Print PDF
Delayed gastric emptying is relatively common among both diabetic and non-diabetic patients. Delayed emptying of both solids and liquids has been detected in symptomatic and asymptomatic PD patients. A mechanical or neurogenic mechanism triggered by the presence of intra-abdominal fluid is thought to retard gastric emptying1,2. The mainstay of therapy for symptomatic cases is prokinetic medications (e.g. metocloprimide or erythromycin).
Pancreatitis is an infrequent but serious event often associated with peritoneal dialysis. Although the presence of PDF in the lesser sac, irritants in PDF, peritonitis, hypertriglyceridemia and hypercalcemia have been considered as potential risk factors, there is controversy regarding a causative relationship between pancreatitis and PD. The clinical manifestations are abdominal pain with or without cloudy fluid, culture negative peritonitis, markedly elevated serum amylase (> 3 x normal levels), increased amylase in the dialysis effluent (> 100 U/l) and dialysate leukocytosis with sterile culture. Traditional therapy is indicated without significant changes in the PD prescription.
Several other gastrointestinal complications have been described including ischemic colitis and necrotizing enteritis, related to hypoperfusion of the bowel following hypotension; gastrointestinal bleeding from dilated submucosal vessels in the bowel; pneumoperitoneum with or without pain resulting from free air infused with the dialysis fluid and hepatic subcapsular steatosis (see Intraperitoneal Insulin Administration) among patients receiving IP insulin.
Back to Non-Infectious Complications of PD
References:
-
Fernstrom A, Hylander B, Gryback P, Jacobsson H, Hellstrom PM. Gastric emptying and electrogastrography in patients on CAPD. Perit Dial Int 19:429-437, 1999
-
Brown-Cartwright D, Smith HJ, Feldman M. Gastric emptying of an indigestible solid in patients with end-stage renal disease on continuous ambulatory peritoneal dialysis. Gastroenterology 95:49-51, 1988