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   Name          = Gastroparesis|
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   MeshID        = D018589 |
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{{CMG}}
{{Gastroparesis}}


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{{CMG}}; {{AE}} {{SSH}}, {{MSI}} {{FT}}


==Overview==
{{SK}} Chronic delayed gastric emptying; delayed gastric emptying; gastric stasis


'''Gastroparesis''', also called delayed gastric emptying, is a medical condition consisting of a [[paresis]] (partial [[paralysis]]) of the [[stomach]] ("gastro-"), resulting in food remaining in the stomach for a longer period of time than normal. Normally, the stomach contracts to move food down into the [[small intestine]] for digestion. The [[vagus nerve]] controls these contractions. Gastroparesis may occur when the [[vagus nerve]] is damaged and the muscles of the stomach and intestines do not work normally. Food then moves slowly or stops moving through the digestive tract.
==[[Gastroparesis overview|Overview]]==


==Causes==
==[[Gastroparesis historical perspective|Historical Perspective]]==


Gastroparesis may be chronic or transient; transient gastroparesis may arise in acute illness of any kind, with the use of certain cancer treatments or other drugs which affect digestive action, or due to [[anorexia]], [[bulimia]] and other abnormal eating patterns.
==[[Gastroparesis classification|Classification]]==


Chronic gastroparesis is frequently due to [[autonomic neuropathy]].  This may occur in people with [[type 1 diabetes]] or [[type 2 diabetes]]. The vagus nerve becomes damaged by years of high blood glucose, resulting in gastroparesis.  Gastroparesis has also been associated with various [[autoimmune disease]]s and syndromes, such as [[fibromyalgia]] and [[Parkinson's disease]], and may occur as part of a mitochondrial disorder.
==[[Gastroparesis pathophysiology|Pathophysiology]]==


Chronic gastroparesis can also be caused by other types of damage to the vagus nerve, such as [[abdominal surgery]].<ref>[http://www.mayoclinic.com/health/gastroparesis/DS00612/DSECTION=3 Gastroparesis: Causes - MayoClinic.com<!-- Bot generated title -->]</ref>
==[[Gastroparesis causes|Causes]]==


Idiopathic gastroparesis (gastroparesis with no known cause) accounts for a third of all chronic cases; it is thought that many of these cases are due to an autoimmune response triggered by an [[viral infection|acute viral infection]]. "[[Stomach flu]]", [[mononucleosis]], and others have been anecdotally linked to the onset of the condition, but no systematic study has proven a link.
==[[Gastroparesis differential diagnosis|Differentiating Gastroparesis from other Diseases]]==


==Signs and Symptoms==
==[[Gastroparesis epidemiology and demographics|Epidemiology and Demographics]]==


The most common symptoms of gastroparesis are<ref>[http://www.mayoclinic.com/health/gastroparesis/DS00612/DSECTION=symptoms Gastroparesis:  Symptoms - MayoClinic.com]</ref>
==[[Gastroparesis risk factors|Risk Factors]]==


*Chronic nausea
==[[Gastroparesis screening|Screening]]==
*Vomiting (especially of undigested food)
*Early satiety


Other symptoms include
==[[Gastroparesis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


*Heartburn
==Diagnosis==
*Weight loss
[[Gastroparesis diagnostic study of choice|Diagnostic Study of Choice]] | [[Gastroparesis history and symptoms| History and Symptoms]] | [[Gastroparesis physical examination | Physical Examination]] | [[Gastroparesis laboratory findings|Laboratory Findings]] | [[Gastroparesis x ray|X-ray]] | [[Gastroparesis Echocardiography and Ultrasound|Echocardiography and Ultrasound]] | [[Gastroparesis CT scan|CT scan]] | [[Gastroparesis MRI|MRI]] | [[Gastroparesis other imaging findings|Other Imaging Findings]] | [[Gastroparesis other diagnostic studies|Other Diagnostic Studies]]
*Abdominal bloating
*Erratic blood glucose levels
*Lack of appetite
*Gastroesophageal reflux
*Spasms of the stomach wall


==Diagnosis and Treatment==
==Treatment==
[[Gastroparesis medical therapy|Medical Therapy]] | [[Gastroparesis surgery|Surgery]] | [[Gastroparesis primary prevention|Primary Prevention]] | [[Gastroparesis secondary prevention|Secondary Prevention]] | [[Gastroparesis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Gastroparesis future or investigational therapies|Future or Investigational Therapies]]


Gastroparesis can be diagnosed with tests such as [[x ray]]s, [[manometry]], and [[gastric emptying scan]]s.  The clinical definition for gastroparesis is based solely on the emptying time of the stomach and not on other symptoms, and severity of symptoms does not necessarily correlate with the severity of gastroparesis.  Therefore, some patients may have marked gastroparesis with few, if any, serious complications.
==Case Studies==
 
[[Gastroparesis case study one|Case#1]]
Treatment includes dietary changes (low-fiber and low-residue diets, and in some cases, restrictions on fat and/or solids), oral medications such as [[Metoclopramide]] (Reglan, Maxolon, Clopra), [[Cisapride]] (Propulsid), [[Erythromycin]] (E-Mycin, Erythrocin, Ery-Tab, EES) and [[Domperidone]] (Motilium); adjustments in insulin dosage for those with [[diabetes]], a [[jejunostomy tube]], [[parenteral nutrition]], implanted gastric neurostimulators ("[[stomach pacemaker]]s"), or [[botulinum toxin]].
 
[[Viagra]], which increases blood flow to the genital area, is also being used by some practitioners to stimulate the GI tract in diabetic gastroparesis. 
 
The antidepressant [[Mirtazapine]] has also proven effective in the treatment of gastroparesis unresponsive to conventional treatment.  This is due to its anti-emetic and appetite stimulant properties.  Mirtazapine acts on the same serotonin receptor as the popular anti-emetic [[Ondansetron]]<ref>[http://psy.psychiatryonline.org/cgi/content/full/47/5/440 Mirtazapine for Severe Gastroparesis Unresponsive to Conventional Prokinetic Treatment]</ref>.
 
==Complications==
 
Primary complications of gastroparesis include:
 
* Fluctuations in [[blood glucose]] due to unpredictable digestion times (in diabetic patients)
* General malnutrition due to the symptoms of the disease (which frequently include vomiting and reduced appetite) as well as the dietary changes necessary to manage it
* Severe fatigue and weight loss due to calorie deficit
* [[Intestinal obstruction]] due to the formation of [[bezoar]]s (solid masses of undigested food)
* [[Bacterial infection]] due to overgrowth in undigested food
 
==External links==
* [http://www.mayoclinic.com/health/gastroparesis/DS00612 Overview] at [[Mayo Clinic]]
* [http://www.uchospitals.edu/online-library/content=P00370 Overview] at [[University of Chicago Hospitals]]
 
{{SIB}}
{{Gastroenterology}}
 
[[Category:Gastroenterology]]
 
[[pl:Gastropareza]]
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Latest revision as of 13:49, 8 February 2018

Gastroparesis
ICD-10 K31.8
ICD-9 536.3
DiseasesDB 32575
MedlinePlus 000297
MeSH D018589

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2], Madhu Sigdel M.B.B.S.[3] Feham Tariq, MD [4]

Synonyms and keywords: Chronic delayed gastric emptying; delayed gastric emptying; gastric stasis

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Gastroparesis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice | History and Symptoms | Physical Examination | Laboratory Findings | X-ray | Echocardiography and Ultrasound | CT scan | MRI | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case#1

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