Gastroparesis physical examination

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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]

Overview

Patients with gastroparesis usually appear normal. Physical examination of patients with gastroparesis is usually remarkable for upper abdominal distension, epigastric or periumbilical tenderness, and no guarding or rigidity.

Physical Examination

• Physical examination of patients with gastroparesis is usually remarkable for:upper abdominal distension, epigastric or periumbilical tenderness, and no guarding and rigidity.
• The presence of other findings on physical examination depends on cause of gastroparesis.

Appearance of the Patient

• Patients with gastroparesis usually appear normal.

Vital Signs

• Low-grade fever may be present in postviral idiopathic gastroparesis. In minority of cases, patients have a preceeding history of upper respiratory infection or gastrointestinal infection.
• Orthostatic hypotension may be present in diabetic gastroparesis.

Skin

• Skin examination of patients with severe gastroparesis show signs of dehydration like dry mouth, dry skin , shrunken eyes.
• Raynaud's phenomenon may be present in gastroparesis related to connective tissue disorder.

Neck

• Thyromegaly / thyroid nodules may be present in hypothyroidism.

Lungs

• Fine/coarse crackles upon auscultation of the lung bases is a feature in connective tissue disease (eg. systemic sclerosis) related gastroparesis

Abdomen

• Abdominal distention
• Abdominal tenderness in the epigastric or periumbilical region
• Guarding and rigidity is absent.
• succussion splash can be elicited 3 hours or more after food intake, reflecting retention of gastric content.