Pathophys Gastroparesis

Question 1

2 major Functional areas of stomach & functions

Answer 1

fundus (relaxation/acommodation)

antrum/body (grinding/mixing/transfer)

Question 2

where’s the pacemaker

Answer 2

mid part of greater curvature

Question 3

fundic abnormality result

Answer 3

can’t get food in

Question 4

antral or pacemaker abnormality result

Answer 4

can’t get food out

Question 5

causes of gastroperesis

Answer 5

diabetes (30%)
idiopathic (30%)
post-surg (15%)
viral (8%)
misc/parkinson's/pseudo-obstruction/sclerdermer

Question 6

symptoms of gastroparesis

Answer 6

nausea (93%)
abdominal pain (90%)
early satiety/anorexia (86%)
vomiting (68%)

Question 7

dx of gastroparesis

Answer 7

history & exam
labs
need upper endoscopy
gastric emptying study
rarely electrogastrograhy

Question 8

alternative to endoscopy in gastroparesis

Answer 8

barium swallow

Question 9

gastric emptying study

Answer 9

> 10% at 4 hrs is indicative of delayed gastric emptying

Question 10

principles of management of gastroparesis

Answer 10

general supportive care
decompression (peg tube)
suppression of bacterial growth
symptomatic tx of diarrhea/constipation
nutrition

Question 11

medical tx for gastroparesis

Answer 11

anti-emetics (phenargan & ondanstron)
metoclopramide (bbw tremmors)
macrolide antibiotics (mimic motolin)
cisapride (stim 5HT4 receptors, banned)
domperidone (bought in CA)
botox
gastric pacemaker