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Henry P. Parkman, MD; Stanley S. Schwartz, MD

Arch Intern Med. 1987;147(8):1477-1480.

Abstract
• The prevalence of associated gastrointestinal disorders with diabetic gastroparesis was studied retrospectively by reviewing all data on patients with diabetic gastroparesis who were admitted to the Hospital of the University of Pennsylvania, Philadelphia, over a four-year period. Twenty diabetic patients with intractable nausea and vomiting, thought to be secondary to diabetic gastroparesis, underwent upper gastrointestinal tract endoscopy after failure to respond to conventional therapy for gastroparesis within several days. Nine (45%) patients had normal upper endoscopic examination results. Eleven (55%) patients were discovered to have other gastrointestinal tract disorders that could explain their persistent symptoms of nausea and vomiting. Specifically, three patients had Candida esophagitis, four had erosive esophagitis, two had gastric ulcers, one had duodenal erosions, and one had bile reflux gastritis. These 11 patients improved when therapy was altered to treat their additional disorder. Management of diabetic gastroparesis is discussed with emphasis on early upper gastrointestinal tract endoscopy for patients who fail to respond to therapy initially.

(Arch Intern Med 1987;147:1477-1480)

Author Affiliations
From the Gastrointestinal Section, Department of Medicine (Dr Parkman), and The Grace and Everett Rodebaugh Clinical Center for Diabetes Research and Education, Diabetes Section, Department of Medicine (Dr Schwartz), Hospital of the University of Pennsylvania, Philadelphia.

Footnotes
Accepted for publication May 13, 1987.

Reprint requests to University of Pennsylvania Medical Group, Third Floor, Ravdin Building, 3400 Spruce St, Philadelphia, PA 19104 (Dr Schwartz).

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