Overview
Definition
A syndrome characterized by delayed gastric emptying of solid food in the absence of mechanical obstruction.
Epidemiology
Most common in patients with diabetes (Diabetic gastroparesis) and idiopathic cases.
Etiology & Risk Factors
- Autonomic neuropathy (vagus nerve damage in diabetes)
- Post-viral syndrome
- Post-surgical vagotomy
Clinical Symptoms
- Nausea and vomiting of undigested food hours after eating
- Early satiety
- Postprandial fullness
- Bloating
- Weight loss
Clinical Approach
Diagnosis
- Gastric Emptying Study (using radiolabeled meal, showing >10% retention at 4 hours)
- Upper endoscopy (to rule out mechanical obstruction)
Management
- Dietary modifications (small, frequent, low-fat, low-fiber meals)
- Prokinetic agents (Metoclopramide, Erythromycin, Domperidone)
- Antiemetics
- Gastric electrical stimulation (Enterra) for refractory cases
Complications
- Malnutrition
- Severe dehydration
- Bezoar formation
- Poor glycemic control in diabetic patients