Nutritional problems in end-stage liver disease: contribution of impaired gastric emptying and ascites

J Clin Gastroenterol. 2002 Jan;34(1):89-93. doi: 10.1097/00004836-200201000-00018.

Abstract

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.

MeSH terms

  • Aged
  • Ascites / etiology
  • Ascites / physiopathology*
  • Female
  • Gastric Emptying / physiology*
  • Humans
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / therapy*
  • Male
  • Middle Aged
  • Nutrition Disorders / etiology
  • Nutrition Disorders / physiopathology
  • Paracentesis*
  • Radionuclide Imaging
  • Statistics, Nonparametric
  • Stomach / diagnostic imaging