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Gastroparesis
cautionfunctional
Description
Delayed gastric emptying in the absence of mechanical obstruction. Most commonly idiopathic or diabetic in etiology. Causes nausea, vomiting, early satiety, and bloating.
Key Features
- Nausea and vomiting (often of undigested food hours after eating)
- Early satiety and postprandial fullness
- Bloating and upper abdominal pain
- Diabetes mellitus (especially with neuropathy)
- Confirmed delayed gastric emptying on scintigraphy
Diagnostic Criteria
- Diagnosis requires ALL of:
- 1. Symptoms of gastroparesis (nausea, vomiting, early satiety, bloating)
- 2. Objective evidence of delayed gastric emptying (scintigraphy: > 10% retention at 4 hours)
- 3. Absence of mechanical gastric outlet obstruction (confirmed by endoscopy or imaging)
Red Flags
- • Severe dehydration
- • Malnutrition/significant weight loss
- • Bezoar formation
- • Uncontrolled diabetes with gastroparesis
Differential Clues
Vomiting undigested food hours after eatingDiabetes with neuropathySuccussion splashNormal endoscopy but delayed scintigraphy
Sources: DynaMed. Gastroparesis. EBSCO Information Services. | ACG Guidelines on Gastroparesis 2013