What is Gastroparesis?

A health condition that causes stomach muscles to not move enough for digestion is called gastroparesis. In normal circumstances, the stomach muscles contract and send food through the digestive tract but in people with this condition motility (stomach movement) is reduced it does not work at all. As a result, it prevents the stomach from emptying properly.

Mostly, the exact cause of gastroparesis is not known but sometimes, it is linked with diabetes. Moreover, some people develop this condition after surgery or a viral infection.

In addition, certain medications and health conditions also may prevent the stomach from emptying correctly. These include allergies, weight loss, antihypertensive medicines, antidepressants, opioid painkillers, and others. Do not administer previous medicines without a doctor’s approval because gastroparesis symptoms may worsen.

This condition negatively affects digestion and can cause nausea, vomiting, and abdominal pain as well as problems with levels of blood sugar and nutrition.

Unfortunately, there is no way to cure this condition but with proper treatment, you may get some relief.

Symptoms

These include:

  • Abdominal pain or bloating
  • Nausea
  • Vomiting
  • Feeling full even after several bites
  • Vomiting
  • Acid reflux
  • Blood sugar levels change
  • Lack of appetite
  • Weight loss caused by not getting enough nutrients (also known as malnutrition)

However, many people with this condition do not experience any symptoms. Immediately contact your healthcare professional if you experience any of the previous symptoms.

Causes

However, not every time it is possible to determine the cause of gastroparesis. Sometimes, it happens due to damage to the nerve (vagus nerve) that controls stomach muscles. It helps manage all that happens in the digestive tract including contracting of the stomach muscles to push food into the small intestine. If this nerve is damaged, the signals cannot reach the muscles of the stomach as they should, which causes the food to remain in the stomach longer than it should.

Furthermore, health conditions (such as diabetes) and surgery to the small intestine or stomach can damage the vagus nerve.

Risk Factors

This condition can occur at any age but mostly in women and people assigned to females at birth (AFAB) than men and people assigned to males at birth (AMAB). The following factors may elevate your risk of developing gastroparesis. Examples include:

  • Viral infections
  • Type 1 and 2 diabetes
  • Surgery on the stomach, esophagus, or small intestine
  • Cancers or cancer treatments (including radiation therapy)
  • Medicines (such as opioid pain medications)
  • Scleroderma (a condition in which the skin becomes tightened and hardened)
  • Nervous system conditions (including migraine, Parkinson’s disease, multiple sclerosis, and others)
  • Hypothyroidism (underactive thyroid gland)

What Are The Potential Complications of Gastroparesis?

If you do not get treatment for this condition, you may experience the following complications. These include:

  • Dehydration (loss of body fluids usually caused by persistent vomiting or diarrhea)
  • Malnutrition – It commonly occurs due to a lack of appetite, which prevents the body from getting enough nutrients.
  • Bezoars – This is food that does not digest and remains in the stomach and turns into a solid mass. These bezoars may cause nausea and vomiting. In case bezoars prevent food from passing to the small intestine it may be life-threatening.
  • Worsening of diabetes – While gastroparesis does not cause diabetes, it may worsen it. This occurs due to changes in the amount of food that passes through the small intestine leading to changes in the blood sugar levels.
  • Decreased quality of life – The gastroparesis symptoms may interact with your daily routine.

Diagnosis

Healthcare providers perform different tests to diagnose gastroparesis. The following tests also help exclude other conditions that cause similar symptoms.

Gastric Emptying Tests

The following tests help doctors see how fast the stomach empties. For example:

  • Scintigraphy – This is the primary test done if gastroparesis is suspected by the doctors. It involves eating a small meal (such as toast or eggs) with radioactive material in it. Thereafter, doctors will follow the movement of the radioactive material using a scanner. As a result, physicians understand the rate at which food goes away from the stomach.
  • Breath tests – This test involves eating either a liquid or solid food with a special substance that the body absorbs. After some time, they measure this substance that comes when you are breathing out. Breath tests also help doctors see how fast the food leaves the stomach.

