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 -

Gastric stasis

• cisapride
• Motilides
  
  

Nausea/vomiting

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

Gastric stasis

• Specific psycho-therapy
• Dopamine-antagonists