How do you establish the diagnosis

Before symptoms can be definitely attributed to gastroparesis, other diseases of the upper gastrointestinal tract must be ruled out. For this reason, an oesophagogastroduodenoscopy (OGD) exam must be performed first. A typical finding of gastroparesis in OGD is undigested food that was consumed 8-12 hours earlier and no pyloric stenosis. The most reliable method for diagnosis of gastroparesis is the study of stomach emptying time after the administration of a certain radiolabeled solid food. When this exam is planned, no prokinetic agents should be given to the patient. Pyloric and duodenal manometry are useful methods for diagnosing pyloric spasm and desynchronization of gastric and duodenal peristaltic waves, but only in selected patients who have relevant symptoms but whose scintigraphy is normal.

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