Gastroparesis causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Madhu Sigdel M.B.B.S.[2] Farman Khan, MD, MRCP [3]

## Overview

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The etiology of gastroparesis can be broadly classified into idiopathic, diabetic, post-surgical and medication induced. Life threatening causes of gastroparesis include brainstem stroke and hypokalemia (which may lead to cardiac arrythmias). Surgical procedures most commonly associated with gastroparesis include distal gastrectomy, pancreatoduodenectomy, cholecystectomy and fundoplication. Common medications associated with the development of gastroparesis include narcotics, tricyclic antidepressants, octreotide, amylin analogues, dopamine analogues and phenothiazines.

## Causes

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### Life threatening causes

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Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

* Brainstem stroke
* Hypokalemia

Gastroparesis causes developed by WikiDoc.org

### Common causes

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* Idiopathic[1][2]
* Diabetes mellitus (Type II is more common cause than type I DM)[1] \- second commonest cause
* Post- surgical: Distal gastrectomy for cancer of stomach, pancreatoduodenectomy, cholecystectomy, fundoplication etc[3]
* Narcotics
* Phenothiazines
* Pregnancy
* Scleroderma
* Systemic sclerosis
* Vagotomy

### Less common causes

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Transient gastroparesis may arise in acute illness of any kind:

* Certain cancer treatments or other drugs which affect digestive action
* Anorexia
* Bulimia
* Other abnormal eating patterns
* Medications (anticholinergics and narcotics) that slow contractions in the intestine

Chronic gastroparesis is frequently due to autonomic neuropathy:

* Type 1 diabetes or type 2 diabetes:
* The vagus nerve becomes damaged by years of high blood glucose, resulting in gastroparesis
* Fibromyalgia
* Parkinson's disease
* Mitochondrial disorder
* Abdominal surgery[4]
* Amyloidosis
* Scleroderma
* Abdominal migraine
* Hypothyroidism
* Gastroesophageal reflux disease

Idiopathic gastroparesis (gastroparesis with no known cause) accounts for a third of all chronic cases; it is thought that many of these cases are due to an autoimmune response triggered by an acute viral infection:

* Stomach flu
* Mononucleosis, and others have been anecdotally linked to the onset of the condition, but no systematic study has proven a link

Gastroparesis causes developed by WikiDoc.org

### Causes by Organ System

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Cardiovascular | Percutaneous catheter ablation for atrial fibrillation; prevalence of gastroparesis after radio-frequency ablation is 10% and cryoablation procedures is 6%, respectively.[5]

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Chemical/Poisoning | No underlying causes
Dental | No underlying causes
Dermatologic | No underlying causes
Drug Side Effect | Tricyclic antidepressants, phenothiazines, octreotide, narcotics, muscarinic cholinergic receptor antagonists,

glucagon-like peptide (GLP)-1 agonists, amylin analogues, dopamine agonists, cholangiocarcinoma, calcium channel blockers, anticholinergics, alpha-2-adrenergic agonists

Ear Nose Throat | No underlying causes
Endocrine | Hypothyroidism, hypoparathyroidism, diabetes mellitus type 2, diabetes mellitus type 1
Environmental | No underlying causes
Gastroenterologic | Ulcers in first portion of duodenum, pyloric stenosis, pyloric channel ulcer, pancreatic pseudocyst, pancreatic cancer,

gastroesophageal reflux disease, gastric polyps, gastric cancer, duodenal cancer, abdominal migraine

Genetic | No underlying causes
Hematologic | No underlying causes
Iatrogenic | Surgery on the stomach or vagus nerve, complication of stomach surgery for ulcer disease or weight loss, vagotomy
Infectious Disease | Rotavirus, postviral syndromes, Norwalk virus, AIDS, acute viral infection
Musculoskeletal/Orthopedic | No underlying causes
Neurologic | Primary dysautonomias, Parkinson's disease, brainstem stroke or tumor, autonomic neuropathy, autoimmune gastrointestinal dysmotility
Nutritional/Metabolic | No underlying causes
Obstetric/Gynecologic | Pregnancy
Oncologic | Ampullary cancer
Ophthalmologic | No underlying causes
Overdose/Toxicity | No underlying causes
Psychiatric | Psychogenic, vomiting, depression, bulimia, anxiety, neurosis, anorexia nervosa
Pulmonary | Small cell lung cancer[6]
Renal/Electrolyte | Kidney failure, hypomagnesemia, hypokalemia
Rheumatology/Immunology/Allergy | Systemic sclerosis, scleroderma, polymyositis, lupus
Sexual | No underlying causes
Trauma | No underlying causes
Urologic | No underlying causes
Miscellaneous | Myotonic dystrophy, idiopathic, congenital obstruction, Bouveret syndrome, amyloidosis, amyloid neuropathy

