Flashcards in GASTROPARESIS AND GASTRIC OUTLET OBSTRUCTION Deck (13)
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.
What are the causes of gastroparesis?
Previous surgival vagotomy
Autonomic neuropathy - often from diabetes
Connective tissue disease - Ehlers-Danlos, scleroderma
What are the clinical features of gatroparesis?
Chronic nausea (especially morning nausea)
Feeling of fullness after a few bites
Weight loss and malnutrition
Who is more affected by gastroparesis?
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
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
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.
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)
What are the clinical features of gastric outlet obstruction?
Vomiting - often projectile
Sloshing sound heard in epigastric regions
What investigations would be ordered for someone with suspected gastric outlet obstruction?
Why would you do U&Es in someone with gastric outlet obstruction?
Check for metabolic alkalosis and hypokalaemia due to prolonged vomiting
What are the complications of gastric outlet obstruction?