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Gastrointestinal - Gastroparesis
In this episode, we review gastroparesis, a chronic disorder of delayed gastric emptying without mechanical obstruction. We break down normal gastric motility, the role of the vagus nerve and interstitial cells of Cajal, and how dysfunction leads to impaired antral contraction and pyloric relaxation. The discussion highlights key risk factors—including diabetes, postsurgical vagal injury, and medications—along with classic symptoms such as nausea, early satiety, and postprandial fullness. We cover diagnostic strategies with gastric emptying studies and evidence-based management, from dietary modification and prokinetic therapy to advanced interventions for refractory cases.
References
1) Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817.
2) Dilmaghani S, Zheng T, Camilleri M. Epidemiology and healthcare utilization in patients with gastroparesis: a systematic review. Clin Gastroenterol Hepatol. 2023;21(9):2239-2251.e2. doi:10.1016/j.cgh.2022.07.011.
3) Reddivari AKR, Mehta P. Gastroparesis. [Updated 2024 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551528/
4) Schol J, Wauters L, Dickman R, et al; ESNM Gastroparesis Consensus Group. United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis. United European Gastroenterol J. 2021;9(3):287-306. doi:10.1002/ueg2.12060.
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By Kristopher Maday, PA-C, DFAAPAIn this episode, we review gastroparesis, a chronic disorder of delayed gastric emptying without mechanical obstruction. We break down normal gastric motility, the role of the vagus nerve and interstitial cells of Cajal, and how dysfunction leads to impaired antral contraction and pyloric relaxation. The discussion highlights key risk factors—including diabetes, postsurgical vagal injury, and medications—along with classic symptoms such as nausea, early satiety, and postprandial fullness. We cover diagnostic strategies with gastric emptying studies and evidence-based management, from dietary modification and prokinetic therapy to advanced interventions for refractory cases.
References
1) Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817.
2) Dilmaghani S, Zheng T, Camilleri M. Epidemiology and healthcare utilization in patients with gastroparesis: a systematic review. Clin Gastroenterol Hepatol. 2023;21(9):2239-2251.e2. doi:10.1016/j.cgh.2022.07.011.
3) Reddivari AKR, Mehta P. Gastroparesis. [Updated 2024 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551528/
4) Schol J, Wauters L, Dickman R, et al; ESNM Gastroparesis Consensus Group. United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on gastroparesis. United European Gastroenterol J. 2021;9(3):287-306. doi:10.1002/ueg2.12060.