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Malignancy-associated gastroparesis: Pathophysiology and management

Mehnaz A Shafi, MD
Eiad Nasser, MD
Milind Javle, MD
Section Editors
Reed E Drews, MD
Eduardo Bruera, MD
Deputy Editor
Diane MF Savarese, MD


The management of nausea and vomiting in cancer patients is a challenging task. Gastroparesis is one of the most underdiagnosed problems in cancer patients, and often overlooked as a potential etiology of chronic nausea and vomiting.

While the exact prevalence is not known, gastroparesis is common among patients with upper gastrointestinal tract tumors (gastric, pancreatic, esophageal, and biliary) [1,2]. Pancreatic cancer-associated gastroparesis is common. Patients with pancreatic cancer often present with nausea and vomiting in the absence of mechanical obstruction [3]. These patients may also have a more generalized disorder of gastrointestinal motility, with components of dysphagia and abnormal small bowel motility (intestinal pseudo-obstruction, "functional ileus"). (See "Chronic intestinal pseudo-obstruction".)

Gastroparesis is important to recognize for many reasons.

The consequences of malignancy-associated gastroparesis can be serious, particularly in the context of other common problems that affect nutrition and fluid-electrolyte balance in cancer patients. If unrecognized and untreated, malignancy-associated gastroparesis can compound the anorexia and cachexia that often accompanies advanced cancer and the gastrointestinal side effects of specific anticancer treatments such as radiation or chemotherapy. The potential consequences include chronic nausea and vomiting, electrolyte disturbances, dehydration, hospitalization, and significant impairment of quality of life. (See "Palliative care: Assessment and management of nausea and vomiting".)

Misdiagnosis of malignancy-associated gastroparesis as chemotherapy-induced emesis can lead to delays in administration of potentially efficacious anticancer therapy.

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Literature review current through: Nov 2017. | This topic last updated: Mar 17, 2017.
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