Although patients with cirrhosis of the liver frequently present with many gastrointestinal (GI) complaints that are most likely due to abnormal GI motility, the cause of motility disorders in this patient population is unknown. In the January 2004 issue of the Journal of Clinical Gastroenterology, G. Nicholas Verne, MD, and associates reported on their study that examined the role of autonomic dysfunction in delayed gastric emptying in cirrhotic patients.
The study involved 20 patients with cirrhosis of the liver and postprandial abdominal pain, nausea, and vomiting and 10 asymptomatic noncirrhotic patients with hepatitis C (control group). In a solid-phase gastric emptying study, the mean percentage of retention at 100 minutes was 70.7% in the cirrhotic group, compared with 26.1% in the control group (greater than 50% at 100 minutes was considered abnormal). The composite autonomic score, which was the result of 5 standardized cardiovascular tests to assess autonomic function, was 3.4 for the cirrhotic group, compared with 1.2 for the control group (greater than 1.5 was considered abnormal).
The presence of autonomic dysfunction correlates positively with underlying motility disorders such as delayed gastric emptying. The authors conclude that gastroparesis is common in patients with cirrhosis of the liver and may account for GI symptoms of postprandial abdominal pain, nausea, and vomiting.