Diagnosis and Management of Gastroparesis

Ramos, Gabriela Piovezani; Law, Ryan; Camilleri, Michael

doi:10.14309/ajg.0000000000002003

Cited by 3 publications

(6 citation statements)

References 21 publications

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“…A correlation was reported by Nelson et al [22] between DG incidence with both age and insufficient glycemic control, while this study along with previous studies did not document such dependence [23][24][25]. However, the results coincide with the studies of Friedenberg et al [20] and Camilleri et al [25], agreeing that the female gender seemed a significant predictor of DG [25][26][27].…”

Section: Discussionsupporting

confidence: 84%

Gastroparesis-Related Symptoms in Patients With Type 2 Diabetes Mellitus: Early Detection, Risk Factors, and Prevalence

Asghar¹,

Asghar²,

Shahid³

et al. 2023

Cureus

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BackgroundThe symptoms of gastroparesis, such as bloating, postprandial fullness, early satiety, nausea, and abdominal discomfort, progressively worsen the quality of life of the affected individuals. The diagnosis is established on the assessment of gastric function that confirms delayed gastric emptying in the absence of structural etiologies. This study aimed to detect gastroparesis-related clinical symptoms early in patients with type 2 diabetes mellitus (T2DM), investigate the concomitant risk factors, and evaluate the prevalence.

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Section: Discussionsupporting

confidence: 84%

Gastroparesis-Related Symptoms in Patients With Type 2 Diabetes Mellitus: Early Detection, Risk Factors, and Prevalence

Asghar¹,

Asghar²,

Shahid³

et al. 2023

Cureus

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“…Besides typical symptoms (i.e., nausea, vomiting, and abdominal pain), the accurate diagnosis of gastroparesis often requires tests such as scintigraphy, capsule endoscopy, and/or electrogastrography (EGG). The gold standard for diagnosis with a 90% sensitivity is the scintigraphic assessment of solid emptying over four hours [23,24]. Scintigraphy, also known as a gastric emptying study, involves eating a meal charged with a contrast agent, which is radiologically tracked as it moves through the digestive system [24].…”

Section: Diagnosismentioning

confidence: 99%

“…The gold standard for diagnosis with a 90% sensitivity is the scintigraphic assessment of solid emptying over four hours [23,24]. Scintigraphy, also known as a gastric emptying study, involves eating a meal charged with a contrast agent, which is radiologically tracked as it moves through the digestive system [24]. The stomach takes up this radiopharmaceutical and emits gamma rays, which a gamma camera can detect.…”

Section: Diagnosismentioning

confidence: 99%

“…During an EGG, the patient is typically asked to fast for a period before the test and may be given a meal or liquid to consume before the recording [23,28,33]. The test involves placing several small electrodes on the surface of the skin of the abdomen, which is connected to a recording device [24,34]. The recording device then records the electrical signals generated by the stomach muscles as the patient digests the meal or liquid.…”

Section: Diagnosismentioning

confidence: 99%

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Diabetic Gastroparesis: A Narrative Review of a Neglected Complication

