Viral gastroparesis: a subgroup of idiopathic gastroparesis--clinical characteristics and long-term outcomes

Abstract

Objectives: Viral gastroparesis has been regarded as a subgroup of idiopathic gastroparesis.

Methods: We have reviewed the medical records of 143 patients diagnosed as having gastroparesis. Fifty-two patients were regarded as idiopathic in origin, of which 12 were identified as consistent with a postviral etiology. Their follow-up and current status were assessed by interview. Available for interview were 32 patients: 11 from the viral group and 21 from idiopathic group.

Results: All "viral gastroparesis" patients reported gradual improvement of their symptoms, no hospitalizations during the previous 6 months, stable weight, were not disabled, and remained professionally active. In comparison, 21 "idiopathic" patients had an indolent, slowly progressive clinical presentation. The idiopathic group had a significantly longer duration of illness (p < 0.05) with greater symptom score of abdominal pain, early satiety, and anorexia, and overall worse quality of life (p < 0.05).

Conclusions: A viral etiology should be considered in gastroparesis patients when their illness is characterized by an acute onset, initial severe illness and slow resolution toward a satisfactory quality of life. Idiopathic gastroparesis is a more slowly progressive illness, and patients remain significantly more symptomatic for a longer period of time.