Gastroparesis causes developed by WikiDoc.org

### Causes in Alphabetical Order

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* Abdominal migraine
* Acute viral infection
* AIDS
* Alpha-2-adrenergic agonists
* Ampullary cancer
* Amyloid neuropathy
* Amyloidosis
* Anorexia nervosa
* Anticholinergics
* Anxiety neurosis
* Autoimmune gastrointestinal dysmotility
* Autonomic neuropathy
* Bouveret Syndrome
* Brainstem stroke or tumor
* Bulimia
* Calcium channel blockers
* Cholangiocarcinoma
* Complication of stomach surgery for ulcer disease or weight loss
* Congenital obstruction
* Depression

* Diabetes mellitus type 1
* Diabetes mellitus type 2
* Dopamine agonists
* Duodenal cancer
* Gastric cancer
* Gastric polyps
* Gastroesophageal reflux disease
* Glucagon-like peptide (GLP)-1 agonists and amylin analogues
* Hypokalemia
* Hypomagnesemia
* Hypoparathyroidism
* Hypothyroidism
* Idiopathic
* Kidney failure
* Lupus
* Muscarinic cholinergic receptor antagonists
* Myotonic dystrophy
* Narcotics
* Norwalk virus
* Octreotide

* Pancreatic cancer
* Pancreatic pseudocyst
* Parkinson's disease
* Phenothiazines
* Polymyositis
* Postviral syndromes
* Pregnancy
* Primary dysautonomias
* Psychogenic vomiting
* Pyloric channel ulcer
* Pyloric stenosis
* Rotavirus
* Scleroderma
* Small cell lung cancer
* Surgery on the stomach or vagus nerve
* Systemic sclerosis
* Tricyclic antidepressants
* Ulcers in first portion of duodenum
* Vagotomy
* Viral infection [7] [8]

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Gastroparesis causes developed by WikiDoc.org

## References

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1. ↑ 1.0 1.1 Hyett B, Martinez FJ, Gill BM, Mehra S, Lembo A, Kelly CP; et al. (2009). "Delayed radionucleotide gastric emptying studies predict morbidity in diabetics with symptoms of gastroparesis". Gastroenterology. 137 (2): 445–52. doi:10.1053/j.gastro.2009.04.055. PMID 19410575.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
2. ↑ Bharucha AE (2015). "Epidemiology and natural history of gastroparesis". Gastroenterol Clin North Am. 44 (1): 9–19. doi:10.1016/j.gtc.2014.11.002. PMC 4323583. PMID 25667019.
3. ↑ Glowka TR, Webler M, Matthaei H, Schäfer N, Schmitz V, Kalff JC; et al. (2017). "Delayed gastric emptying following pancreatoduodenectomy with alimentary reconstruction according to Roux-en-Y or Billroth-II". BMC Surg. 17 (1): 24. doi:10.1186/s12893-017-0226-x. PMC 5359898. PMID 28320386.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
4. ↑ Gastroparesis: Causes - MayoClinic.com
5. ↑ Aksu T, Golcuk S, Guler TE, Yalin K, Erden I (2015). "Gastroparesis as a Complication of Atrial Fibrillation Ablation". Am J Cardiol. 116 (1): 92–7. doi:10.1016/j.amjcard.2015.03.045. PMID 25933733.CS1 maint: Multiple names: authors list (link)
6. ↑ Vaidya GN, Lutchmansingh D, Paul M, John S (2014). "Gastroparesis as the initial presentation of pulmonary adenocarcinoma". BMJ Case Rep. 2014. doi:10.1136/bcr-2014-207228. PMC 4265036. PMID 25498111.CS1 maint: Multiple names: authors list (link)
7. ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
8. ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

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