Gastroparesis - Revision history

Ostermayer: Prepared the page for translation

2026-01-04T22:56:44Z

Prepared the page for translation

Rossdonaldson1: /* Evaluation */

2024-02-01T00:49:00Z

Evaluation

← Older revision		Revision as of 00:49, 1 February 2024
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	==Evaluation==		==Evaluation==
			[[File:GastroparesisXray.jpg\|thumb\|Simple abdominal X-ray reveals a large amount of material in the stomach, suggesting severe gastric hypomotility.]]
	*Definitive diagnosis of gastroparesis not typically made in ED		*Definitive diagnosis of gastroparesis not typically made in ED
	**Gold standard is gastric emptying scintigraphy of a solid-phase meal		**Gold standard is gastric emptying scintigraphy of a solid-phase meal

Neil.m.young: /* ED Management */

2021-06-30T02:48:38Z

ED Management

← Older revision		Revision as of 02:48, 30 June 2021
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	*Refractory disease:		*Refractory disease:
	**[[Nasogastric tube]] to decompress stomach		**[[Nasogastric tube]] to decompress stomach
	**Advanced therapies (not in ED) may include: placement of jejunostomy and/or [[G-tube complications\|gastrostomy tube]], pyloric injection of botulinum toxin, [[Gastric pacemaker complication\|gastric electric stimulation]		**Advanced therapies (not in ED) may include: placement of jejunostomy and/or [[G-tube complications\|gastrostomy tube]], pyloric injection of botulinum toxin, [[Gastric pacemaker complication\|gastric electric stimulation]]
	*Prevention of future exacerbations:		*Prevention of future exacerbations:
	**Review medications, [[opioids]], [[anticholinergics]], [[PPI]]s may worsen or trigger symptoms		**Review medications, [[opioids]], [[anticholinergics]], [[PPI]]s may worsen or trigger symptoms

Elcatracho: /* Background */

2021-02-10T15:55:01Z

Background

← Older revision		Revision as of 15:55, 10 February 2021
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	==Background==		==Background<ref>Parkman HP, Hasler WL, Fisher RS. American Gastroenterlogical Association technical review on the diagnosis and treatment of gastroparesis. Gastroenterology. 2004; 127(5): 1592-1622.</ref>==
	*Chronic GI disorder characterized by delayed gastric emptying ''without'' mechanical obstruction		*Chronic GI disorder characterized by delayed gastric emptying ''without'' mechanical obstruction
	*More common in women, presumed due to elevated progesterone		*More common in women, presumed due to elevated progesterone

Elcatracho: /* References */

2021-02-10T15:54:06Z

References

← Older revision		Revision as of 15:54, 10 February 2021
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	==References==		==References==
	<references/>		<references/>
	*1. Parkman HP, Hasler WL, Fisher RS. American Gastroenterlogical Association technical review on the diagnosis and treatment of gastroparesis. Gastroenterology. 2004; 127(5): 1592-1622.

	[[Category:GI]]		[[Category:GI]]

Elcatracho: /* ED Management */

2021-01-15T06:50:21Z

ED Management

← Older revision		Revision as of 06:50, 15 January 2021
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	*[[IVF]], [[Electrolyte repletion]]		*[[IVF]], [[Electrolyte repletion]]
	*[[Antiemetics]]		*[[Antiemetics]]
	**Dopamine receptor antagonists: [[Prochlorperazine]], [[promethazine]], trimethobenzamide		**Dopamine receptor antagonists: [[Haloperidol]], [[Prochlorperazine]], [[promethazine]], trimethobenzamide
			***[[Haloperidol]] has been shown to reduce the rate of admission and morphine equivalent doses of analgesia<ref>Ramirez R, Stalcup P, Croft B, Darracq MA. Haloperidol undermining gastroparesis symptoms (HUGS) in the emergency department. Am J Emerg Med. 2017;35(8):1118-1120. doi:10.1016/j.ajem.2017.03.015</ref>
	**[[Ondansetron]]		**[[Ondansetron]]
	*Prokinetic agents: enhance gut contractility		*Prokinetic agents: enhance gut contractility

