From the Guidelines
Postprandial fullness should be managed by eating smaller, more frequent meals, avoiding foods that cause bloating, and considering prokinetic medications or proton pump inhibitors if symptoms persist, as it can be a predictor of delayed gastric emptying and is associated with gastroparesis and functional dyspepsia 1. To manage postprandial fullness, several strategies can be employed:
- Eating smaller, more frequent meals throughout the day rather than three large ones to reduce symptoms of fullness and bloating
- Chewing food thoroughly and eating slowly to improve digestion and reduce symptoms
- Avoiding foods that commonly cause bloating, such as carbonated beverages, beans, and certain vegetables like broccoli and cabbage
- Limiting fatty foods, which can delay stomach emptying and exacerbate symptoms Some key points to consider:
- Postprandial fullness can be a predictor of delayed gastric emptying, which is a key factor in the development of gastroparesis and functional dyspepsia 1
- The sensation of postprandial fullness occurs because stretch receptors in the stomach wall signal fullness to the brain, but this can be exaggerated in certain conditions where stomach emptying is delayed or sensitivity to normal distension is increased
- Over-the-counter options like simethicone (Gas-X) can help with gas-related fullness, while prokinetic medications such as metoclopramide (5-10mg before meals) may be prescribed for more severe cases to improve stomach emptying 1
- Proton pump inhibitors like omeprazole (20mg daily) might be recommended if acid reflux contributes to symptoms It is essential to consult a healthcare provider if symptoms persist beyond two weeks or are accompanied by weight loss, vomiting, or severe pain, as postprandial fullness could indicate an underlying digestive disorder such as gastroparesis or functional dyspepsia 1.
From the Research
Postprandial Fullness in Gastroparesis
- Postprandial fullness is a common symptom of gastroparesis, a disorder characterized by delayed gastric emptying in the absence of mechanical outlet obstruction 2, 3, 4.
- The condition commonly manifests as upper gastrointestinal symptoms, including nausea, vomiting, postprandial fullness, early satiety, abdominal pain, and bloating 2.
- Gastroparesis can be caused by various factors, including idiopathic, diabetic, and postsurgical causes, as well as neurodegenerative disorders, myopathies, and medication-induced causes 3.
Management of Postprandial Fullness in Gastroparesis
- The management of gastroparesis involves nutritional support, medications, and procedures, with prokinetic and antiemetic agents being the mainstay of treatment 2, 5, 3.
- Metoclopramide, domperidone, and cisapride are some of the pharmacological agents used to manage gastroparesis, with metoclopramide being the only Food and Drug Administration-approved medication for gastroparesis 3, 6.
- Domperidone has been shown to improve symptoms of gastroparesis, including postprandial fullness, early satiety, and nausea, with significant improvement in overall gastroparesis symptom severity 4.
Treatment Outcomes and Side Effects
- Treatment with domperidone has been shown to improve symptoms of gastroparesis, with improvement in overall gastroparesis symptoms occurring on day 3 of treatment and maintaining during the treatment 4.
- Side effects of domperidone include palpitations, headache, breast tenderness, menstrual bleeding, dizziness, drowsiness, chest pain, swelling, and constipation 4.
- The gastroparesis cardinal symptom index-daily diary (GCSI-DD) is a useful tool to document efficacy of therapy for gastroparesis, allowing for daily symptom scoring and tracking of treatment response 4.