Gastroparesis

Gastroparesis (also called delayed gastric emptying) occurs when the stomach takes longer than normal to empty of food. This is due to a problem with motility (the movement of the muscles in the digestive tract). The nerves to the stomach are damaged or do not work properly (neuropathy). For many people, gastroparesis is a lifelong condition. But treatment can help relieve symptoms and prevent complications.

How Gastroparesis Develops

Gastroparesis means that food and fluids move too slowly out of the stomach into the duodenum.

 

With normal digestion, signals from nerves tell the stomach muscles when to contract. These muscles move food from the stomach into the duodenum (the first part of the small bowel). With gastroparesis, the nerves are damaged. This causes motility to slow down or stop completely. As a result, food cannot properly move from the stomach. Malnutrition can result. Bezoars (hardened lumps of food) can form in the stomach and cause other complications as well.

Causes of Gastroparesis

Gastroparesis can be caused by any of the following:

• Diabetes (blood sugar control is important)

• Surgery involving any of the digestive organs, such as the stomach and bowels

• Certain medications, such as strong pain medications (narcotics)

• Certain conditions, such as systemic scleroderma, Parkinson’s disease, and thyroid disease

In many cases, the cause of gastroparesis cannot be found.

Signs and Symptoms of Gastroparesis

These can include:

• Nausea and vomiting

• Feeling full quickly when eating

• Abdominal pain

• Heartburn

• Abdominal bloating

• Weight loss

• Loss of appetite

• High and low blood sugar levels (in people with diabetes)

Diagnosing Gastroparesis

Your doctor will ask about your symptoms and health history. You’ll also be examined. In addition, blood tests and X-rays are often done to check your health and rule out other problems. To confirm the problem, you may need other tests as well. These can include:

• Upper endoscopy. This is done to see inside the stomach and duodenum. For the test, an endoscope is used. This is a thin, flexible tube with a tiny camera on the end. It’s inserted through the mouth and down into the stomach and duodenum.

• Upper gastrointestinal (GI) series. This is done to take X-rays of the upper GI tract from the mouth to the small bowel. For the test, a substance called barium is used. The barium coats the upper GI tract so that it will show up clearly on X-rays.

• Gastric emptying scan. This is done to measure how quickly food leaves the stomach. For the test, a meal containing a harmless radioactive substance (tracer) is eaten. Then scans of the stomach are done. The tracer shows up clearly on the scans and shows the movement of the food through the stomach.

Treating Gastroparesis

The goal of treatment is to help you manage your condition. Treatment may include one or more of the following:

• Dietary changes. You may need to make changes to your eating habits and daily diet. For instance, your doctor may instruct you to eat small, frequent (4-6) meals throughout the day. Doing this can keep you from feeling full too quickly. You may be placed on a liquid or “soft” diet. This means you’ll eat liquid foods or foods that are mashed or put through a blender. In addition, you may need to avoid foods high in fats and fiber. These can slow digestion (delay stomach emptying). Chew foods well before swallowing. Solid foods in the stomach do not empty well. Drink fluids during your meal and sit upright or walk after meals to aid in digestion. For more help with your diet, your doctor can refer you to a dietitian. In severe cases, you may need a feeding tube. This sends liquid food or medication directly to your small bowel, bypassing the stomach.

• Foods to try:

• Medications. These can help manage symptoms, such as nausea and vomiting. They can also improve motility. Each medication has specific risks and side effects. Your doctor can tell you more about any medication that is prescribed for you.

• Surgery. You may need to have a tube surgically inserted into the stomach. The tube removes excess air and fluid. This can relieve severe symptoms of nausea and vomiting. In rare cases, other surgery may be needed on the stomach or small bowel. This is to create a new passageway for food to be emptied from the stomach.

Long-term Concerns 

With treatment, most people can manage their symptoms and maintain their usual routines. If your symptoms are moderate to severe, you may need to see your doctor more frequently for checkups. Also, other treatments will likely be needed.