Gastroparesis is a condition that causes your stomach to take too long to empty its contents. It causes delayed gastric emptying. This affects the muscles in your stomach that help move the food through the digestive tract. Normally your muscles contract and push food from the stomach into the small intestines. If you have gastroparesis this process is either slowed down or doesn’t work at all. This in return can hold up your digestion.
Causes
The cause of gastroparesis is unknown. Most of the cases are categorized as idiopathic gastroparesis, meaning the cause is unknown. The second most common is diabetes induced gastroparesis. This is caused by a complication of having diabetes. You can also develop gastroparesis after surgery if there is an injury to the vagus nerve. Surgeries that could lead to injury to the vagus nerve are a gastrectomy, gastric bypass surgery, or a cholecystectomy. Certain medications can worsen gastroparesis such as opioid pain relievers, antidepressants, high blood pressure medications, or allergy medications. Hypothyroidism, Parkinson’s disease, multiple sclerosis, amyloidosis, or scleroderma are conditions that can raise your risk of gastroparesis. Gastroparesis affects more women than it does men.
Symptoms
Symptoms can vary in severity. Some people may have no noticeable symptoms. Pain from gastroparesis is usually in the upper belly around your stomach and can feel dull or sharp. Other symptoms include indigestion, bloated stomach, feeling full all the time, nausea, vomiting, regurgitating, loss of appetite, acid reflux, heartburn, blood sugar fluctuations, constipation, and not getting enough nutrition.
Complications
Complications can arise from gastroparesis. It can cause unstable bacteria growth to occur in your stomach. Dehydration can occur if you aren’t able to eat and drink anything and keep it down. A small intestine blockage can occur. If undigested food is left in your stomach for too long it can cause a bezoar. Malnutrition is a complication. Unstable blood sugar levels are also a complication.
Diagnosis
When diagnosing gastroparesis there are a number of tests your doctor can perform. One of the main tests your doctor will do is a gastric emptying scintigraphy test. This is a test that starts with you eating a small amount of food that has a small amount of radioactive material in it. A scanner is then placed over your stomach. This scanner can detect the radioactive material and see how fast the food is moving through your digestive tract.
Your doctor may also want to do a gastric emptying breath test. This is where you eat either a food or liquid that contains a substance that your body absorbs and will then be detectable in your breath. Your breath is then taken in a few samples over the course of a few hours. The detectable substance is then measured to show how fast your stomach is emptying by the amount of the substance in your breath.
Another test option is an upper gastrointestinal endoscopy. This is done when a tiny tube with a camera is passed down through your esophagus to look at your upper digestive tract; your esophagus, stomach, and part of your small intestines. The upper GI endoscopy can look for peptic ulcer disease, or pyloric stenosis which are both signs of gastroparesis. Other imaging tests your doctor may want to do are an abdominal ultrasound, a CT scan, or an MRI.
Treatment
Treating the underlying condition, or cause of your gastroparesis can help alleviate symptoms. If there isn’t an underlying cause there are other treatment options. Changing your diet is one of the main treatments. Your doctor may refer you to a dietician who can help make sure you are getting all the right nutrients you need to not become malnourished. They can also help you know what foods are easier for you to eat and which foods to stay away from. Diet changes may include eating smaller meals, chewing food thoroughly, eating cooked fruits and vegetables instead of raw, avoid fibrous fruits and vegetables, eating low-fat foods, switching to more soups or purees, drinking up to 54 oz of water daily, exercising gently after eating, and avoiding lying down after eating. It may also be beneficial for you to take a daily multivitamin.
There are medications that can help your gastroparesis. Options may include medications that help stimulate the stomach muscles to contract and speed up the digestion process. Medications that help control nausea and vomiting can also be prescribed if needed.
In some severe cases you may not be able to handle food or liquids at all. If this is true your doctor may suggest a feeding tube. This is usually done when gastroparesis is severe or blood sugar levels are uncontrollable with other treatment options. A feeding tube can be done through your nose or mouth. It can also be surgically positioned directly into your small intestines through your skin. If long term use is needed your doctor may suggest an IV feeding tube that would be put straight into a vein, or a central line.
Gastroparesis can be short lived and resolved after an infection passes or you get the underlying cause treated and balanced. Other times it can be a lifelong condition. Gastroparesis isn’t always curable, but it can be managed. With proper treatment quality of life can improve drastically.
Diabetes is the most common single cause of gastroparesis. #HealthSurgeon
Sources:
https://www.hopkinsmedicine.org/health/conditions-and-diseases/gastroparesis#:~:text=Gastroparesis%2C%20also%20called%20gastric%20stasis,solid%20mass%20called%20a%20bezoar.
https://www.mayoclinic.org/diseases-conditions/gastroparesis/diagnosis-treatment/drc-20355792
https://my.clevelandclinic.org/health/diseases/15522-gastroparesis
https://www.webmd.com/digestive-disorders/digestive-disorders-gastroparesis