Gastroparesis differential diagnosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Gastroparesis should be differentiated from other diseases that cause chronic nausea and vomiting. The differentials include psychiatric illnesses, rumination syndrome, funtional dyspepsia and cyclic vomiting syndrome.
Differentiating Gastroparesis from other Diseases
Gastroparesis should be differentiated from other diseases that cause chronic nausea and vomiting. The differentials include the following:[1][2][3][4][5][6]
| Disorder | Clinical features | Laboratory findings | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Chronic nausea | Vomiting | Diarrhea | Retching | Lethargy | Social withdrawal | Photophobia | Epigastric pain/burning | Lanugo hair | Hypogonadism | Russel's sign | Body mass index (normal range: 18.5 to 24.9) | Complete blood count (CBC) | Electrolyte imabalance | Lipase and amylase levels | Endoscopic findings | Gastric scintigraphy | Ambulatory esophageal pH and impedance testing | |
| Gastroparesis | ✔ | ✔ (within 1 hour of eating) | - | ✔ | - | - | ✔ | - | - | - | ↓ | ✔ | ||||||
| Anorexia nervosa | ✔ | ✔ | ✔ | - | ✔ | - | - | ✔ | ✔ | - | ↓ | Leukocytosis, anemia | ✔ | |||||
| Bulimia nervosa | ✔ | ✔ | ✔ | ✔ | ✔ | - | - | - | ✔ | ✔ | Normal | Leukocytosis, anemia | ✔ | |||||
| Rumination syndrome | ✔ | ✔ (Regurgitation more common) | ✔ | - | ✔ | ✔ | ✔ | ✔ | - | - | - | ↓ | Normal | ✔ | ||||
| Functional dyspepsia | ✔ | ✔ | ✔ | ✔ | - | - | - | - | - | - | Normal | Normal | ✔ | |||||
| Cyclic vomiting syndrome | ✔ | ✔ | - | ✔ | - | - | - | - | - | - | ↓ | Leukocytosis, anemia | ✔ | |||||
| Pancreatitis | ✔ | ✔ | ✔ | ✔ | - | - | ✔ | - | - | - | Normal | Leukocytosis | ✔ | |||||
| Gastric outlet obstruction | ✔ | ✔ (within 1 hour of eating) | - | - | - | - | ✔ | - | - | - | ↓ | Leukocytosis | ✔ | |||||
- Celiac disease
- Diabetic neuropathy
- Pancreatitis
- Diabetic diarrhea
- Gall bladder disease [7]
References
- ↑ Parkman HP (2015). "Idiopathic gastroparesis". Gastroenterol. Clin. North Am. 44 (1): 59–68. doi:10.1016/j.gtc.2014.11.015. PMC 4324534. PMID 25667023.
- ↑ Werlin SL, Fish DL (2006). "The spectrum of valproic acid-associated pancreatitis". Pediatrics. 118 (4): 1660–3. doi:10.1542/peds.2006-1182. PMID 17015559.
- ↑ Noddin L, Callahan M, Lacy BE (2005). "Irritable bowel syndrome and functional dyspepsia: different diseases or a single disorder with different manifestations?". MedGenMed. 7 (3): 17. PMC 1681633. PMID 16369243.
- ↑ Gupta R, Kalla M, Gupta JB (2012). "Adult rumination syndrome: Differentiation from psychogenic intractable vomiting". Indian J Psychiatry. 54 (3): 283–5. doi:10.4103/0019-5545.102434. PMC 3512372. PMID 23226859.
- ↑ "Body weight in bulimia nervosa | SpringerLink".
- ↑ Sağlam F, Sivrikoz E, Alemdar A, Kamalı S, Arslan U, Güven H (2015). "Bouveret syndrome: A fatal diagnostic dilemma of gastric outlet obstruction". Ulus Travma Acil Cerrahi Derg. 21 (2): 157–9. PMID 25904280.
- ↑ http://www.wrongdiagnosis.com/g/gastroparesis/misdiag.htm