they were seen in outpatient follow-up and less symptomatic (10.3 ± 2.9 mm/h and 0.3 ± 0.1 mg/l; P = 0.0001 and P = 0.211, respectively). Conclusions: Poor glycemic control, infection, noncompliance with/intolerance of medications, and, perhaps, adrenal insufficiency were contributory factors leading to hospitalizations of gastroparetic patients. Hospitalized patients with gastroparesis exacerbations had elevated ESR and CRP levels. Although many patients with elevated inflammatory markers had evidence of infection, some did not. Assessment of inflammatory markers may help indicate those gastroparetic patients in whom a search for infection should be undertaken.

AB - Background: The clinical course of patients with gastroparesis is characterized by symptomatic exacerbations often necessitating hospitalization. Aims: To investigate precipitating factors leading to hospitalization for exacerbation of symptoms in patients with gastroparesis. Methods: This was a retrospective review of 103 admissions (63 patients) for gastroparesis exacerbation. Results: Etiologic categories for gastroparetic patients were diabetic (43%), idiopathic (39%), and post surgical (8%). Poor glycemic control was present in 36%, infection in 19% (12 urinary tract infections and two bacteremia), and noncompliance with or intolerance of, medications in six and 5% of patients, respectively. Fasting morning cortisol concentrations were <3 mcg/dl in 9%. Elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were seen in 34 of 65 (52%) and 11 of 50 patients (22%), respectively. No identifiable infection was found in 74 and 45% of patients with elevated ESR and elevated CRP, respectively. ESR and CRP were higher when patients were symptomatic necessitating hospitalization (26.2 ± 6.6 mm/h and 1.6 ± 1.0 mg/l) compared with when they were seen in outpatient follow-up and less symptomatic (10.3 ± 2.9 mm/h and 0.3 ± 0.1 mg/l; P = 0.0001 and P = 0.211, respectively). Conclusions: Poor glycemic control, infection, noncompliance with/intolerance of medications, and, perhaps, adrenal insufficiency were contributory factors leading to hospitalizations of gastroparetic patients. Hospitalized patients with gastroparesis exacerbations had elevated ESR and CRP levels. Although many patients with elevated inflammatory markers had evidence of infection, some did not. Assessment of inflammatory markers may help indicate those gastroparetic patients in whom a search for infection should be undertaken.

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KW - Inflammation

KW - Nausea

KW - Vomiting

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