Gastroparesis is a disorder that occurs when the stomach takes too
long to empty food. This disorder, also known as delayed gastric emptying, is a
result of weak or abnormal muscles in the stomach. There’s no known cure for
gastroparesis, but medical treatment can help you manage your symptoms.
The exact cause of gastroparesis isn’t known, but it’s thought to
have something to do with disrupted nerve signals in the stomach. It’s believed
that the vagus nerve, which controls the movement of food through the digestive
tract, becomes damaged and causes food to be digested slowly or not at all.
A common cause of damage to the vagus nerve is diabetes,
specifically diabetes that isn’t well controlled. High levels of blood sugar
can change the way the vagus nerve gets its nutrients. Surgeries that involve
the stomach or other digestive organs can also damage the vagus nerve.
Is at Risk for Developing Gastroparesis?
Certain health conditions can make it harder for your stomach to
empty, increasing your chances of developing gastroparesis. The risk factors
- diabetes mellitus
- some cancer treatments
- eating disorders, like anorexia and bulimia
- hypothyroidism or an overactive thyroid
- Parkinson’s disease
- medications that make the stomach empty more
Are the Symptoms of Gastroparesis?
The symptoms of gastroparesis can range from mild to severe. They
occur more often in some people than others. The symptoms of gastroparesis can
- upper abdominal pain
- loss of appetite
- excess gas
- changes in your blood sugar levels
- feeling full after only eating a little
- unintended weight loss
- swollen abdomen
Is Gastroparesis Diagnosed?
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, which might include:
- an ultrasound,
which uses sound waves to create an image of your organs and can be used to
rule out pancreatitis and gallbladder disease
- an X-ray taken
after you drink a liquid containing barium that lets your doctor see if your
stomach is emptying like it should
- an upper
endoscopy, which uses a long, thin scope that your doctor guides down
your throat to see the lining of your stomach
Once your doctor has ruled out other possible causes of your symptoms,
they’ll order tests that will confirm that you have gastroparesis. These tests
- a gastric emptying scintigraphy test, which
involves eating a small amount of a radioactive substance so your doctor can
see how fast food is being digested
- a SmartPill, which is a capsule that contains a
device to track how fast food moves through your digestive tract
Is Gastroparesis Treated?
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 medication, diet changes, and even surgery in some cases.
Your doctor may prescribe one or more medications to treat your
gastroparesis. Medicines like prochlorperazine (Compro) and diphenhydramine
(Benadryl) are often given to control nausea and vomiting caused by
Medicines like metoclopramide (Reglan) and cisapride (Prepulsid, Propulsid)
stimulate the stomach muscles and help with digestion. But these drugs can
cause side effects. Talk with your doctor to decide which medication is right
If your malnutrition or vomiting remains an issue even with the
use of medicine, 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. Surgery could entail stomach stapling or a stomach bypass
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 like:
- eating well-cooked vegetables and fruit to lower
the amount of fiber they contain
- eating mostly low-fat foods
- drinking water during your meal
- avoiding foods that have a lot of fiber, like
broccoli and oranges
- eating smaller meals more often
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.
Uncommon and Experimental Treatment Options
Gastric Neurostimulator (Enterra Therapy System)
In a few treatment centers across the United States, doctors are testing
a device called a gastric neurostimulator, or Enterra Therapy system. The
device releases electrical signals that help control nausea and vomiting. This
treatment is mainly used on those who have had great difficulty in eliminating
their nausea and vomiting with medicine.
Botulinum Toxin Type A
Botulinum toxin type A is a toxin that reduces muscle activity.
It has been shown to relax the pyloric sphincter muscle, which is the muscle
that controls the flow of food from the stomach to the small intestine. Using
botulinum toxin type A on the pyloric sphincter muscle allows the stomach to
pass more food into the small intestine.
Are the Complications of 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:
- decreased blood pressure
- increased heartbeat
- rapid breathing
- decreased urine output
- weakened immune system
- poor wound healing
- muscle weakness
Gastroparesis causes food to stay in the stomach for too long,
which can 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.