ClaireLewis at 20:55, 29 September 2019

2019-09-29T20:55:57Z

← Older revision		Revision as of 20:55, 29 September 2019
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	*GI disorders associated with delayed emptying:		*GI disorders associated with delayed emptying:
	**[[GERD]], [[Achalasia]]		**[[GERD]], [[Achalasia]]
	**Atrophic gastritis, celiac disease		**Atrophic [[gastritis]], celiac disease
	**Functional dyspepsia		**Functional [[dyspepsia]]
	**Hypertrophic [[~~Pyloric~~ stenosis]]		**Hypertrophic [[pyloric stenosis]]
	*Non-GI conditions/risk factors associated with delayed gastric emptying		*Non-GI conditions/risk factors associated with delayed gastric emptying
	**Medications: [[opioids]], [[anticholinergics]], [[PPI]]s, [[alcohol]], tobacco, progesterone		**Medications: [[opioids]], [[anticholinergics]], [[PPI]]s, [[alcohol]], tobacco, progesterone
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	***Gastric outlet obstruction/[[Pyloric stenosis]]		***Gastric outlet obstruction/[[Pyloric stenosis]]
	***[[Volvulus]]		***[[Volvulus]]
	***Strangulated hernia		***Strangulated [[hernia]]
	**[[Pancreatitis]]		**[[Pancreatitis]]
	**[[Appendicitis]]		**[[Appendicitis]]
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	**[[Spontaneous bacterial peritonitis]]		**[[Spontaneous bacterial peritonitis]]
	**[[Urinary tract infection]]		**[[Urinary tract infection]]
	**Bacterial toxins, ~~Viruses~~ (~~adeno~~, ~~norwalk~~, ~~rota~~)		**[[bacterial disease\|Bacterial]] toxins, [[viruses]] ([[adenovirus]], [[norovirus]], [[rotavirus]])
	*Drugs/Toxins		*Drugs/Toxins
	**[[Heavy metal toxicity]]		**[[Heavy metal toxicity]]
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	*[[Urinalysis]], uHCG		*[[Urinalysis]], uHCG
	*Consider:		*Consider:
	**ECG (if >50 or at risk for cardiac disease)		**[[ECG]] (if >50 or at risk for cardiac disease)
	**[[RUQ US]]		**[[RUQ US]]
	**Acute abdominal series including an upright CXR (if risk for perforated ulcer)		**[[Acute abdominal series]] including an upright CXR (if risk for perforated ulcer)
	**CT abdomen/pelvis to rule out obstruction		**CT abdomen/pelvis to rule out obstruction
	**Upper endoscopy or radiographic upper GI series to exclude mechanical obstruction or ulcer disease		**Upper endoscopy or radiographic upper GI series to exclude mechanical obstruction or ulcer disease

Josgood: /* Gastroparesis (by organ system) */

2017-07-23T23:20:16Z

Gastroparesis (by organ system)

← Older revision		Revision as of 23:20, 23 July 2017
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	**Bacterial toxins, Viruses (adeno, norwalk, rota)		**Bacterial toxins, Viruses (adeno, norwalk, rota)
	*Drugs/Toxins		*Drugs/Toxins
	**[[Heavy metal ~~poisoning~~]]		**[[Heavy metal toxicity]]
	**[[Methanol toxicity]]		**[[Methanol toxicity]]
	*Endocrine		*Endocrine

Josgood: /* Gastroparesis (by organ system) */

2017-07-23T23:19:40Z

Gastroparesis (by organ system)

← Older revision		Revision as of 23:19, 23 July 2017
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	*Drugs/Toxins		*Drugs/Toxins
	**[[Heavy metal poisoning]]		**[[Heavy metal poisoning]]
	**[[Methanol ~~poisoning~~]]		**[[Methanol toxicity]]
	*Endocrine		*Endocrine
	**[[Diabetic ketoacidosis]]		**[[Diabetic ketoacidosis]]

ClaireLewis: /* Complications */

2017-01-15T20:37:37Z

Complications

← Older revision		Revision as of 20:37, 15 January 2017
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	==Complications==		==Complications==
	*[[Acute Gastric Dilation]]		*[[Acute Gastric Dilation]]
	*[[Esophagitis]]		*[[Esophagitis]], [[Mallory-Weiss tear]]
	*[[Mallory-Weiss tear]]
	*[[Bezoar]]		*[[Bezoar]]
	*Dehydration		*[[Dehydration]], [[malnutrition]], [[electrolyte abnormalities]]
	*Malnutrition

	==Disposition==		==Disposition==