Gastroparesis

Question 1

what causes gastroparesis

Answer 1

diabetes
medications (opioids and anticholinergic drugs
trauma, post surgical (vagus nerve injury)
neurological (MS and spinal cord injury)
idiopathic/post viral

Question 2

clinical features of gastroparesis

Answer 2

nausea/vomiting
early satiety
bloating and abdominal pain
weight loss and labile glucose in diabetics
epigastric distension and successuion splash on examination

Question 3

diagnosis of gastroparesis

Answer 3

exclude obstruction with upper EGD
exclude external compression (if suspected with CT scan to look for masses)
assess motility with nuclear gastric emptying study

Question 4

treatment of gastroparesis

Answer 4

diet: frequent small meals with low fat and only soluble fiber
promotility drugs: erythromycin and metoclopramide
gastric electrical stimulation and or jejunal feeding tubes for refractory symptoms

Question 5

impaired gastric emptying can be caused by:

Answer 5

gastric dysmotility (gastroparesis)
gastric outlet obstruction (GOO) due to mechanical (pancreatic cancer, gastric polyp or mucosal scarring from PUD causes

Question 6

gastric emptying scintigraphy will show

Answer 6

> 10% gastric retention in 4 hours following a solid meal and this is abnormal.

Question 7

potential causes for gastroparesis are:

Answer 7

diabetes, thyroid dx, autoimmune dx

gastroduodenal mamometry and autonomic testing can be helpful to distinguish if it’s a myopathyic or neuropathic cause behind this.