Gastroparesis

Gastroparesis is a motility disorder of the stomach that manifests as a set of symptoms associated with delayed gastric emptying in the absence of mechanical obstruction. The cardinal symptoms of gastroparesis are nausea and vomiting, although other dyspeptic symptoms such as postprandial fullness, early satiety, bloating, epigastric pain, and belching are frequently present as well. There is a significant overlap of symptoms between gastroparesis and functional dyspepsia, especially postprandial distress syndrome. While abdominal pain is often not considered a classic symptom of gastroparesis, prior evidence from referral centers indicates that up to 90% of patients report neuropathic or nociceptive abdominal pain and that 41% of them are on chronic opioids. The most common subtype of gastroparesis is idiopathic, followed by diabetic and postsurgical such as fundoplication or bariatric procedures. Medications that alter gastrointestinal motility such as opioid agonists are another common cause of gastroparesis. Smooth muscle disorders such as scleroderma and amyloidosis, and neurodegenerative disorders such as parkinsonism and paraneoplastic syndrome can also lead to gastroparesis. Postviral gastroparesis has rarely been reported, although it may be more prevalent as a complication of norovirus infection in childhood.