National survey of physicians' perception of the cause, complications, and management of gastroparesis

Abstract

Objectives: Manifestations of gastroparesis are heterogeneous and clinical complications are poorly defined. Misconceptions of gastroparesis may be common. The objective was to determine physicians' perception of gastroparesis and identify areas that need further research and education.

Methods: A physician survey was prospectively developed and tested. The survey included questions on the etiology, symptoms, management and perceived complications of gastroparesis. Physicians' feedback included rated responses by Likert scale and ranked responses by priority. A total of 3658 surveys were mailed to gastroenterologists and general practitioners using an online physician directory and a local medical society directory. Analysis of variance and t test were utilized.

Results: A total of 397 surveys were returned. 85.9% of responses were from the national survey and 14.1% were local. Physicians ranked diabetes (70%) as the most common cause of gastroparesis, followed by idiopathic (21%) and postsurgical (9%). Postprandial epigastric pain (61%) was ranked as the most frequent symptom of gastroparesis, followed by retching/vomiting (20%) and heartburn/regurgitation (19%). 60% believed scintigraphy t1/2 is an accurate measurement of gastric emptying. Only one-third believed gastric electrical stimulation was effective as treatment of gastroparesis. Physicians rated abdominal pain as the most clinically significant complication of gastroparesis surpassing weight loss, hospitalization for dehydration, and malnutrition (P < 0.01). There were small but statistically significant differences between gastroenterologists versus general practitioners and private versus academic physicians.

Conclusion: More physician awareness and education is needed on gastroparesis and the standardized four-hour gastric scintigraphy method, as well to clarify the management strategy for this condition.