Use of Anti-reflux Medications and Prevalence of Erosive Esophagitis in Patients With Gastroparesis: A Retrospective Study

Introduction: Gastroparesis is a condition characterized by delayed gastric emptying, and may be present in 10% to 33% of patients with gastroesophageal reflux disease (GERD). Studies have shown conflicting results about the correlation between delayed gastric emptying and GERD. Therefore, the pathogenic role of delayed gastric emptying in GERD remains controversial. We conducted a retrospective study to evaluate the use of anti-reflux medications and prevalence of erosive esophagitis in patients with gastroparesis. Methods: A retrospective study at a single tertiary-care center was performed after IRB approval. All adult patients that underwent gastric emptying scintigraphy (GES) at our hospital from January 2013 through August 2014 were included. Patient charts were reviewed for the following data: Age, gender, GES results, EGD findings, and use of anti-reflux medications including proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RAs). Statistical analysis was performed using descriptive statistics, two-tailed unpaired t-test for continuous data, and Fisher's exact test for categorical data with statistical significance defined as p < 0.05. Results: A total of 600 patients who underwent GES were identified consisting of 154 males and 446 females with mean age 47.7 ± 16.4 years. Out of these, 296 patients were in the non-gastroparesis (non-GP) group who had normal GES results. There were 304 patients in the gastroparesis (GP) group with delayed gastric emptying documented by abnormal GES. Use of antireflux medications (PPIs and/or H2RAs) was 72.5% in the non-GP group (214/295 patients) compared to 81.3% in the GP group (247/304 patients) (p=0.01). There were a total of 483 patients in the study population who underwent upper endoscopy. Erosive esophagitis was seen in 30 out of 242 patients in the non-GP group, and 30 out of 241 patients in the GP group (12.4% vs 12.5%, p=1.00). Conclusion: The use of anti-reflux medications was significantly higher in those patients with gastoparesis. However, the prevalence of erosive esophagitis was similar (˜12%) in both the GP and non-GP groups.