Gastroparesis

Definition

Gastroparesis is a disorder that affects the digestive system. During normal digestion, the stomach breaks down food and then contracts to push food down to the small intestine. With gastroparesis, there is delayed emptying of the stomach. Food either moves slowly through the digestive tract or does not move at all. This can pose problems since the food can harden causing blockage, nausea, and vomiting. Bacteria can also start to grow. Gastroparesis is a potentially serious condition. It requires care from your doctor.

The Stomach and Intestines

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Causes

Movement of food in the digestive system is controlled by the vagus nerve. Gastroparesis occurs when this nerve is damaged.

Risk Factors

The main risk factor is diabetes. Diabetes can damage the vagus nerve, which may lead to gastroparesis. High blood sugar can also damage blood vessels that carry nutrients and oxygen to the vagus nerve, preventing it from working properly. Other risk factors include:

• Gastroesophageal reflux disease (GERD)
• Surgery that involves the stomach or vagus nerve
• Taking certain medicines (eg, anticholinergics or narcotics)
• 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 or chemotherapy

Symptoms

If you have any of these symptoms, do not assume it is due to gastroparesis. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

• Feeling full early during a meal
• No appetite
• Nausea and vomiting
• Bloating
• Pain in your abdomen or esophagus (the muscular tube that carries food from your mouth to your stomach)
• Heartburn
• Weight loss

The following may worsen symptoms:

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

Diagnosis

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

• Blood tests
• Tests to measure:
  • 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:
  • Ultrasound —uses sound waves to create an image of organs inside the body
  • Barium x-ray —uses a milky fluid to coat the lining of the intestines to create an x-ray image
  • Gastric emptying study—uses radioactive meal to measure stomach emptying directly with an x-ray
• Other procedures
  • Upper 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 capture information on the digestive system

Treatment

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

Prevention

To help reduce your chances of getting gastroparesis, take the following steps:

• Control diabetes. Since diabetes is a common risk factor for gastroparesis, it is important that you follow treatment plans from your doctor if you have diabetes.
• Avoid medicines that delay gastric emptying. Some medicines may keep your stomach from emptying properly. These include narcotic pain medicines, calcium channel blockers, and some antidepressants. Keep a list of all the medicines you are taking and share this list with your doctor. Make sure you talk to your doctor before stopping any medicines.