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Wednesday, December 30, 2015

Gastroparesis

Gastroparesis



Pathogenesis. Gastroparesis literally means the presence of a weak stomach. The most common association for gastroparesis is diabetes. Electrolyte problems with potassium, magnesium, and calcium can also weaken the musculature of the bowel wall.
Clinical Presentation. Patients present with early satiety, postprandial nausea, and a general sense of increased abdominal fullness. This is from decreased motility of the stomach and the accumulation of food there. Gastroparesis generally occurs in those presenting with abdominal pain and bloating and who have a long-standing history of diabetes, along with retinopathy, neuropathy, nephropathy, and history of poor glycemic  control.

Diagnosis. Although a gastric-emptying study can be done with the ingestion of radioisotope- labeled food, this is rarely necessary. The diagnosis of diabetic gastroparesis is generally obvious as the cause of bloating, vomiting, and nausea in a long-term diabetic after endoscopy excludes other diseases.
Treatment. The treatment of gastroparesis is with agents that will increase motility of the stomach, such as erythromycin or metoclopramide. Erythromycin increases motilin levels.

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