A 45-year-old male patient presented with h/o
- Fullness after meals
- Nausea and vomiting since 4-5 months
History of presenting complaints
The vomiting is recurrent and he vomits at least 4-5 times in a day. Due to this he has not able to attend his office regularly. He has taken proton pump inhibitor and domperidone, but did not get much relief.
The vomitus is non-projectile, and is usually the colour of the food that he has eaten. It is never bilious.
He c/o pain in the abdomen at times
There is no h/o dysphagia, fever or headache.
He c/o constipation since the last few days. Stool colour is normal.
There is h/o weight loss.
Personal history
He is a known diabetic since 4-5 years on metformin, He is not regular with his medications.
Family history
There is a family history of diabetes, mother is a diabetic.
Personal history:
Works in private office
Married
Non-smoker
Used to consumes alcohol (< 20 units per week) but has stopped since his symptoms have started.
Which of these is a gastrointestinal manifestation of diabetic autonomic neuropathy ?
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