Gastroparesis

Question 1

What are some causes of gastroparesi?

Answer 1

DIABETES
Idiopathic
Scleroderma
Parkinson's/CNS
Post-surgery

Question 2

What are some symptoms and signs of gastroparesis?

Answer 2

N/V
Abdominal pain
Early satiety
Food in stomach after overnight fast

Question 3

Pathogenesis of fundic gastroparesis?

Answer 3

Decreased distention and compliance

Question 4

Pathogenesis of antral abnormality?

Answer 4

Low amplitue waves
Decreased frequency
Arrythmia
Pylorospasm

Question 5

Describe a gastric emptying study

Answer 5

Ingest radiolabelled food
Measure percentage emptied @ 2 and 4 h
Retention of >10%@4 h indicates delayed

Question 6

What are the diagnostic procedure options for gastroparesis?

Answer 6

Endoscopy
Manometry
Breath test with 13-C acetate
Wireless motility

Question 7

How do you manage gastroparesis?

Answer 7

General: rehydrate & electrolytes
Decompression: PEG tube
Symptomatic/control bacteria
Nutrition: jejunostomy

Question 8

What is metoclopramide?

Answer 8

D receptor blocker that inhibits gastric smooth muscle relaxation

only drug approved for gastroparesis

BBW: tardive dyskinesia

Use up to 6 wks

Question 9

What antibiotics are used for acute episodes of gastroparesis?

Answer 9

Macrolides

Long QT

Question 10

What is cisapride?

Answer 10

Serotonin stimulant

Not used in USA

Question 11

Domperidone

Answer 11

D receptor blocker

Not in USA

Question 12

When do you use a gastric pacemaker?

Answer 12

Refractory disease of > 1 yr