Last revised by Joshua Yap on 7 Aug 2023

Gastroparesis (plural: gastropareses) is a functional gastric disorder caused by abnormal gastric motility with delayed stomach emptying in the absence of mechanical obstruction and results in gastric distension.

Commonly presents with nausea, vomiting, postprandial fullness, early satiety, weight loss and/or weight gain and epigastric pain. 

The most common etiologies are 1:

  • marked enlargement of gas-filled gastric bubble

A study of 50 patients with gastroparesis over an 8-year period found the following signs 2:

  • decreased or absent gastric peristalsis

  • gastric dilatation and delayed emptying of barium

  • debris/barium bezoar and retained fluid

  • measuring emptying of a liquid meal by serially evaluating cross-sectional changes in the volume of the gastric antrum

  • marked gastric dilatation in the absence of mechanical obstruction or gastric masses

The gold standard of diagnosis is solid meal gastric scintigraphy 3,4. Egg albumin radiolabelled with 37 MBq Tc-99m sulfur colloid is generally used and administered orally with toasted bread as an egg sandwich.

Measuring simultaneous solid and liquid emptying can be done with a liquid phase, in which water is labeled with 3.7 MBq In-111 DTPA. Data acquisition is performed for 60-120 minutes. Measurement of the half-emptying time is the simplest way to assess gastric transit.

Management includes dietary modification, prokinetic and antiemetic medications, and surgical interventions. Gastric electrical stimulation techniques have been introduced (gastric pacemaker).

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