Cholecystectomy and clinical presentations of gastroparesis

Henry P. Parkman, Katherine Yates, William L. Hasler, Linda Nguyen, Pankaj J. Pasricha, William J. Snape, Gianrico Farrugia, Kenneth L. Koch, Jorge Calles, Thomas L. Abell, Irene Sarosiek, Richard W. McCallum, Linda Lee, Aynur Unalp-Arida, James Tonascia, Frank Hamilton

Research output: Contribution to journalArticle

21 Scopus citations

Abstract

Background: Many patients with gastroparesis have had their gallbladders removed. Aim: To determine if clinical presentations of patients with gastroparesis differ in those with prior cholecystectomy compared to patients who have not had their gallbladder removed. Methods: Gastroparetic patients were prospectively enrolled in the NIDDK Gastroparesis Registry. Detailed history and physical examinations were performed; patients filled out questionnaires including patient assessment of GI symptoms. Results: Of 391 subjects with diabetic or idiopathic gastroparesis (IG), 142 (36 %) had a prior cholecystectomy at the time of enrollment. Patients with prior cholecystectomy were more often female, older, married, and overweight or obese. Cholecystectomy had been performed in 27/59 (46 %) of T2DM compared to 19/78 (24 %) T1DM and 96/254 IG (38 %) (p = 0.03). Patients with cholecystectomy had more comorbidities, particularly chronic fatigue syndrome, fibromyalgia, depression, and anxiety. Postcholecystectomy gastroparesis patients had increased health care utilization, and had a worse quality of life. Independent characteristics associated with prior cholecystectomy included insidious onset (OR = 2.06; p = 0.01), more comorbidities (OR = 1.26; p < 0.001), less severe gastric retention (OR(severe) = 0.68; overall p = 0.03) and more severe symptoms of retching (OR = 1.19; p = 0.02) and upper abdominal pain (OR = 1.21; p = 0.02), less severe constipation symptoms (OR = 0.84; p = 0.02), and not classified as having irritable bowel syndrome (OR = 0.51; p = 0.02). Etiology was not independently associated with a prior cholecystectomy. Conclusions: Symptom profiles in patients with and without cholecystectomy differ: postcholecystectomy gastroparesis patients had more severe upper abdominal pain and retching and less severe constipation. These data suggest that prior cholecystectomy is associated with selected manifestations of gastroparesis.

Original languageEnglish (US)
Pages (from-to)1062-1073
Number of pages12
JournalDigestive Diseases and Sciences
Volume58
Issue number4
DOIs
StatePublished - Apr 1 2013

Keywords

  • Cholecystectomy
  • Diabetes
  • Gallbladder
  • Gastric emptying
  • Gastroparesis

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

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    Parkman, H. P., Yates, K., Hasler, W. L., Nguyen, L., Pasricha, P. J., Snape, W. J., Farrugia, G., Koch, K. L., Calles, J., Abell, T. L., Sarosiek, I., McCallum, R. W., Lee, L., Unalp-Arida, A., Tonascia, J., & Hamilton, F. (2013). Cholecystectomy and clinical presentations of gastroparesis. Digestive Diseases and Sciences, 58(4), 1062-1073. https://doi.org/10.1007/s10620-013-2596-y