Case Study 243: Gastroparesis | Explained by Dr. Betsy Grunch
Description: Case Study 243: Gastroparesis
Gastroparesis is delayed stomach emptying with no physical blockage.
Why it happens:
• Long-standing high blood sugar damages the vagus nerve
• The vagus nerve controls stomach muscle contractions
• Impaired signaling → food and liquid sit in the stomach far longer than normal
The key clue:
• The “sloshing” sound/sensation is a real exam finding called a succussion splash
• Caused by retained fluid and food in a stomach that isn’t emptying
• Points toward a motility problem, not a structural one
Why the workup looked normal:
• Gastroparesis is functional, not structural
• Endoscopy and imaging aren’t expected to show anything
• The confirming test is a gastric emptying study (meal with tracer, tracked over time)
Management:
• Tighter glucose control (high blood sugar itself slows emptying)
• Smaller, more frequent low-fat, low-fiber meals
• Prokinetic medications to stimulate stomach contractions
• Anti-nausea medication as needed
• Gastric electrical stimulation for severe, refractory cases
#Gastroparesis #SundayCaseStudy #CaseStudy243 #ladyspinedoc Close description
Gastroparesis is delayed stomach emptying with no physical blockage.
Why it happens:
• Long-standing high blood sugar damages the vagus nerve
• The vagus nerve controls stomach muscle contractions
• Impaired signaling → food and liquid sit in the stomach far longer than normal
The key clue:
• The “sloshing” sound/sensation is a real exam finding called a succussion splash
• Caused by retained fluid and food in a stomach that isn’t emptying
• Points toward a motility problem, not a structural one
Why the workup looked normal:
• Gastroparesis is functional, not structural
• Endoscopy and imaging aren’t expected to show anything
• The confirming test is a gastric emptying study (meal with tracer, tracked over time)
Management:
• Tighter glucose control (high blood sugar itself slows emptying)
• Smaller, more frequent low-fat, low-fiber meals
• Prokinetic medications to stimulate stomach contractions
• Anti-nausea medication as needed
• Gastric electrical stimulation for severe, refractory cases
#Gastroparesis #SundayCaseStudy #CaseStudy243 #ladyspinedoc Close description