Antroduodenal Manometry for the Evaluation of Patients with Suspected Gastroparesis

The symptom pattern of patients with a documented delay in gastric emptying has been evaluated recently in a large cohort of patients entered in the Gastroparesis Registry supported by the NIH. The predominant symptoms of gastroparesis are nausea, vomiting, and in a large percentage of patients, abdominal pain. Nausea is the predominant symptom in 34.5% of 319 patients and occurs in 84.3% of patients. Similar numbers of these patients have vomiting (28.9%/68.7%) and abdominal pain (19.8%/71.8%) (personal communication). Interestingly, patients with chronic nausea, vomiting, or abdominal pain may have a normal gastric emptying. This chapter addresses how antroduodenal manometry can assist in managing patients with chronic nausea, vomiting and abdominal pain by measuring baseline gastric, pyloric, and small intestinal contractions and the response to a meal or drugs.