Replying to @Joyce🌸 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
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