Gastroparesis: Causes, Symptoms, Diagnosis, Treatment, and Prevention
Gastroparesis involves a malfunction of the stomach muscles that causes the stomach to take too long to empty its contents into the small intestine, which can lead to nausea, vomiting, bloating, pain, and malnutrition.
What causes gastroparesis?
Most gastroparesis cases are caused by damage to the vagus nerve, which controls stomach contractions. The vagus nerve can be damaged by diseases, such as diabetes, or by abdominal or esophageal surgery.
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Infections, especially viral infections
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Certain medications that slow down the stomach emptying, such as opioids, antidepressants, and allergy drugs
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Connective tissue diseases, such as scleroderma
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Nervous system diseases, such as Parkinson’s disease and multiple sclerosis
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Thyroid disorders, such as hypothyroidism or hyperthyroidism
Sometimes, the cause of gastroparesis is unknown. This is called idiopathic gastroparesis.
What are the symptoms of gastroparesis?
The symptoms of gastroparesis vary from person to person and may depend on the type and amount of food eaten. Some of the common symptoms are:
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Nausea
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Vomiting, especially vomiting undigested food a few hours after eating
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Feeling full after eating only a small amount of food
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Acid reflux or heartburn
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Abdominal pain or bloating
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Changes in blood sugar levels
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Lack of appetite and weight loss
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Malnutrition and vitamin deficiencies
Some people with gastroparesis may not have any noticeable symptoms. However, if left untreated, gastroparesis can lead to serious complications, such as:
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Dehydration due to vomiting
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Bacterial overgrowth in the stomach due to food stagnation
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Bezoars, which are hard masses of undigested food that can block the stomach or intestine
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Unpredictable blood sugar levels in people with diabetes
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Reduced quality of life and emotional distress
How is gastroparesis diagnosed?
Your doctor will ask you about your medical history, symptoms, medications, and diet. You may also need to undergo some tests to check your stomach function. These tests include:
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Blood tests to check your blood sugar levels, blood cell count, and thyroid function
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Scintigraphy measures how quickly your stomach empties after eating a meal containing a radioactive substance. A scanner tracks the movement of the substance.
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An endoscopy uses a thin tube and camera to examine your esophagus and stomach to detect any abnormalities or blockages.
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Ultrasound, which is a test that uses sound waves to create images of your stomach and other organs. This can help check for any problems in your abdomen.
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In the barium swallow test, you swallow a liquid containing barium, which shows up on X-rays and can provide information about stomach emptying delays or problems.
How is gastroparesis treated?
There is no cure for gastroparesis, but treatments can help manage the symptoms and improve your quality of life. The main goals of treatment are to:
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Relieve nausea and vomiting
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Stimulate stomach emptying
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Maintain adequate nutrition and hydration
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Control blood sugar levels
The treatment options for gastroparesis may include:
Medications
Your doctor may prescribe you some medications to help with your symptoms. Some of the common medications are:
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Antiemetics, which are drugs that prevent or reduce nausea and vomiting. Examples are prochlorperazine and diphenhydramine.
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Prokinetics, which are drugs that stimulate the stomach muscles to contract and move food along. Examples are metoclopramide, erythromycin, and domperidone.
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Antacids or acid blockers, which are drugs that reduce acid production or neutralize acid in the stomach. Examples are ranitidine and omeprazole.
Some of these medications may have side effects or interactions with other drugs. You should always follow your doctor’s instructions on how to take them safely and effectively.
Dietary changes
You may need to make some changes to your diet to help your stomach empty faster and reduce your symptoms. Some of the dietary tips are:
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Eat smaller and more frequent meals throughout the day
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Chew your food well and eat slowly
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Avoid foods that are high in fat or fiber, as they can slow down your stomach emptying
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Drink enough fluids to stay hydrated, but avoid drinking too much during meals
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Choose foods that are easy to digest, such as soups, smoothies, purees, and soft foods
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Avoid foods that can cause gas or bloating, such as beans, cabbage, broccoli, and carbonated drinks
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Avoid foods that can irritate your stomach, such as spicy, acidic, or fried foods
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Avoid alcohol and tobacco, as they can worsen your symptoms
You may also benefit from consulting a dietitian, who can help you plan a balanced and nutritious diet that suits your needs and preferences.
Procedures
If medications and dietary changes are not enough to control your symptoms, you may need to undergo some procedures to help your stomach emptying. Some of the procedures are:
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Jejunostomy, which is a surgery that involves inserting a feeding tube through your skin into your small intestine. This can help you get enough nutrients and fluids without relying on your stomach.
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Botulinum toxin injection, which is a procedure that involves injecting botulinum toxin (Botox) into the valve between your stomach and small intestine. This can help relax the valve and allow food to pass through more easily.
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Gastric electrical stimulation, which is a surgery that involves implanting a device in your abdomen that sends electrical pulses to your stomach muscles. This can help stimulate your stomach contractions and improve your symptoms.
There may be risks and complications associated with these procedures, such as infection, bleeding, or device malfunctions. You should discuss the benefits and drawbacks of each procedure with your doctor.
Alternative therapies
Alternative therapies may provide relief for gastroparesis patients, including acupuncture, hypnosis, biofeedback, or herbal remedies. However, there is not enough scientific evidence to support the effectiveness or safety of these therapies for gastroparesis. If you are taking supplements or herbs, please inform your doctor before attempting any alternative therapies.
How can gastroparesis be prevented?
There is no sure way to prevent gastroparesis, but you can reduce your risk by:
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Keeping your blood sugar levels under control if you have diabetes
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Taking your medications as prescribed and avoiding drugs that can slow down your stomach emptying
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Avoiding abdominal or esophageal surgeries if possible
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Eating a healthy and balanced diet
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Staying physically active and maintaining a healthy weight
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Managing stress and practicing relaxation techniques
The chronic condition gastroparesis affects digestion, nutrition, and quality of life. However, you can manage your symptoms and live well with gastroparesis with proper diagnosis, treatment, and self-care. When you have questions or concerns about gastroparesis, you should consult your doctor or gastroenterologist, who specializes in digestive disorders.
