Causes: DM, scleroderma, intestinal pseudobstruction, previous gastric surgery.
- Other less common causes: metabolic derangements, hypokalemia, hypercalcemia, hypocalcemia, hyperglycemia, narcotic analgesics, anti-cholinergics, chemo Tx.
Labs: NM gamma camera scanning - gastric emptying study.
Tx: avoid high fat, high fiber diet
- High calorie iso-osmotic meals may be beneficial.
- Correct metabolic derangements
- Reglan (metoclopramide) 10 mg PO qid, 30 min before meals
- Erythromycin, 250 mg PO tid or 200 mg IV
- Zelnorm (tegaserod - 5-HT4) agonist: 2 - 6 mg PO bid, 30 min ac.