Case history
Case history #1
A 25-year-old woman with a history of type 1 diabetes mellitus of 8 years' duration presents with episodes of postprandial nausea, vomiting, epigastric pain, fullness, and bloating. Her diabetes has been poorly controlled over the years and is complicated by peripheral neuropathy, retinopathy, and nephropathy. She reports that she has had multiple emergency department visits and admissions to the hospital as a result of dehydration from nausea and vomiting.
Case history #2
A 35-year-old woman presents with symptoms of worsening nausea, vomiting, abdominal pain, and bloating of 2 years' duration. Symptoms are typically postprandial and have been progressively getting worse. The patient recollects that she had a "viral illness" before the onset of the above symptoms. She has had significant weight loss related to the disease and multiple hospital admissions related to nausea and vomiting.
Other presentations
Other presentations of gastroparesis include typical symptoms (i.e., postprandial nausea, vomiting, bloating, and epigastric pain) after operations such as gastric surgery or fundoplication due to vagal nerve injury. In these patients, a sham feeding test shows evidence of vagal nerve damage.[3][4] Patients with multiple sclerosis occasionally present with symptoms of gastroparesis due to a demyelinating lesion in the distal medullary region of the brain.[5][6]
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