Flashcards in GASTROPARESIS AND GASTRIC OUTLET OBSTRUCTION Deck (13)
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1
What is gastroparesis?
Reduced mobility of the stomach, resulting in food remaining in the stomach for an abnormally long time. Normally the result of vagal never damage.
2
What are the causes of gastroparesis?
Previous surgival vagotomy
Autonomic neuropathy - often from diabetes
Idiopathic
Connective tissue disease - Ehlers-Danlos, scleroderma
Parkinson's
Hypochlorydria
3
What are the clinical features of gatroparesis?
Chronic nausea (especially morning nausea)
Vomiting
Abdominal pain
Feeling of fullness after a few bites
Weight loss and malnutrition
Heartburn
4
Who is more affected by gastroparesis?
Women
5
What investigations would you for someone with the signs and symptoms of gastroparesis and what might you see?
Barium meal - distension of stomach with reduced passage of barium in duodenum
Radioisotope scan
6
What are the treatment options for someone diagnosed with gastroparesis?
Antiemetics with prokinetic action - Domperidone or metoclopramide
In severe cases a motilin analogue such as erythromycin might be needed.
Gastric pacemaker can be used in patients with refractory symptoms
7
What causes gastric outlet obstruction?
Long standing peptic ulcer disease leading to scarring and narrowing of the gastric outlet.
Can be as a result of compression on outlet by gastric or pancreatic cancer, or by lymph nodes.
8
What do we call gastric outlet obstruction affecting the pylorus?
Pyloric stenosis (not to be confused with congenital type which is not due to scarring but hypertrophy of fibromuscular layer)
9
What are the clinical features of gastric outlet obstruction?
Vomiting - often projectile
Sloshing sound heard in epigastric regions
10
What investigations would be ordered for someone with suspected gastric outlet obstruction?
Barium meal
Endoscopy
U&Es
11
Why would you do U&Es in someone with gastric outlet obstruction?
Check for metabolic alkalosis and hypokalaemia due to prolonged vomiting
12
What are the complications of gastric outlet obstruction?
Metabolic alkalosis
Aspiration pneumonia
Malnutrition
13
