Diabetic gastroparesis

Gastroparesis (gastro- from Ancient Greek γαστήρ - gaster, 'stomach'; and -paresis, πάρεσις - 'partial paralysis'), also called delayed gastric emptying, is a medical disorder consisting of weak muscular contractions (peristalsis) of the stomach, resulting in food and liquid remaining in the stomach for a prolonged period of time. Stomach contents thus exit more slowly into the duodenum of the digestive tract. Gastroparesis (gastro- from Ancient Greek γαστήρ - gaster, 'stomach'; and -paresis, πάρεσις - 'partial paralysis'), also called delayed gastric emptying, is a medical disorder consisting of weak muscular contractions (peristalsis) of the stomach, resulting in food and liquid remaining in the stomach for a prolonged period of time. Stomach contents thus exit more slowly into the duodenum of the digestive tract. Symptoms include nausea, vomiting, abdominal pain, feeling full soon after beginning to eat (early satiety), abdominal bloating, and heartburn. The most common known mechanism is autonomic neuropathy of the nerve which innervates the stomach: the vagus nerve. Uncontrolled diabetes mellitus is a major cause of this nerve damage; other causes include post-infectious and trauma to the vagus nerve. Diagnosis is via one or more of the following: barium swallow X-ray, barium beefsteak meal, radioisotope gastric-emptying scan, gastric manometry, and esophagogastroduodenoscopy (EGD). Complications include malnutrition, fatigue, weight loss, vitamin deficiencies, intestinal obstruction due to bezoars, and small intestine bacterial overgrowth. Treatment includes dietary modifications, medications to stimulate gastric emptying, medications to reduce vomiting, and surgical approaches. The prognosis in children, in idiopathic gastroparesis in adults, and in post-infectious is the likelihood of complete recovery; in diabetic gastroparesis it is more likely to be slowly progressive and even fatal. The prevalence of post-infectious gastroparesis is up to 4% of the population; up to 90% are young women. The most common symptoms of gastroparesis are the following: