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
- coeliac disease
- anorexia
- Parkinson's disease
- multiple sclerosis
- scleroderma
- amyloidosis
- systemic lupus erythematosus
- hypothyroidism
- chronic renal insufficiency
- acute viral infection
- paraneoplastic syndrome (tumour-associated)
- use of specific drugs
- use of alcohol
- chronic mesenteric ischaemia
- median arcuate ligament syndrome
Diagnostic investigations
1st investigations to order
- FBC
- serum glucose
- serum creatinine
- serum potassium
- liver function tests
- serum total protein
- serum albumin
- serum amylase and lipase
- thyroid-stimulating hormone
- HbA1c
- pregnancy test
Investigations to consider
- gastric emptying scintigraphy
- upper gastrointestinal endoscopy
- abdominal x-ray
- contrast radiography
- wireless motility capsule (WMC)
- gastric emptying breath test (GEBT)
Emerging tests
- electrogastrography
Treatment algorithm
acute symptoms
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.
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
- Acute pancreatitis
- Cyclic vomiting syndrome
- Functional dyspepsia
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