Decreased gastric emptying is divided temporally into 2 groups:
(1) transient (reversible on correction of precipitating cause)
(2) chronic
Causes of a transient delay in gastric emptying:
(1) acute stress (pain, cold, other)
(2) drugs (anticholinergic agent, beta-adrenergic agent, levodopa, morphine or other opioids, nicotine)
(3) hyperglycemia
(4) hypokalemia
(5) hypothyroidism
(6) acute viral gastroenteritis
(7) postoperative
Causes of a chronic delay in gastric emptying (gastroparesis):
(1) insulin-dependent diabetes mellitus (diabetic gastroparesis)
(2) postvagotomy
(3) gastroesophageal reflux disease (GERD)
(4) scleroderma (progressive systemic sclerosis)
(5) systemic lupus erythematosus (SLE)
(6) amyloidosis
(7) dermatomyositis
(8) myotonic dystrophy or other muscular dystrophy
(9) autonomic degeneration
(10) tumor in the brainstem
(11) spinal cord injury
(12) paraneoplastic (lung carcinoma, other)
(13) post-radiation injury
(14) porphyria
(15) neurofibromatosis
(16) ischemic gastropathy (may reverse on revascularization)
(17) anorexia nervosa
(18) chronic idiopathic pseudo-obstruction
(19) idiopathic
where:
• The association with GERD may not be causal, in that reflux is likely if the there is delayed gastric emptying.
Differential diagnosis:
(1) mechanical obstruction to gastric emptying