Valko

2023

CRDOJ

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Diabetic gastroparesis is a form of autonomic neuropathy resulting in a complication of diabetes mellitus and characterized by delayed gastric emptying. The prevalence is estimated to be 5% among type 1 diabetics and 1% among type 2 diabetics. It is most commonly seen in people who have had diabetes for 10 years and have already developed other microvascular complications. The pathophysiology of diabetic gastroparesis is complex and not yet fully understood, but it is believed to involve several interrelated factors. One of the main contributing factors is damage to the nerves (diabetic neuropathy) that control the muscles of the stomach and intestines. This can lead to abnormal contractions and motility in the stomach, resulting in delayed gastric emptying and associated symptoms. The cardinal symptoms of gastroparesis include nausea, vomiting, postprandial fullness, early satiety, bloating, upper abdominal pain, and in severe cases, anorexia, and weight loss, with a characteristic cyclic pattern with periodic exacerbations. The diagnosis typically involves a combination of medical history, physical examination, and laboratory tests (i.e., scintigraphy, capsule endoscopy, and/or electrogastrography). The main targets of the management of gastroparesis include symptomatic control, correction of nutritional deficiencies, and maintenance of optimal weight. Pharmacological therapies aim to improve symptoms and include prokinetics, motilin agents, ghrelin agonists, 5HT4 receptor agonists, antiemetics, and neuromodulators. In order to ensure the successful management of diabetic gastroparesis, it is essential to achieve adequate glucose control with dietary and insulin intake modifications. Endoscopic therapies can be an effective alternative when conservative measures have failed to improve symptoms. Overall, diabetic gastroparesis is a debilitating and progressive disease that significantly affects a patient's quality of life and has limited treatments. This narrative review provides an updated overview of the medical approach to this multifaceted condition.

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“…Among the various types of diabetic neuropathy, diabetic gastroparesis (DGP) was documented first by Rundles in 1945 [ 2 ] and Kassandra coined the term “ gastroparesis diabeticorum ” [ 3 ]. Gastroparesis is a chronic symptomatic gastric disorder characterized by impaired gastric motility in the absence of outlet obstruction [ 4 , 5 ] and DM is one of the leading causes of gastroparesis [ 5 , 6 ]. The manifestations of DGP include early satiety, postprandial fullness, nausea, vomiting, and abdominal pain [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Gastroparesis might not be uncommon in patients with diabetes mellitus in a real-world clinical setting: a cohort study

Lee,

Park,

Park

et al. 2024

BMC Gastroenterol

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Background This study investigated the frequency of diabetic gastroparesis and associated risk factors in a real-world clinical setting. Methods This retrospective cross-sectional study included patients who underwent assessments of solid gastric emptying time (GET) by technetium-99 m scintigraphy between May 2019 and December 2020. We categorized patients into three groups according to gastric retention of technetium-99 m: rapid (< 65% at 1 h or < 20% at 2 h), normal (≤60% at 2 h and/or ≤ 10% at 4 h), and delayed (> 60% at 2 h and/or > 10% at 4 h). Results Patients with diabetes mellitus (DM) were more likely to show abnormal GET than those without DM (119 [70.8%] vs. 16 [44.4%]). The mean glycated A1c was 10.3% in DM patients. DM patients with normal GET were significantly younger (57.2 years, P = 0.044) than those with delayed (65.0 years) or rapid GET (60.2 years). Fasting glucose levels were the lowest in the normal GET group and the highest in the rapid GET group (delayed: 176.3 mg/dL, normal: 151.2 mg/dL, rapid: 181.0 mg/dL, P = 0.030). However, glycated A1c was not significantly different among the delayed, normal, and rapid GET groups in patients with DM. Patients with delayed and rapid GET showed a higher frequency of retinopathy (6.0 vs. 15.5%, P = 0.001) and peripheral neuropathy (11.3 vs. 24.4%, P = 0.001) than those with normal GET. In the multinomial logistic regression analysis, retinopathy demonstrated a positive association with delayed GET, while nephropathy showed a significant negative correlation. Conclusion DM gastroparesis in the clinical setting was not uncommon. Abnormal GET, including delayed and rapid GET, was associated with DM retinopathy or peripheral neuropathy.

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Diagnosis and Management of Gastroparesis

Cited by 3 publications

References 21 publications

Gastroparesis-Related Symptoms in Patients With Type 2 Diabetes Mellitus: Early Detection, Risk Factors, and Prevalence

Gastroparesis-Related Symptoms in Patients With Type 2 Diabetes Mellitus: Early Detection, Risk Factors, and Prevalence

Diabetic Gastroparesis: A Narrative Review of a Neglected Complication

Gastroparesis might not be uncommon in patients with diabetes mellitus in a real-world clinical setting: a cohort study

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