title: Cholecystectomy and clinical presentations of gastroparesis.
abstract: BACKGROUND
  Many patients with gastroparesis have had their gallbladders removed.
  
  
  OBJECTIVE
  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.
authors: Gastroenterology Section, Parkinson Pavilion, School of Medicine, Temple University, 8th Floor 3401 North Broad Street, Philadelphia, PA 19140, USA. henry.parkman@temple.edu
authors: Henry P
authors: HP
authors: Parkman
authors: Katherine
authors: K
authors: Yates
authors: William L
authors: WL
authors: Hasler
authors: Linda
authors: L
authors: Nguyen
authors: Pankaj J
authors: PJ
authors: Pasricha
authors: William J
authors: WJ
authors: Snape
authors: Gianrico
authors: G
authors: Farrugia
authors: Kenneth L
authors: KL
authors: Koch
authors: Jorge
authors: J
authors: Calles
authors: Thomas L
authors: TL
authors: Abell
authors: Irene
authors: I
authors: Sarosiek
authors: Richard W
authors: RW
authors: McCallum
authors: Linda
authors: L
authors: Lee
authors: Aynur
authors: A
authors: Unalp-Arida
authors: James
authors: J
authors: Tonascia
authors: Frank
authors: F
authors: Hamilton
mesh_terms: D000328:Adult; D000932:Antiemetics / Q000627:therapeutic use; D002763:Cholecystectomy; D005260:Female; D005746:Gastric Emptying; D018589:Gastroparesis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use; D011183:Postoperative Complications / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D014481:United States / Q000453:epidemiology
chemical_list: D000932:Antiemetics; D009294:Narcotics