Gastroparesis and Cancer-Related Gastroparesis in Palliative Care Patients

Gastroparesis is a disorder related to delayed gastric emptying commonly associated with diabetes mellitus. There has been relatively little study on the prevalence of gastroparesis in advanced cancer. This lack of knowledge is further complicated by the overlap of cardinal symptoms of gastroparesis with symptoms of advanced cancer and its treatment. Postprandial fullness, early satiety, nausea, vomiting, bloating, and loss of appetite are the cardinal symptoms of gastroparesis. Early satiety is a common complaint in cancer, and connections between this and gastroparesis have not been fully explored. A complex interplay between multiple enteric cells governs normal gastric motility. It can be partitioned into different motor patterns and phases of gastric emptying, with multiple hormones and neurotransmitters implicated in its function. Aside from the common causes of diabetes and idiopathic gastroparesis, there are many other causes. Cancer-specific potential causes of gastroparesis can be related to cancer, cancer treatment and its complications, infections, and palliative therapy. There are also other chronic noncancer causes of gastroparesis that palliative providers may encounter. The diagnosis of gastroparesis relies on methods of ascertaining gastric emptying. The treatment of gastroparesis encompasses diet, pharmacological management, and pyloric interventions.