Factors associated with abnormal gastric emptying in alcohol-related chronic pancreatitis.
BACKGROUND
Patients with alcohol-related chronic pancreatitis (ARCP) may present with abnormal gastric emptying (GE), which has been ascribed mainly to nutrient maldigestion. Nevertheless, many patients also have diabetes with autonomic dysfunction and malnutrition and the role of these factors on abnormal GE has not been investigated.


OBJECTIVE
To determine the influences of malabsorption, diabetes, malnutrition, and autonomic dysfunction on GE abnormalities in patients with ARCP.


METHODS
Forty ARCP outpatients and 18 healthy controls were studied. GE was measured by scintigraphy after a standard, liquid, nutrient meal labeled with Technetium-phytate. Autonomic function was evaluated by cardiovascular tests. The influence of each factor on abnormal GE was assessed by Bayesian multiple regression analysis.


RESULTS
In the ARCP group, GE was abnormal in 19 patients (47.5%), who showed either accelerated (N=12) or delayed emptying (N=7). Diabetes was highly prevalent (P<0.01) in ARCP patients with either rapid or delayed GE (18/19). Multiple regression analysis showed that not only diabetes, but also autonomic dysfunction has significant effects on abnormal GE, whereas malabsorption and malnutrition seemed not to be associated to abnormal emptying.


CONCLUSIONS
A substantial proportion of patients with ARCP may have abnormal GE. Either delayed or accelerated GE seem to be related to underlying diabetes mellitus and autonomic neuropathy rather than to nutrient malabsorption and malnutrition.
Rosa-E-Silva
Lucilene
L
Department of Medicine, Londrina School of Medicine, State University of Londrina, Londrina, State of Paraná, Brazil.
Troncon
Luiz E A
LE
Gallo
Lourenço
L
Foss
Milton C
MC
Passos
Afonso D C
AD
Perdoná
Gleici C
GC
Achcar
Jorge A
JA
Oliveira
Ricardo B
RB
D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005746:Gastric Emptying; D006801:Humans; D008297:Male; D008875:Middle Aged; D019512:Pancreatitis, Alcoholic / Q000150:complications / Q000503:physiopathology*; D011877:Radionuclide Imaging; D012307:Risk Factors; D013270:Stomach / Q000000981:diagnostic imaging; D013667:Technetium
D013667:Technetium