Gastroparesis natural history, complications and prognosis

The natural history of gastroparesis is largely unknown. Common complications include fluctuations in blood glucose due to unpredictable digestion times in diabetic patients, malnutrition, weight loss, malnutrition and vitamin and mineral deficiencies, Intestinal obstruction due to the formation of bezoars and bacterial infection due to overgrowth in undigested food. Postviral gastroparesis has a good prognosis while prognosis for diabetic gastroparesis is poor.

• The natural history of gastroparesis is largely unknown, especially there is minimal data on the natural history of diabetic gastroparesis.^[1][2]
• In the Olmsted County epidemiology study, of all the incident cases of gastroparesis, one third patients died and another one third required medications, hospitalization or tube feeding related to gastroparesis.^[2]

Common complications of gastroparesis include:^[3][4][5]

• Fluctuations in blood glucose levels and even ketoacidosis due to unpredictable digestion times especially in diabetic patients
• Malnutrition
• Weight loss
• Intestinal obstruction due to the formation of bezoars (solid masses of undigested food)
• Bacterial infection due to overgrowth in undigested food
• Dehydration
• Electrolyte imbalances

• Prognosis of gastroparesis is uncertain even with appropriate treatment modalities, as majority of them seem to provide only temporary benefit.
• The estimated 5-year survival for gastroparesis based on ‘Gastroparesis study in Olmsted County’, Minnesota from 1996 to 2006, was 67% with worse prognosis for diabetic gastroparesis.
• Prognosis of diabetic gastroparesis mainly depends upon blood sugar level and duration of diabetes.^[1][6]
• Postviral gastroparesis has a good prognosis. 
• The patients with autonomic dysfunction have slower resolution of their symptoms that may take several years and the prognosis is worse than in postviral gastroparesis without autonomic disorders.^[7]

Template:WH Template:WS