Gastroparesis diabeticorum

Alternative names
Gastroparesis; Delayed gastric emptying

Definition

Gastroparesis is a condition in which the stomach’s ability to empty its contents is impaired, unrelated to obstruction.

Causes, incidence, and risk factors

The cause of gastroparesis is unknown, but disruption of nerve stimulation to the intestine may be responsible. The condition is a common complication of diabetes and can be a complication of some surgeries. Risk factors for gastroparesis include diabetes, systemic sclerosis, previous vagotomy, previous gastrectomy, visceral neuropathy, and use of anticholinergic medication.

Symptoms

• Nausea and vomiting
  
• Abdominal distention
  
• Premature abdominal fullness after meals
  
• Unintentional weight loss

• Isotope study showing gastroparesis
  
• Upper GI series showing gastric retention
  
• EGD (esophagogastroduodenoscopy)

Diabetics may improve symptoms of gastroparesis by gaining better control of blood sugar levels. Dietary management with small meals and soft foods (which should be well-cooked and well-chewed) may be of benefit. Medications seem to provide little long-term benefit. Metoclopramide and cholinergic medications can be used. Some cases respond to botulinum toxin ("botox") injection into the pylorus (outlet of the stomach). In some people, gastroenterostomy may be of benefit.

Expectations (prognosis)

Many treatments seem to provide only temporary benefit.

Complications

Persistent nausea and vomiting may cause electrolyte imbalances, dehydration, and Malnutrition. Diabetics may have serious Complications related to poor blood sugar control.

Calling your health care provider

Apply home treatment such as dietary management. Call your provider if symptoms persist or if there are new symptoms.

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