Gastroparesis: A Review

Area of Science:

• Gastroenterology
• Digestive Health
• Medical Diagnostics

Background:

• Gastroparesis is characterized by delayed gastric emptying without obstruction, predominantly affecting females.
• Common causes include type 2 diabetes (51.7%), postsurgical effects (15%), and idiopathic factors (11.3%).
• Risk factors encompass neurological disorders, hypothyroidism, and viral infections.

Purpose of the Study:

• To summarize the current understanding of gastroparesis diagnosis and management.
• To outline diagnostic criteria and treatment guidelines for gastroparesis.

Main Methods:

• Diagnosis relies on gastric emptying scintigraphy or the carbon 13 stable isotope breath test.
• Gastric retention thresholds define mild (10%-15%), moderate (16%-35%), and severe (>35%) gastroparesis.
• Diagnostic imaging includes upper endoscopy and CT scans to exclude mechanical obstruction.

Main Results:

• Prevalence of definite gastroparesis was 21.5 per 100,000 persons in a 2018 US study.
• Treatment strategies are stratified by severity, including dietary modifications, antiemetics, prokinetics, and optimized glycemic control for diabetic patients.
• Severe or refractory cases may necessitate interventions like gastric peroral endoscopic myotomy (G-POEM) or gastric electrical stimulation.

Conclusions:

• Gastroparesis management requires a multi-faceted approach tailored to disease severity.
• Early diagnosis and appropriate treatment are crucial for managing symptoms and improving patient outcomes.
• Ongoing research and guideline updates, such as those from the AGA, guide clinical practice for gastroparesis.