Journal of clinical gastroenterology · 2002
Nutritional problems in end-stage liver disease: contribution of impaired gastric emptying and ascites.
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Scolapio James S, Ukleja Andrzej, McGreevy Kai, Burnett Omer L, O'Brien Peter C
Аннотация
GOALS: To evaluate gastric emptying before and after paracentesis in patients with cirrhosis.
BACKGROUND: Patients with ascites often report early satiety. The effect of paracentesis on gastric emptying has not been studied previously.
STUDY: Twelve patients who required therapeutic paracentesis were studied (mean age, 57 years; range, 47-69 years). Gastric emptying was performed with radionuclide scintigraphy. Satiety was evaluated with a visual analogue scale. Wilcoxon signed-rank tests were used for comparison between pre-and poststudies.
RESULTS: The causes of cirrhosis included alcohol (seven patients), a combination of alcohol and hepatitis C (two), chronic hepatitis C only (one), primary biliary cirrhosis (one), and cryptogenic (one). The median volume of ascitic fluid removed at paracentesis was 5,450 mL (range, 2,500-7,200 mL). Median 2-hour gastric emptying was 65.5% before paracentesis and 61.5% after ( p > 0.05). Median 4-hour gastric emptying was 92.5% before paracentesis and 96.5% after ( p > 0.05). Both satiety score and caloric intake were significantly improved after paracentesis ( p < 0.05).
CONCLUSIONS: Although satiety and calorie intake improve after large-volume paracentesis in patients with cirrhosis, these changes do not seem to correspond with improved gastric emptying. Therefore, other mechanisms most likely contribute to satiety.
BACKGROUND: Patients with ascites often report early satiety. The effect of paracentesis on gastric emptying has not been studied previously.
STUDY: Twelve patients who required therapeutic paracentesis were studied (mean age, 57 years; range, 47-69 years). Gastric emptying was performed with radionuclide scintigraphy. Satiety was evaluated with a visual analogue scale. Wilcoxon signed-rank tests were used for comparison between pre-and poststudies.
RESULTS: The causes of cirrhosis included alcohol (seven patients), a combination of alcohol and hepatitis C (two), chronic hepatitis C only (one), primary biliary cirrhosis (one), and cryptogenic (one). The median volume of ascitic fluid removed at paracentesis was 5,450 mL (range, 2,500-7,200 mL). Median 2-hour gastric emptying was 65.5% before paracentesis and 61.5% after ( p > 0.05). Median 4-hour gastric emptying was 92.5% before paracentesis and 96.5% after ( p > 0.05). Both satiety score and caloric intake were significantly improved after paracentesis ( p < 0.05).
CONCLUSIONS: Although satiety and calorie intake improve after large-volume paracentesis in patients with cirrhosis, these changes do not seem to correspond with improved gastric emptying. Therefore, other mechanisms most likely contribute to satiety.