Last reviewed: 13 Feb 2025
Last updated: 05 Jan 2024
Summary
Definition
History and exam
Key diagnostic factors
- postprandial fullness
- nausea
- vomiting
- early satiety
Full details
Other diagnostic factors
- epigastric pain
- fullness
- bloating
- weight loss
- succussion splash
Full details
Risk factors
- diabetes mellitus
- previous gastric and pancreatic surgery
- female sex
- achalasia
- atrophic gastritis
- functional dyspepsia
- celiac disease
- anorexia
- Parkinson disease
- multiple sclerosis
- scleroderma
- amyloidosis
- systemic lupus erythematosus
- hypothyroidism
- chronic renal insufficiency
- acute viral infection
- paraneoplastic syndrome (tumor-associated)
- use of specific drugs
- alcohol
- chronic mesenteric ischemia
- median arcuate ligament syndrome
Full details
Diagnostic tests
1st tests to order
- CBC
- serum glucose
- serum creatinine
- serum potassium
- liver function tests
- serum total protein
- serum albumin
- serum amylase and lipase
- thyroid-stimulating hormone
- HbA1c
- pregnancy test
Full details
Tests to consider
- gastric emptying scintigraphy
- upper gastrointestinal endoscopy
- abdominal x-ray
- contrast radiography
- wireless motility capsule (WMC)
- gastric emptying breath test (GEBT)
Full details
Emerging tests
- electrogastrography
Treatment algorithm
ACUTE
acute symptoms
ONGOING
refractory to medical therapy
Contributors
Authors
Savio C. Reddymasu, MD
Associate Professor of Medicine
Creighton University School of Medicine
Phoenix Regional Campus
St. Joseph's Hospital and Medical Center
Phoenix
AZ
Disclosures
SCR is an author of a reference cited in this topic. SCR declares that he has no competing interests.
Mojtaba M. Olyaee, MD
Professor of Medicine
Chief
Division of Gastroenterology
University of Kansas Medical Center
Kansas City
KS
Disclosures
MMO declares that he has no competing interests.
Peer reviewers
John Kepros, MD
Director
Trauma Services
Assistant Professor
Michigan State University
Lansing
MI
Disclosures
JK declares that he has no competing interests.
Eamonn M.M. Quigley, MD, FRCP, FACP, FACG, FRCPI
Department of Medicine
Clinical Sciences Building
Cork University Hospital
Cork
Ireland
Disclosures
EMMQ declares that he has no competing interests.
Differentials
- Acute pancreatitis
- Cyclic vomiting syndrome
- Functional dyspepsia
More DifferentialsGuidelines
- Retinopathy, neuropathy, and foot care: standards of care in diabetes
- Informed consent for GI endoscopic procedures
More Guidelines
Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer