Gastroparesis is a disorder that occurs when the stomach takes too long to empty food. This disorder leads to a variety of symptoms that can include nausea, vomiting, feeling easily full, and a slow emptying of the stomach, known as delayed gastric emptying.
Gastroparesis can be due to a variety of issues. There’s no known cure for gastroparesis, but medical treatment can help you manage your symptoms. Here’s what you need to know.
While the exact cause of gastroparesis isn’t known, it’s thought to have something to do with disrupted nerve signals in the stomach. It’s believed that when the nerves to the stomach become affected by a variety of factors, food can move through it too slowly. Other problems such as the stomach being overly sensitive to signals from the nervous system and the stomach not being able to react to a meal are believed to also have a role in this condition.
Most types of gastroparesis fit into one of these categories:
- idiopathic, or unknown
Nearly 36 percent of gastroparesis cases aren’t linked to an identifiable cause. This is known as idiopathic. Many times this condition occurs after a viral illness, but it’s not fully understood.
Surgeries that involve the stomach or other digestive organs can also change signals to the stomach. About 13 percent of people with gastroparesis have the type known as postsurgical.
Other health conditions are also associated with gastroparesis but are less common. These include:
- viral infections
- some cancers
- cystic fibrosis
- Parkinson’s disease
- autoimmune diseases
- amyloidosis, a condition that causes an abnormal protein buildup in organs
- medications that make the stomach empty more slowly
- thyroid disorders
The symptoms of gastroparesis can range from mild to severe. They occur more often in some people than others.
The symptoms of gastroparesis can include:
Your doctor will perform a physical exam and ask you questions about your medical history. In order to rule out other possible causes of your symptoms, your doctor will probably want to run some tests. These might include:
- An ultrasound. Ultrasounds use sound waves to create an image of your organs. It can be used to rule out liver disease, pancreatitis, and gallbladder disease.
- Blood tests. Blood tests can check for diabetes and other conditions.
- An upper endoscopy. In an upper endoscopy procedure, your doctor guides a long, thin scope down your esophagus and into your stomach to check for blockages in the stomach and other conditions.
Once your doctor has ruled out other possible causes of your symptoms, they’ll order tests to see how well your stomach empties. These tests can include a:
- Gastric emptying scintigraphy test. A gastric emptying scan involves eating a small amount of food with a harmless radioactive substance so that your doctor can see how fast food is being digested and emptied from your stomach.
- SmartPill. A SmartPill is a capsule that contains a device to track how fast food moves through your digestive tract.
- Carbon breath test. In this test, carbon dioxide production is tracked through the digestive system.
If your gastroparesis is caused by a condition like diabetes, the first step is to improve control of that underlying condition. After that, your doctor may recommend medications, diet changes, and even surgery in some cases.
Your doctor may prescribe one or more medications to treat your gastroparesis.
Medications to control nausea and vomiting caused by gastroparesis can include:
Other medications stimulate the stomach muscles and help with digestion. These include:
- metoclopramide (Reglan)
- erythromycin (EES)
- domperidone (Motilin)
However, these drugs can cause side effects. Talk with your doctor to weigh the pros and cons of each medication to find out which one is right for you.
If your malnutrition or vomiting remains an issue even with the use of medications, your doctor may decide that surgery on your stomach is necessary. The goal of surgery for gastroparesis is to help your stomach empty more effectively.
A stomach stimulator known as a GES (gastric electrical stimulator) can be implanted into the stomach. This device is FDA approved for individuals who don’t respond to medications. Studies have shown that in the first year after this surgery, up to 97 percent of people with a GES have less nausea and vomiting and are able to gain weight. The device may also improve life expectancy related to gastroparesis.
Seeing a dietitian — an expert on food and nutrition — is a common part of treatment for gastroparesis. A dietitian can suggest foods that your body can digest more easily, allowing your body to absorb more nutrients. Your dietitian might make suggestions to you, such as:
- eat four to six meals per day
- drink high-calorie liquids
- limit alcohol and carbonated beverages
- take a daily multivitamin, if tolerated
- limit certain meats and dairy
- eat well-cooked vegetables and fruit to lower the amount of fiber they contain
- eat mostly low-fat foods
- avoid foods that have a lot of fiber, like broccoli and oranges
- ensure there’s adequate time after meals before lying down for bed
- substitute solid foods for pureed or liquid foods
If you have a severe case of gastroparesis, you might not be able to eat solid foods and drink liquids. In this case, you may need a feeding tube until your condition improves.
Quitting cigarette smoking can also be beneficial to your overall condition.
Botulinum toxin type A
Botulinum toxin type A is a toxin that reduces muscle activity. It’s been studied in gastroparesis and other gastrointestinal tract disorders.
Injection of the medication into the pyloric sphincter muscle improved this condition in some studies. However, due to contradictory results and the small size of most studies, scientists state that more research is needed before it can be recommended.
Vagal nerve stimulation
The vagus nerve is important to digestion. In 2018, research is underway to study the use of vagal nerve stimulation for people with gastroparesis. This study is looking at the effectiveness of self-administered nerve stimulation twice a day.
The hope is that vagal nerve stimulation will help reduce inflammation and nerve problems associated with gastroparesis.
The symptoms associated with gastroparesis, such as vomiting and decreased appetite, can cause dehydration and malnutrition. Dehydration and malnutrition can cause numerous problems, including:
- electrolyte imbalances
- decreased blood pressure
- increased heartbeat
- rapid breathing
- decreased urine output
- a weakened immune system
- poor wound healing
- muscle weakness
Since gastroparesis causes food to stay in the stomach for too long, it can also cause an overgrowth of bacteria. The food can also harden into masses called bezoars that cause nausea, vomiting, and obstruction in the stomach.
Managing blood glucose levels is essential for people with diabetes. Gastroparesis can make it harder to manage those levels.
If you suspect you have gastroparesis, talk to your doctor. They’ll do a thorough exam before diagnosing the condition. If you do have gastroparesis, work with your doctor to develop a treatment plan based on your particular health needs.
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