Summary
Definition
History and exam
Key diagnostic factors
- postprandial fullness
- nausea
- vomiting
- early satiety
Other diagnostic factors
- epigastric pain
- fullness
- bloating
- weight loss
- succussion splash
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 kidney disease
- acute viral infection
- paraneoplastic syndrome (tumor-associated)
- use of specific drugs
- alcohol
- chronic mesenteric ischemia
- median arcuate ligament syndrome
Diagnostic tests
1st tests to order
- CBC
- serum glucose
- serum creatinine
- serum potassium
- LFTs
- serum total protein
- serum albumin
- serum amylase and lipase
- thyroid-stimulating hormone
- HbA1c
- pregnancy test
Tests to consider
- gastric emptying scintigraphy
- upper gastrointestinal endoscopy
- abdominal x-ray
- contrast radiography
- gastric emptying breath test
Emerging tests
- wireless motility capsules (WMCs)
- electrogastrography
Treatment algorithm
acute symptoms
refractory to medical therapy
Contributors
Authors
Michael Camilleri, MD, DSC, MPhil, MRCP
Professor of Medicine, Pharmacology and Physiology
Division of Gastroenterology and Hepatology
Department of Medicine
Mayo Clinic
Rochester
Minnesota, MN
Disclosures
MC declares that he has no competing interests.
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.
Acknowledgements
Dr Michael Camilleri and Dr Savio Reddymasu would like to gratefully acknowledge Dr Mojtaba Olyaee, a previous contributor to this topic.
Disclosures
MC 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.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Camilleri M, Kuo B, Nguyen L, et al. ACG clinical guideline: gastroparesis. Am J Gastroenterol. 2022 Aug 1;117(8):1197-220.Full text Abstract
Lacy BE, Tack J, Gyawali CP. AGA clinical practice update on management of medically refractory gastroparesis: expert review. Clin Gastroenterol Hepatol. 2022 Mar;20(3):491-500.Full text Abstract
Schol J, Wauters L, Dickman R, et al. United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis. United European Gastroenterol J. 2021 Apr;9(3):287-306.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Cyclic vomiting syndrome
- Functional dyspepsia
- Gastric outlet obstruction
More DifferentialsGuidelines
- ACG clinical guideline: gastroparesis
- Consensus on gastroparesis
More Guidelines
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