Gastroparesis

Gastroparesis is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

Definition

Gastroparesis consists of abnormally delayed emptying of stomach contents into the small bowel in the absence of gastric outlet obstruction or ulceration, usually as a result of damage to the nerves or smooth muscle involved in gastric emptying. Symptoms significantly overlap with functional dyspepsia, which can also be associated with delay in gastric emptying on objective testing.1

Etiology

  • Mechanical obstruction should always be excluded.
  • In addition to evaluating for acute metabolic derangements and potential offending medications (e.g., narcotics, anticholinergic agents, chemotherapeutic agents, glucagon-like peptide 1 receptor agonists, and amylin analogs), patients with gastroparesis should be screened for diabetes mellitus, thyroid dysfunction, neurologic disease, prior gastric or bariatric surgery, and autoimmune disorders (e.g., scleroderma).
  • If no predisposing cause is identified, gastroparesis is designated idiopathic.

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General Principles

Definition

Gastroparesis consists of abnormally delayed emptying of stomach contents into the small bowel in the absence of gastric outlet obstruction or ulceration, usually as a result of damage to the nerves or smooth muscle involved in gastric emptying. Symptoms significantly overlap with functional dyspepsia, which can also be associated with delay in gastric emptying on objective testing.1

Etiology

  • Mechanical obstruction should always be excluded.
  • In addition to evaluating for acute metabolic derangements and potential offending medications (e.g., narcotics, anticholinergic agents, chemotherapeutic agents, glucagon-like peptide 1 receptor agonists, and amylin analogs), patients with gastroparesis should be screened for diabetes mellitus, thyroid dysfunction, neurologic disease, prior gastric or bariatric surgery, and autoimmune disorders (e.g., scleroderma).
  • If no predisposing cause is identified, gastroparesis is designated idiopathic.

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