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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