Question 1

What is the Meaning of Delayed Gastric Emptying?

Accepted Answer

Delayed Gastric Emptying, or gastroparesis, is a chronic condition impairing food movement from the stomach into the small intestine. This deceleration occurs without physical obstruction, leading to prolonged gastric content retention. It represents a functional disorder of digestive motor activity.

Question 2

What is the Context of Delayed Gastric Emptying?

Accepted Answer

This condition primarily affects the upper gastrointestinal tract, often arising from vagus nerve damage controlling gastric contractions. While idiopathic cases exist, it is frequently observed in long-standing diabetes, where chronic hyperglycemia can cause autonomic neuropathy affecting gastric motility. Hormonal factors, including gut peptides, also modulate gastric transit.

Question 3

What is the Significance of Delayed Gastric Emptying?

Accepted Answer

Clinically, delayed gastric emptying can lead to significant morbidity, presenting with persistent nausea, recurrent vomiting, early satiety, bloating, and abdominal discomfort. These manifestations severely impact nutritional status, medication absorption, and quality of life. Managing this condition is crucial for symptom alleviation and preventing dehydration or poor glycemic control in diabetics.

Question 4

What is the Mechanism of Delayed Gastric Emptying?

Accepted Answer

The underlying mechanism typically involves dysfunction of gastric smooth muscle contractions or impaired pyloric sphincter relaxation. This dysmotility often stems from vagus nerve damage, essential for coordinating stomach muscle activity and propulsion. Alterations in interstitial cells of Cajal, pacemakers of gastrointestinal motility, or neurochemical imbalances within the enteric nervous system contribute.

Question 5

What is the Application of Delayed Gastric Emptying?

Accepted Answer

Patients with delayed gastric emptying require a comprehensive management approach. Dietary modifications, such as consuming smaller, more frequent meals low in fat and fiber, are often recommended to facilitate gastric transit. Pharmacological interventions include prokinetic agents to stimulate gastric motility, or antiemetics for nausea and vomiting. For diabetic gastroparesis, meticulous blood glucose management is paramount.

Question 6

What is the Metric of Delayed Gastric Emptying?

Accepted Answer

Diagnosis of delayed gastric emptying is most accurately confirmed using gastric emptying scintigraphy (GES), which measures the rate radiolabeled meal exits the stomach over several hours. Other diagnostic tools include the wireless motility capsule, providing data on transit times throughout the gastrointestinal tract, and breath tests that quantify gastric emptying by detecting specific labeled substrates in exhaled air. Symptomatic assessment and clinical history also contribute.

Question 7

What is the Risk of Delayed Gastric Emptying?

Accepted Answer

Untreated or poorly managed delayed gastric emptying carries several risks, including chronic malnutrition due to inadequate nutrient absorption and dehydration from persistent vomiting. In diabetic patients, it can lead to erratic blood glucose fluctuations, complicating diabetes management and increasing hypoglycemia or hyperglycemia risk. Bezoar formation, a mass of undigested material in the stomach, and aspiration pneumonia are also potential serious complications.

Delayed Gastric Emptying

Meaning

Context

Significance

Mechanism

Application

Metric

Risk

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