Upper Gastrointestinal Endoscopy

This test is done to check the esophagus (the tube that connects the throat with the stomach), stomach, and a small part of the small bowel (duodenum). At the end of a small and flexible tube is attached a small camera that allows your doctor to see inside the previous organs. In addition, upper gastrointestinal (GI) endoscopy also may be used to identify other conditions including peptic ulcer disease, pyloric stenosis, and others.

Ultrasound

This is a special test that uses sound waves to make detailed images of different body organs and tissues. It helps diagnose other problems not only gastroparesis. These include gallbladder or kidney problems and others.

Treatment

Usually, the gastroparesis treatment begins with treatment for underlying conditions. For instance, if diabetes causes this condition, doctors will recommend some treatment that will help manage blood sugar levels. For example:

Dietary Changes

The treatment goal is to improve symptoms and ensure enough calories and nutrition. However, gastroparesis may significantly improve with dietary changes. These changes involve finding foods that are easier to digest. Dieticians usually recommend the following tips for people with gastroparesis. Examples include:

  • It is recommended to chew food well
  • Eat smaller meals more frequently instead of one but large
  • Do not consume raw fruits and vegetables and those that are rich in fiber (such as broccoli and oranges) because it may lead to bezoars
  • Most of the time you should eat low-fat foods
  • Include in your diet soups and pureed foods
  • Drink at least 34 ounces (1 liter) of water daily to prevent dehydration
  • Regularly exercise
  • Avoid carbonated drinks or alcohol
  • Quit smoking or never begin
  • You should go for a walk after a meal instead of lying down
  • Use supplements and vitamins (consult with your doctor before taking one because it may interact with certain medicines you are using)

Medicines

Check below some medicines usually prescribed for people with gastroparesis:

  • Medications that help the muscles of the stomach work – The only medication approved by the FDA (the U.S. Food and Drug Administration) for gastroparesis treatment is Metoclopramide. However, this medicine may cause severe adverse reactions. Recently, the FDA approved nasal spray with Metoclopramide to be used in gastroparesis treatment and it has fewer negative effects. Another medicine used to improve stomach muscle work is Erythromycin but its effectiveness lowers over time.
  • Medicines to lessen nausea and vomiting – These include Diphenhydramine, Ondansetron, and Prochlorperazine.

Surgery

Sometimes, people cannot eat food or drink liquids and require a jejunostomy tube (feeding tube). This feeding tube is inserted directly into the small bowel. However, another option is available to reduce pressure from gastric contents and it is called gastric venting.

During this procedure feeding tubes can be inserted through the mouth, nose, or directly into the small bowel. In most cases, this feeding tube is used for short periods. This treatment option is often used in people with gastroparesis is severe and there are no available other options to control blood sugar levels.

Gastric Electrical Stimulation

This treatment option involves a special device that is put in the body during surgery. It gives electrical impulses to the stomach muscles, which help better move food. As per studies, this device is mostly effective for people with both diabetes and gastroparesis. Furthermore, the FDA approved this device to control symptoms of gastroparesis when dietary changes and medications do not work.

Frequently Asked Questions

Can gastroparesis be cured?

Unfortunately, there is no way to cure the condition but with proper treatment, you can get rid of symptoms and improve your quality of life.

What are the most common gastroparesis symptoms?

These include:

  • Unusual weight loss
  • Heartburn
  • Abdominal pain
  • Bloating
  • Belching
  • Nausea
  • Vomiting

If you experience any of the previous symptoms, immediately contact your healthcare professional.

What are the potential complications of gastroparesis?

If you ignore the symptoms and do not get treatment for this condition, it may lead to some unpleasant and sometimes life-threatening complications. These include:

  • Reduced quality of life
  • Bezoars
  • Persistent losing weight without trying
  • Reduced calorie intake
  • Worsening of diabetes due to inability to control blood sugar
  • Dehydration
  • Malnutrition

If you have additional questions, ask your healthcare provider.

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