Predictors of gastroparesis in out-patients with secondary and idiopathic upper gastrointestinal symptoms

Background. Delayed gastric emptying occurs frequently in patients with upper gastrointestinal symptoms associated with functional or organic diseases. Aims. To evaluate whether: (i) the prevalence of delayed gastric emptying is influenced by the presence of organic disease; (ii) demographic or clinical factors predict modestly or markedly (gastroparesis) delayed emptying. Patients. A total of 327 consecutive out-patients with upper gastrointestinal symptoms. Methods. Routine diagnostic work-up and evaluation of demographic factors, gastrointestinal symptom evaluation and scintigraphic gastric emptying of solids were performed. Results. Organic diseases were detected in 227/327 (65%) patients: 33% had delayed emptying and 20% gastroparesis. Female gender (OR: 2.1; 95% C.I.: 1.3–3.4), overweight (0.5; 0.3–0.9), relevant postprandial fullness (1.8; 1.1–3.2) and relevant epigastric bloating (1.8; 1.1–2.9), but not the presence of organic diseases, were associated with delayed emptying. Female gender (3.9; 1.3–11.9) and relevant postprandial fullness (4.1; 1.7–10.2) were associated with gastroparesis. Conclusions. (i) There is a high prevalence of delayed gastric emptying and gastroparesis in out-patients with upper gastrointestinal symptoms, which is not influenced by the presence of organic disease; (ii) female gender, low body weight, relevant fullness and bloating are associated with delayed emptying; female gender and relevant postprandial fullness predict gastroparesis.