[Gastroparesis--diagnosis and treatment]

Gastroparesis is a disorder characterized by a delay in gastric emptying of a meal in the absence of a mechanical gastric outlet obstruction. Diagnosis of gastroparesis is based on the presence of symptoms ( nausea, vomiting, postprandial abdominal fullness), excluded mechanical obstruction (endoscopy) and on objectively determined delay in gastric emptying. Gastric emptying can be assessed by scintigraphy and stable isotope breath tests. The true prevalence of gastroparesis is unknown. The aetiology of gastroparesis is diverse. In approximately one third of cases, gastroparesis is related to the presence of diabetes mellitus; one third of case is of unknown cause (idiopathic). Mild disease will respond to dietary and life style measures and prokinetics (domperidone, metoclopramide, erytromicyne). Severe disease can benefit from intrapyloric botulinum toxin injection, gastric pacing or more radical surgical interventions (partial or total gastrectomy).