Volunteer
GSK Logo
Gastroenterology Societyof KenyaAdvancing Digestive Health Care
Back to Presentations
Gastric Disorders

Gastroparesis Management

Comprehensive diagnosis and treatment approaches for gastroparesis - delayed gastric emptying and associated symptoms

GSK Clinical Team
May 2025
GSK Clinical Research

Download Presentation

Download PowerPoint FileOpen in New Tab

Definition & Overview

Gastroparesis is a chronic condition characterized by delayed gastric emptying in the absence of mechanical obstruction. It affects the normal movement of food from the stomach to the small intestine, leading to various gastrointestinal symptoms.

Key Characteristics:

  • Delayed gastric emptying without mechanical obstruction
  • Chronic condition affecting gastric motility
  • Common in patients with diabetes mellitus
  • Can be idiopathic or secondary to various causes
  • Significantly impacts quality of life

Etiology & Risk Factors

Primary Causes

  • Diabetes Mellitus

    Most common cause, especially type 1 diabetes

  • Idiopathic Gastroparesis

    Unknown cause, often affects young women

  • Post-surgical

    Following gastric or esophageal surgery

Secondary Causes

  • • Medications (opioids, anticholinergics)
  • • Neurological disorders (Parkinson's, MS)
  • • Connective tissue diseases
  • • Viral infections
  • • Eating disorders
  • • Hypothyroidism

Clinical Presentation

Primary Symptoms

  • Nausea and vomiting
  • Early satiety
  • Postprandial fullness
  • Abdominal pain

Secondary Symptoms

  • Weight loss
  • Malnutrition
  • Dehydration
  • Poor glycemic control (in diabetics)

Diagnosis

Initial Assessment

  • • Detailed history and physical examination
  • • Rule out mechanical obstruction
  • • Assess for underlying conditions
  • • Review medication history

Diagnostic Tests

Gastric Emptying Scintigraphy

  • • Gold standard test
  • • Measures gastric emptying rate
  • • Solid meal with radiolabeled marker

Other Diagnostic Tools

  • • Upper GI endoscopy
  • • Gastric manometry
  • • Breath tests
  • • Wireless motility capsule

Severity Classification

Mild

  • • Symptoms easily controlled
  • • Normal weight maintenance
  • • Occasional nausea/vomiting
  • • Minimal impact on daily life

Moderate

  • • Symptoms partially controlled
  • • Some weight loss
  • • Frequent nausea/vomiting
  • • Moderate impact on daily life

Severe

  • • Symptoms poorly controlled
  • • Significant weight loss
  • • Persistent nausea/vomiting
  • • Major impact on daily life

Treatment Approaches

Multidisciplinary Approach

Treatment requires a comprehensive, multidisciplinary approach involving dietary modifications, medications, and in severe cases, procedural interventions.

Dietary Management

  • • Small, frequent meals
  • • Low-fat, low-fiber diet
  • • Liquid nutrition supplements
  • • Avoid high-fat and high-fiber foods
  • • Adequate hydration

Medical Therapy

  • • Prokinetic agents (metoclopramide, domperidone)
  • • Antiemetic medications
  • • Pain management
  • • Blood glucose control (in diabetics)
  • • Nutritional support

Advanced Treatment Options

Endoscopic Procedures

  • • Botulinum toxin injection
  • • Gastric electrical stimulation
  • • Endoscopic pyloromyotomy
  • • Gastric peroral endoscopic myotomy (G-POEM)

Surgical Options

  • • Gastric bypass surgery
  • • Gastric resection
  • • Feeding tube placement
  • • Gastric pacemaker implantation

Complications & Prognosis

Potential Complications

  • Malnutrition and weight loss
  • Dehydration and electrolyte imbalances
  • Poor glycemic control in diabetics
  • Bezoar formation
  • Esophageal complications
  • Reduced quality of life

Prognosis Factors

  • • Underlying cause
  • • Severity of symptoms
  • • Response to treatment
  • • Patient compliance
  • • Presence of complications

Long-term Outlook

  • • Chronic condition requiring ongoing management
  • • Quality of life improvement with treatment
  • • Regular monitoring required
  • • Multidisciplinary care essential

Key Takeaways

Summary Points:

  • Gastroparesis is a chronic condition requiring comprehensive management
  • Diabetes mellitus is the most common cause
  • Gastric emptying scintigraphy is the gold standard for diagnosis
  • Treatment involves dietary modifications, medications, and advanced procedures
  • Multidisciplinary approach improves patient outcomes
  • Early diagnosis and intervention are crucial for quality of life