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Review Article

Gastroparesis

Tauseef Ali, MD, Muhammad Hasan, MD, Mehdi Hamadani, MD, Richard F. Harty, MD
Volume: 100 Issue: 3 March, 2007

Abstract:

Gastroparesis is a symptomatic disorder of the stomach characterized by slow or delayed gastric emptying. Diabetes and idiopathic factors account for over 60% of gastroparesis cases. Symptoms associated with delayed gastric emptying include nausea, vomiting, abdominal bloating and early satiety. Delayed gastric emptying due to gastroparesis is managed by dietary adjustments, prokinetic medications, avoidance of medications that retard gastric motor activity and optimizing glycemic control in diabetic patients. Electrical stimulation and gastric pacing are an evolving treatment option for patients who do not respond to standard medical therapy. This article provides a review of gastric motility, the etiologies of gastroparesis and therapeutic approaches to this disorder.


Key Points


* Gastroparesis is defined as delayed gastric emptying. Initial investigations for gastroparesis include comprehensive history and physical examination that can lead to important clues.


* The general principles for treatment of symptomatic gastroparesis are to correct fluid, electrolyte, and nutritional deficiencies, identify and rectify the underlying cause of gastroparesis, and reduce symptoms.


* Prokinetic agents increase antral contractility, correct gastric dysrhythmias, improve antroduodenal coordination and are used to treat the symptoms of gastroparesis.


* Gastric electric stimulation accelerates gastric emptying and improves dyspeptic symptoms.

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