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:

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	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	✔	✔	✔	-		✔	-	-	✔	✔	-
Bulimia nervosa	✔	✔	✔	✔		✔	-	-	-	✔	✔
Rumination syndrome	✔	✔ (Regurgitation more common)	✔	-	✔	✔	✔	✔	-	-	-
Functional dyspepsia	✔	✔	✔	✔		-	-	-	-	-	-
Cyclic vomiting syndrome	✔	✔	-	✔		-	-	-	-	-	-
Pancreatitis	✔	✔	✔	✔		-	-	✔	-	-	-
Gastric outlet obstruction	✔	✔ (within 1 hour of eating)	-	-		-	-	✔	-	-	-

• Celiac disease
• Diabetic neuropathy
• Pancreatitis
• Diabetic diarrhea
• Gall bladder disease