Misdiagnosis of Gastroparesis and Underdiagnosis of Functional Dyspepsia (2024)

FAQs

What is commonly misdiagnosed as gastroparesis? ›

The presenting symptoms of functional dyspepsia mimic those of gastroparesis, leading to overdiagnosis of gastroparesis. Functional dyspepsia should be considered first in patients with characteristic upper GI symptoms suggestive of gastroparesis.

Nausea and vomiting are more prominent in gastroparesis, whereas postprandial abdominal pain or discomfort is more classical for functional dyspepsia. Overtime, the characteristics and severity of symptoms may change in both gastroparesis and functional dyspepsia.

For instance, care must be taken not to confuse functional dyspepsia with other common disorders that may cause upper gastrointestinal distress, like heartburn, irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), functional abdominal bloating, and functional biliary disorders.

Functional dyspepsia is not easily diagnosed because the presentation is similar to other conditions. This condition is defined by the presence of 1 or more of the following symptoms: epigastric pain or burning, early satiety, and postprandial fullness in the absence of structural disease using imaging or endoscopy.

Parkinson's disease, multiple sclerosis, and other neurological disorders have been linked to gastroparesis.

Scintigraphy. This is the most important test used in making a diagnosis of gastroparesis. It involves eating a light meal, such as eggs and toast, that contains a small amount of radioactive material.

Functional dyspepsia is common. It is a constant condition but symptoms don't happen all the time. Symptoms resemble those of an ulcer. They include pain or discomfort in the upper abdomen, bloating, belching and nausea.

Increasing evidence shows involvement of psychological disorders in functional dyspepsia (FD), but how psychological factors exert their influences upon FD remains largely unclear.

The more detailed Rome IV diagnostic criteria define functional dyspepsia as one to three days per week of symptoms of postprandial fullness, early satiety, epigastric pain, or epigastric burning without evidence of structural disease (Table 1).

A PPI is considered first line treatment for functional dyspepsia, with or without symptoms of hyperacidity. Management follows the same approach as for undifferentiated dyspepsia. Functional dyspepsia in patients, that have not responded to a PPI or prokinetic and are H.

What aggravates functional dyspepsia? ›

Dietary recommendations in functional dyspepsia include eating smaller meals and avoiding high-fat meals which have been reported to aggravate clinical symptoms such as nausea and abdominal pain more than isocaloric high-carbohydrate meals.

Medicines that block acid "pumps." Medicines called proton pump inhibitors shut down the acid "pumps" within acid-secreting stomach cells. Proton pump inhibitors available without a prescription include lansoprazole (Prevacid 24HR), omeprazole (Prilosec OTC) and esomeprazole (Nexium 24HR).

Most of the pathophysiology of functional dyspepsia overlaps with gastroparesis, but visceral hypersensitivity is fairly unique to FD. Visceral hypersensitivity is the experience of pain within the inner organs at a level that is more intense than normal.

Does functional dyspepsia ever go away? Among those who seek medical care for their functional dyspepsia, only 20% report permanent relief. How long does functional dyspepsia last? For most people, it's a chronic condition that comes and goes indefinitely, depending on many factors.

The differential diagnosis of dyspepsia includes: acid-related disorders such as gastroesophageal reflux disease (GERD) and peptic ulcer disease (PUD); gastric inflammatory conditions such as helicobacter pylori gastritis or nonsteroidal anti-inflammatory drug (NSAID) related erosions or gastropathy; and less common ...

Sometimes it's a complication of diabetes, and some people develop gastroparesis after surgery. Certain medications, such as opioid pain relievers, some antidepressants, and high blood pressure and allergy medications, can lead to slow gastric emptying and cause similar symptoms.

Gastroparesis patients have a high rate of slow transit constipation by radiopaque marker studies than patients with symptoms of gastroparesis with normal gastric emptying (4). Fourth, perhaps constipation and delayed colonic transit could be the primary problem with a secondary delay in gastric emptying.

Other causes include bacterial and viral infections. Narcotics, antidepressants and other medications which delay stomach emptying may also cause gastroparesis.

Nausea and vomiting are classic symptoms in patients with gastroparesis (1). While most patients experience some degree of nausea, only some gastroparesis patients have vomiting with some studies suggest vomiting is seen in less than 50% of patients with gastroparesis (2).