Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.

In patients with Gastroparesis, is it normal to develop fatty liver and have high chloesterol issues? What are the options for patients with this condition to eat healthfully without being able to digest high fiber, whole wheat foods. One GI has suggested additional surgery to open an additional release pathway to the stomach, the other suggests controling the issue with diet, the diet that raises cholesterol and causes fatty liver. Is there a higher risk of developing esopageal cancer with a patient who stays on a solid food diet vs. an all liquid diet?

Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)

yes

If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:

Diet (small meals, every 2 hours, limited foods) vs. surgery to empty the stomach quicker which would allow for normal eating.

What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)

Gastroparesis patients whose condition has developed either by a previous Highly Selective Vagotomy or other cause Patients who have developed fatty liver and higher cholesterol levels since diagnosis

Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)

Patients who have decided to go ahead with additional surgical procedures

Patients who have had a previous HS Vagotomy

Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)

Improvement in the liver condition and cholesterol levels - to limit worsening

Describe any health-related risks, side effects, or harms that you are concerned about.

Esopageal cancer due to back-up of food from stomach which cannot digest properly

Losing the ability to eat solid foods as I age

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?

unsure

Which priority area(s) and population(s) does this topic apply to? (check all that apply)

EHC Priority Conditions (updated in 2008)

• Cancer
• Functional limitations and disability
• Peptic ulcer disease and dyspepsia

AHRQ Priority Populations

None

Federal Health Care Program

None

Importance

Describe why this topic is important.

14 years ago, I had a HS Vagotomy that was suggested by my physican to treat ulcers. 12 years later I developed gastroparesis which has lead to fatty liver and higher than normal cholesterol levels. I feel these issues will get worse due to the condition. The condition also can cause acid relux and food to come back into the throat, which can cause damage. There doesn't seem to be much research or options for patients with this issue. Many GI physicans do not know much about what can be done or if there are options available through research

What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)

To help those who have a condition that is virtually unknown and untreatable but can cause other health issues.

Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)

yes

If yes, please explain:

I have seen three GI specialists, one felt surgery was the best option to empty the stomach quicker, basically opening an area of the stomach that drains directly into the intestine. The second felt limited diet and very small meals could control the conditional. Yet another had no suggestions other than to say there was nothing that could be done but eventually you may have to go to an all liquid diet. You can see how these are not the best of options, and now the possibility of higher cholestrol and fat on the liver could eventually cause additional health problems

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?

It would give me options and possibily alert me to additional research that has been done that my physican is not aware of

Describe the timeframe in which an answer to your question is needed.

As soon as possible

Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.

Unknown

Nominator Information

Other Information About You: (optional)

Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)

It would give me options and possibily alert me to additional research that has been done that my physican is not aware of

Are you making a suggestion as an individual or on behalf of an organization?

Individual

Please tell us how you heard about the Effective Health Care Program

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