Nausea-Vomiting, Postprandial Fullness-Early Satiety
Causes of nausea & vomiting, postprandial fullness & early satiety
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Parkinson’s d and anti-Parkinson therapy
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Cerebral palsy
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Gastric neuropathy with stasis
Psychic Diagnosis of nausea & vomiting, postprandial fullness & early satiety
all patients
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*upper GI endoscopy to exclude structural alterations
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*gastric emptying tests, electrogastrography
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specific patients
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*autonomic tests, manometry
Management of nausea & vomiting, postprandial fullness & early satiety
Parkinson’s d
In Parkinson’s d gastric emptying time:
a) plays a relevant role in controlling the access of levodopa tablets to its absorptive sites in the small bowel and thus to an efficient management of the neurological manifestations;
b) can be delayed for the disease itself and for the antiparkinson therapy with consequent GI symptoms and worsening in the control of the neurological manifestations.
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Optimize antiparkinson therapy (dopamine agonists and anticholinergics delay gastric emptying)
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Drugs to accelerate gastric emptying of levodopa tablets: domperidone (also anti-nausea), cisapride
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Peripheral dopamine antagonists and/or prokinetics which accelerate normal gastric emptying
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Liquid levodopa –
Other neurological disorders
Gastric stasis
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cisapride
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Motilides
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Nausea/vomiting
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Dopamine-antagonists:Metoclopramide, levosulpiride, domperidone
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5HT3-antagonists
Psychic disorders
Gastric stasis
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Specific psycho-therapy
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Dopamine-antagonists
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