Gastroparesis

ANMS Gastroparesis

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Key Points Key Points ÎGastroparesis is a syndrome characterized by delayed gastric emptying without mechanical obstruction. ÎThe main symptoms include early satiety, postprandial fullness, nausea, vomiting, and bloating. ÎThe etiology of gastroparesis is multifactorial; the main categories being diabetic, idiopathic, and postgastric surgery disorders. ÎGastroparesis is relatively common, affecting up to 2 million individuals in the United States. ÎThe female:male ratio is 4:1, and the mean age of onset is 34 years. ÎSymptoms attributable to gastroparesis are reported by 5 to 12% of patients with diabetes in the community. • Classically, gastroparesis is more common in Type 1 diabetics than Type 2 diabetics. • Studies suggest that for diabetic patients referred to academic medical centers, 20 to 30% of patients report symptoms attributable to gastroparesis. Table 1. Etiology of Gastroparesis Idiopathic Diabetes Mellitus Postsurgical • Partial gastric resection/vagotomy • Postbariatic surgery • Diffuse GI motor disorders (eg. Chronic intestinal pseudo-obstruction • GERD • Achalasia • Gastric ulcer • Eating disorders: anorexia • Neurologic disorders ▶ CNS tumors ▶ Parkinson's disease • Nissen fundoplication • Transplantation: lung, heart-lung GI disorders associated with delayed gastric emptying • Atrophic gastritis • Functional dyspepsia (FD) • Hypertrophic pyloric stenosis • Celiac disease Non-GI disorders associated with delayed gastric emptying • Endocrine and metabolic disorders ▶ Thyroid dysfunction ▶ Parathyroid dysfunction ▶ Chronic renal insufficiency • Collagen vascular disorders ▶ Scleroderma ▶ Systemic lupus erythematosus ▶ Amyloidosis • Gastric infection • Chronic mesenteric ischemia • Tumor associated (paraneoplastic) • Medication associated

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