When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Gastroparesis

Last reviewed: 5 Sep 2024
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 Differentials
  • Guidelines

    • Retinopathy, neuropathy, and foot care: standards of care in diabetes
    • Informed consent for GI endoscopic procedures
    More Guidelines
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer