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 19 January 2018

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News

Ascites impairs gastric function in cirrhosis

Postprandial gastric volumes and accommodation ratios are reduced in cirrhosis and ascites, and large-volume paracentesis increases fasting gastric volumes as well as caloric intake, finds the latest issue of Clinical Gastroenterology & Hepatology.

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Protein calorie malnutrition and weight loss are common among patients with cirrhosis and ascites.

The cause of these symptoms is unclear, with several putative mechanisms proposed.

Dr Ernest Bouras and colleagues from Florida compared gastric volumes between patients with cirrhosis complicated by ascites and controls.

The investigators evaluated the effect of large-volume paracentesis in the patient group.

Patients with cirrhosis and ascites underwent assessment of gastric volumes as measured by single-photon emission computed tomography.

Gastric sensation was assessed by a validated nutrient drink test, and a 3-day assessment of caloric intake before and after large-volume paracentesis.

Gastric volumes were increased by about 312 mL post- vs 241 mL pre-paracentesis
Clinical Gastroenterology & Hepatology

The team used age- and sex-adjusted linear regression models to compare gastric volumes and accommodation ratios between patients and healthy volunteers.

Paired Wilcoxon rank-sum tests were used to compare gastric measures before and after paracentesis among the patient group.

The investigators compared 15 patients with a median age of 54 years with 112 healthy age- and sex-matched controls.

Median postprandial gastric volumes and gastric accommodation were reduced significantly in patients compared with healthy controls.

The investigators found that fasting gastric volumes were increased by a median of 312 mL post- vs 241 mL pre-paracentesis.

Patients tolerated ingestion of larger maximum volumes of a median 964 mL post- vs 738 mL pre-paracentesis.

The team noted that caloric intake was increased at a median 34% kcal post- vs 3110 kcal pre-paracentesis.

Dr Bouras' team commented, “Postprandial gastric volumes and accommodation ratios are reduced in patients with cirrhosis and ascites compared with healthy controls.”

“In addition, large-volume paracentesis increases fasting gastric volumes, volumes ingested until maximal satiation, and caloric intake.”

Clin Gastroenterol Hepatol 2005: 3(11): 1095-100
11 November 2005

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