Gastroparesis

Gastroparesis is ('gastro' means 'stomach' and 'paresis' means 'weakness or partial paralysis') a condition in which muscles of the stomach become weak and impair the passage of food and the process of digestion. 



Clinical features

  • Burning over the abdomen or chest 
  • Food literally getting 'stuck' in the stomach
  • Regurgitation of undigested or partially digested food 
  • Abdominal fullness and bloating
  • Decrease in appetite
  • Eventual loss of weight


Causes

  1. Diabetes mellitus
  2. Injury to vagus nerve during surgeries
  3. Deposition disorders like amyloidosis etc
  4. Drug-induced- opioids, anti-depressants, etc
  5. Nervous system disorders like Parkinson's and multiple sclerosis etc


Management

  • Gastroparesis is a clinical diagnosis that can be confirmed by
  • Gastric emptying study
  • Upper GI endoscopy


Treatment

  • Small and frequent meals are advised in patients having paresis. Some medications can be tried to manage the symptoms like: -

  • Erythromycin 
  • Anti-emetics like ondansetron which help control nausea and prevent vomiting
  • For refractory symptoms, endoscopic procedures like
  • Per oral pyloromyotomy is an endoscopic procedure that enables easier passage of food from the stomach to the duodenum.
  • Enteral feeding through a jejunostomy tube in extremely severe cases


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