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 Nausea-Vomiting, Postprandial Fullness-Early Satiety

 

Causes of nausea & vomiting, postprandial fullness & early satiety

  • Parkinson’s d and anti-Parkinson therapy
  • Cerebral palsy
  • Gastric neuropathy with stasis

Psychic Diagnosis of nausea & vomiting, postprandial fullness & early satiety

all patients

    • *upper GI endoscopy to exclude structural alterations
    • *gastric emptying tests, electrogastrography

specific patients

  • *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.

  • Optimize antiparkinson therapy (dopamine agonists and anticholinergics delay gastric emptying)
  • Drugs to accelerate gastric emptying of levodopa tablets: domperidone (also anti-nausea), cisapride
  • Peripheral dopamine antagonists and/or prokinetics which accelerate normal gastric emptying
  • Liquid levodopa –

Other neurological disorders

Gastric stasis

    • cisapride
    • Motilides

Nausea/vomiting

  • Dopamine-antagonists:Metoclopramide, levosulpiride, domperidone
  • 5HT3-antagonists

Psychic disorders

Gastric stasis

    • Specific psycho-therapy
    • Dopamine-antagonists