From the Guidelines
Inadequate gastric distension is primarily caused by issues with the two-way communication between the upper gut and the brain, including problems with the nerves supplying the stomach and duodenum, which can make them more sensitive to normal function, as well as psychological factors such as stress and changes in the micro-organisms living in the upper gut 1.
Causes of Inadequate Gastric Distension
The causes of inadequate gastric distension can be multifactorial, involving:
- Problems with the nerves supplying the stomach and duodenum, making them more sensitive to normal function 1
- Psychological factors, such as stress, which can trigger symptoms 1
- Changes in the micro-organisms living in the upper gut, which can contribute to symptoms 1
- Slower stomach emptying, contributing to feelings of early fullness 1
Management of Inadequate Gastric Distension
Management of inadequate gastric distension typically involves:
- Dietary modifications, such as avoiding certain foods that may trigger symptoms 1
- Medications, such as prokinetics, to enhance gastric motility, although the guideline recommends only medications with good evidence of efficacy over a placebo 1
- Addressing underlying psychological factors, such as stress, through psychological or behavioral therapies, which may be beneficial for treating symptoms in functional dyspepsia 1
- Managing underlying conditions, such as H. pylori infection, with a short course of antibiotic treatment if a stool test or breath test is positive 1
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Causes of Inadequate Gastric Distension
Inadequate gastric distension can be caused by various factors, including:
- Delayed gastric emptying, which can be due to disordered motility, impaired fundic accommodation, antral hypomotility, gastric dysrhythmias, pylorospasm, and visceral hypersensitivity 2
- Gastroparesis, which can be caused by diabetes, postsurgical complications, or idiopathic factors 2
- Gastroesophageal reflux disease (GERD), which can be caused by disordered motility and not acid hypersecretion 3
- Intestinal gas, which can be caused by excessive air swallowing, partially digested or absorbed polysaccharides, or altered colonic flora 4
Related Factors
Other factors that can contribute to inadequate gastric distension include:
- Feed intolerance in critically ill patients, which can be treated with prokinetic therapy 5
- Use of certain medications, such as opioids or benzodiazepines, which can slow down gastric motility 5
- Presence of certain medical conditions, such as hypoalbuminemia, which can affect gastric function 5
Treatment Options
Treatment options for inadequate gastric distension depend on the underlying cause, but may include:
- Prokinetic agents, such as metoclopramide, erythromycin, or cisapride, to enhance gastric motility 6, 2, 3, 5
- Dietary changes, such as eating small meals, avoiding fat and fiber, and increasing caloric intake in the form of liquids 2
- Antiemetic agents, such as prochlorperazine or ondansetron, to control nausea and vomiting 2