By Dr Ananya Mandal, MD
Gastroparesis is a long term condition that often is seen in diabetes patients. Diagnosis is based on the knowledge of the possible underlying medical conditions as well as the concomitant medications and drugs that may lead to this condition.
Detailed history and physical examination
A detailed history of diabetes or other possible causes of gastroparesis is discovered. Family history of the condition is also important in case of inherited conditions leading to gastroparesis.
Dietary habits are enquired to detect possible anorexia or bulimia. Drug use, especially narcotics abuse, is also enquired of since it may be associated with gastroparesis.
The patient is examined thoroughly to detect signs and symptoms of vitamin and calorie deficiencies and malnutrition. It also helps assess the general health of the patient.
Routine blood counts may reveal anemia or reduced red blood cell count and haemoglobin caused by malnutrition.
Blood biochemistry shows the levels of blood electrolytes and chemicals that may be lost and be excessively low in patients with recurrent vomiting symptoms
Imaging studies include a barium X-ray. Here the patient is asked to swallow a liquid containing the chemical barium, which shows up on X-ray and allows radiologists to watch the passage of this solution through the digestive system via several serial images.
Upper gastrointestinal endoscopy involves passing a long thin tube called an endoscope down to the esophagus. The camera on the tip of the tube shows the pictures of the inner walls of the stomach and gut.
Gastric emptying scan using scintigraphy
This study involves eating a bland food (eggs commonly) containing a very small amount of a radioactive substance or radioisotope that is detected on the scan. The radiation given off the radioisotope is harmless.
After the meal scans are taken at 1, 2, 3, and 4 hours. The radioisotope shows up the emptying of the stomach. When more than 10 percent of the meal is still in the stomach at 4 hours, the diagnosis of gastroparesis is confirmed.
In this test a thin tube containing a wire is passed down the esophagus into the stomach to measure electrical and muscular activity in the stomach as the food passes through it.
An ultrasound scan is advised to check upon the other digestive organs and also to detect obstruction.
SmartPill is an approved diagnostic method by the U.S. Food and Drug Administration (FDA) (in 2006). It is a small device in capsule form that can be swallowed. The device then moves through the gut and collects information that is sent to a small receiver worn around the waist or neck. After a couple of days the capsule passes out in stool. The receiver is analyzed for the information gathered.
After ingestion of a meal with an isotope breath samples are taken to measure the presence of the isotope in carbon dioxide. The results reveal the rate of emptying of the stomach.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)
Last Updated: May 22, 2013