Pain: The overlooked symptom in gastroparesis

OBJECTIVE: Abdominal pain has not been reported generally as a significant feature of the clinical presentation of patients with gastroparesis. METHODS: Using a standardized questionnaire, we analyzed the clinical featu res of 28 consecutive patients referred with established or suspected gastr oparesis over a 4-yr period. The diagnosis of gastroparesis was supported b y abnormalities in gastric emptying studies (GES), electrogastrography (EGG ), or upper endoscopy (EGD). Diagnostic tests were reviewed. RESULTS: A total of 12 male (mean age 39.5 yr) and 18 female patients (mean age 39.6 yr) were included in this study. These patients had been symptoma tic for an average of 37.8 months before their referral to our center. Seve n of these patients had insulin-dependent diabetes. Idiopathic gastroparesi s was present in more than half of the patients. The symptom profile of the 28 patients was as follows: nausea, 92.9%; abdominal pain, 89.3%; early sa tiety, 85.7%; and vomiting, 67.9%. The pain was described as burning, vague , or crampy in nature. Only 36% localized to the upper abdomen. In all, 60% of patients complained of postprandial pain, whereas 80% complained of noc turnal pain that interfered with their normal sleeping pattern. In general, pain responded poorly or not at all to prokinetic agents. CONCLUSIONS: Nausea and abdominal pain are the most common complaints of pa tients with gastroparesis. In 80% of patients, GES and EGG correlated posit ively. (C) 1999 by Am. Cell. of Gastroenterology.