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Flashcards in Gastroparesis Deck (30)
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1

What is gastroparesis?

gastrointestinal motility disorder of the stomach in which there is delayed emptying of food from the stomach into the SI.
It is NOT due to a mechanical obstruction

2

Is gastroparesis more common in men or women?

women

3

T/F People with Type I & Type II Diabetes have significant rates of gastroparesis.

True.
55% of Type I patients

4

What are common symptoms of gastroparesis?

vomiting
postprandial nausea (right after eating)
epigastric fullness after eating just a few bites
abdominal bloating
heartburn
gastroesophageal reflux
changes in blood sugar levels
lack of appetite
weight loss & malnutrition

5

What are some bad results of gastroparesis?

esophagitis
mallory-weiss tears
severe peptic ulcer disease

6

What are 3 things that could aggravate the symptoms of gastroparesis?

eating high fiber foods (raw fruits & veggies)
eating high fat foods (stomach naturally empties more slowly w/ high fat)
eating greasy or rich foods

7

What are some drugs or substances that could aggravate gastroparesis?

alcohol
anticholinergic drugs
calcium channel blockers
dopamine agonists
H2 antagonists
nicotine
proton pump inhibitors

8

Describe the symptoms of Grade 1 Gastroparesis.

mild symptoms that are avoided w/ diet modifications

9

Describe the situation of a Grade 2 Gastroparesis patient.

moderate symptoms
patients need pro kinetics & anti-ememtics for control of symptoms

10

Describe the situation of a Grade 3 Gastroparesis patient.

extreme symptoms
need IV fluids
need enteral or parenteral nutrition
need endoscopic surgery

11

Describe what happens with an upper GI endoscopy.

liquid or general anesthesia
test can show bezoars (blockages of food, hair etc)
can dissolve the bezoars

12

What does ultrasonography help you do in diagnosis of gastroparesis?

it can distinguish b/w gastroparesis & a different condition like pancreatitis or gall bladder disease

13

Describe how scintigraphy can help in the diagnosis of gastroparesis.

this watches gastric emptying
solids labeled w/ a radioisotope are consumed & watched 1-4 hours after a meal...
If it takes more than 4 hours to empty the stomach-->gastroparesis

14

How can a smart pill help in diagnosis of gastroparesis? Which types of patients would not qualify to use this?

it can calculate temp, pH, pressure & transit time
**patients w/ swallowing disorders, narrowing or obstructions along their GI tract, Crohn's disease, diverticulitis, or a cardiac pacemaker shouldn't use the smart pill

15

How does paracetamol/acetaminophen testing help in diagnosing gastroparesis?

after you administer the acetaminophen...you wait & take blood tests to assess gastric emptying

16

T/F You can use radio opaque markers w/ x-rays to diagnose gastroparesis.

true.

17

The idea behind a breath test is that you ingest a material & take breath samples to see how quickly the gastric emptying & intestinal absorption of the material takes place.
What is the breath test for the following:
H. Pylori
Lactose Intolerance
Gastroparesis

H. Pylori: Urea Breath Test
Lactose Intolerance: Hydrogen Breath Test
Gastroparesis: Octanoic Acid Breath Test

18

What are 5 of the main complications with gastroparesis?

Severe Dehydration
GERD
Bezoars
Malnutrition
Decreased Quality of Life

19

Why are gastroparesis patients sometimes severely dehydrated?

b/c of persistent vomiting

20

What can happen to gastroparesis patients with GERD?

the GERD can lead to esophagitis

21

What's the problem with bezoars & gastroparesis?

it can cause nausea, vomiting & obstruction
it can interfere with medication absorption
it can lead to difficulty managing blood glucose levels in Type II Diabetes patients

22

What are 13 diseases that could lead to gastroparesis?

Type II Diabetes
Autonomic Neuropathy
Diabetic Autonomic Neuropathy
Myopathy
Viral Infections
-------------
Gastroduodenitis
Neuroendocrine tumors
duodenitis
esophagitis
postcholecystectomy syndrome
IBS
Endocrine disorders
autoimmune diseases

23

What are 5 possible causes of gastroparesis?

impaired glycemic control
extrinsic & intrinsic neuropathies
abnormalities of ICC cells (pacemakers) in the GI tract
loss of NO synthase
myopathy

24

What are the steps to treatment of gastroparesis?

Suspect Gastroparesis
Diagnose Gastroparesis
Restore Fluids
Optimize Glycemic Control
Make dietary modifications
Take pro kinetics
Enteral Nutrition
Gastric Pacing
Surgery (last resort)

25

What types of diet changes are recommended for patients w/ gastroparesis?

eating smaller, more frequent meals
chewing food well
not drinking carbonated drinks
taking a walk after a meal
avoid high fat & fibrous foods (could form bezoars)
maybe need a liquid diet

26

How does metoclopramide/Reglan work? What are the side effects?

dopamine antagonist
makes the GI contractions work better
prevents nausea & vomiting
Side Effects: fatigue & depression

27

How does erythromycin work? What are the side effects?

motilin receptor agonist-->Migrating Motor Complex
increases smooth muscle contraction
Side Effects: cramps, nausea, altered cardiac contraction

28

What happens with cisapride?

stimulates the 5-HT receptor

29

How does gastric electrical stimulation help w/ gastroparesis?

reduces symptoms of dyspepsia & vomiting
reduces the need for nutritional supplementation
**electrodes are placed in the stomach & connect them to a neurostimulator in the abdominal wall

30

What does hemin do?

increases levels of HO-1 which is expressed in some macrophages
no idea how this helps gastroparesis, but apparently it does.