Gastroparesis
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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). For many people, gastroparesis is a lifelong condition. But treatment can help relieve symptoms and prevent complications. Read on to learn more about gastroparesis and how it can be managed.
How Gastroparesis Develops
Gastroparesis means that food and fluids move too slowly out of the stomach into the duodenum.
With normal motility, signals from nerves tell the stomach muscles when to contract. These muscles move food from the stomach into the duodenum (first part of the small bowel). With gastroparesis, the nerves or muscles are damaged. This causes motility to slow down or stop completely. As a result, food cannot move from the stomach properly. This delayed emptying can cause nausea, vomiting, and other symptoms. 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
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 diabetes patients)
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.
Gastroduodenal manometry. This is done to measure the pressure changes that occur as the muscles in the stomach and small bowel contract during digestion. For the test, a thin tube is inserted through the nose and guided down into the stomach and small bowel. The tube is connected to a computer that collects and records the data.
Wireless capsule device. This is a harmless device shaped like a pill that is swallowed to collect information about the GI tract. As the capsule travels through the GI tract, data is sent to a receiver worn on a necklace or belt. This data is then analyzed. The capsule is passed out of the body through the stool within a few days.
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 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. 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.
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. This may be needed to place a tube 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.
Other treatments. These include botulin toxin and gastric electrical stimulation. They are done less often and may not be available. Your doctor can tell you more about these treatments, if they are options for you.
Diabetes and Gastroparesis
If you have diabetes, gastroparesis can make it harder to manage your blood sugar level. You'll need to take extra steps in your treatment to prevent complications. Work with your doctor to learn what you can do to protect your health. For more information, contact the American Diabetes Association, at www.diabetes.org.
Long-Term Concerns
With treatment, most people can manage their symptoms and maintain their usual routine. 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.
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