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Gastroparesis

(Delayed Gastric Emptying)

Pronounced: gas-tro-PAH-ree-sis

Definition

Gastroparesis is a disorder of the stomach. After you eat food, the stomach breaks down food. The stomach muscles then squeeze and push food down to the small intestine. Gastroparesis is a delay with the emptying of the stomach. Food either moves too slowly or does not move at all.

The delayed food can harden. This can lead to blockages, nausea, and vomiting. Bacteria can also start to grow and make you ill. Gastroparesis can be a serious condition. You will need care from your doctor.

The Stomach and Intestines

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Causes    TOP

The vagus nerve controls movement of the stomach. The nerve may be damaged because of injury or illness. The muscles of the stomach will then not be able to work as needed.

Risk Factors    TOP

The main risk factor for gastroparesis is diabetes. Diabetes can damage nerves.

High blood glucose can also damage blood vessels. It may prevent blood flow to the vagus nerve. The nerve cannot work well without blood flow. Other risk factors include:

  • Gastroesophageal reflux disease (GERD)
  • Surgery that involves the stomach or vagus nerve
  • Taking certain medications, such as anticholinergics or opioids
  • Infection from a virus
  • Diseases affecting the nerves, muscles, or hormones
  • Diseases affecting metabolism (body’s ability to make and use energy)
  • Anorexia or bulimia
  • Radiation therapy or chemotherapy
  • Smoking
  • Alcohol use

Symptoms    TOP

Gastroparesis may cause:

  • Feeling full early during a meal
  • No appetite
  • Nausea and vomiting
  • Bloating
  • Abdominal or esophageal pain
  • Heartburn
  • Weight loss

The following may worsen symptoms:

  • High-fiber foods, like raw vegetables and fruits
  • Fatty foods
  • Carbonated drinks

Diagnosis    TOP

Your doctor will ask about your symptoms and health history. A physical exam will also be done. The doctor may do:

  • Blood tests
  • Tests to measure any of the following:
    • Stomach volume before and after a meal
    • The rate at which the stomach empties
    • The ability of the muscles in the stomach and small intestine to contract and relax
  • Imaging tests can assess the stomach and surrounding structures:
  • Other procedures
    • Upper GI endoscopy—a thin, lighted tube inserted down the throat to examine the esophagus, stomach, and small intestine
    • SmartPill—a pill-sized device that is swallowed to take images of the entire digestive system

Treatment    TOP

Talk with your doctor about the best treatment plan for you. Treatment options include:

Diet

What you eat can affect your symptoms. Work with your doctor or a registered dietitian to create a meal plan that is right for you. Some habits may include:

  • Eating small meals several times throughout the day
  • Following a liquid diet
  • Limiting high-fat and high-fiber foods

Alternative Nutrition

You may need to work around the stomach if the gastroparesis is severe. Nutrients can be delivered directly into the:

  • Intestines—a tube is passed through nose, down throat and into intestine. Long term use may require a tube passed through the stomach wall into the intestine.
  • Bloodstream—through an IV

Medicine    TOP

You may be given medicine to treat the symptoms. It can also help the stomach empty. The medicine can stimulate the stomach muscles. Examples include:

  • Metoclopramide
  • Erythromycin

Other medicine may be given to reduce nausea.

Surgery    TOP

In severe cases, your doctor may consider surgery. This may include removing part of the stomach.

Prevention    TOP

Steps that may reduce the risk of gastroparesis include:

  • If you have diabetes, follow your treatment plan.
  • Be aware of medicine that may delay gastric emptying. These include opioids, calcium channel blockers, and some antidepressants. Talk to your doctor about benefits and risk of your medicine to find what works best for you.

RESOURCES:

American College of Gastroenterology
http://patients.gi.org
American Gastroenterological Association
http://www.gastro.org

CANADIAN RESOURCES

Canadian Association of Gastroenterology
https://www.cag-acg.org
Canadian Digestive Health Foundation
http://www.cdhf.ca

References:

Complicatoins of diabetes mellitus. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/complications-of-diabetes-mellitus. Updated February 2017. Accessed April 4, 2018.
Gastroparesis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T113805/Gastroparesis. Updated December 21, 2015. Accessed April 4, 2018.
Gastroparesis. American College of Gastroenterology website. Available at:
...(Click grey area to select URL)
Updated December 2012. Accessed April 4, 2018.
Gastroparesis. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/gastroparesis. Accessed April 4, 2018.
Shakil A, Church RJ, Rao SS. Gastrointestinal complications of diabetes. Am Fam Physician. 2008;77(12):1697-1702.
Last reviewed April 2018 by EBSCO Medical Review Board Daus Mahnke, MD
Last Updated: 7/19/2018

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