What is Gastroparesis?
Gastroparesis, also known as delayed gastric emptying, is a condition in which the stomach takes longer than usual to empty food into the intestine resulting in early satiety, nausea, and other symptoms.
Causes of Gastroparesis
It is unclear how gastroparesis occurs but it is thought to be caused by damage to the nerves which control the muscles of the stomach. It may be associated with
- Certain medications such as antidepressants, dopamine, progesterone
- Stomach surgery
- Parkinson’s disease
- Neurological disorder
- Metabolic disorder
Gastroparesis is often not associated with any cause or factor and is referred to as idiopathic.
Symptoms of Gastroparesis
Symptoms of gastroparesis include:
- Feeling of fullness
- Early satiety
- Nausea and vomiting
- Loss of appetite
- Stomach pain
- Acid reflux
- Weight loss
- Variations in blood sugar level
Diagnosis of Gastroparesis
Your doctor will review your medical history and symptoms and perform a physical examination. The following diagnostic tests may be performed to diagnose gastroparesis and rule out other conditions:
- Upper GI Series: This study uses barium-based contrast material which is swallowed to enhance x-ray imaging of the stomach.
- Breath test: A breath test may be performed after consuming a solid or liquid containing a chemical. The levels of this chemical in the breath can determine how fast food or liquid is absorbed after passing through the stomach.
- Upper GI Endoscopy: This procedure involves the use of an endoscope, which is a flexible tube containing a miniature camera, to examine the inside of the oesophagus and stomach.
- Gastric scintigraphy (Gastric emptying scan): In this test, you will consume food that is labelled with a radioactive isotope. A scanning machine will be placed above your body to analyse how much food has been emptied from the stomach 4 hours after consumption.
- Ultrasound: This test produces images of the internal organs using sound waves of high frequency.
- Gastroduodenal manometry: This test involves the insertion of a thin tube along with an endoscope into the stomach to record the movement of the smooth muscles of the stomach and small intestine.
- Electronic capsule: A capsule with a small electronic device is swallowed and its movement through the stomach and digestive system is tracked.
- Blood test: A blood test will be performed to detect for malnutrition and dehydration.
Treatment for Gastroparesis
Treatment for gastroparesis may vary based on the severity of the condition. Your doctor may recommend a conservative approach including:
- Lifestyle and dietary changes: This includes:
- A healthy diet including well-cooked vegetables and fruits
- Smaller, more frequent meals to help in easy digestion
- Chewing food properly
- Drinking liquids during meals
- Avoiding carbonated drinks or beverages
- Avoiding smoking and consumption of alcohol
- Drinking plenty of water
- Multivitamin supplements
- Medications: These medications are prescribed to prevent vomiting and nausea, and also to help stimulate muscle activity.
- Metoclopramide: This med helps to increase stomach contractions promoting gastric emptying.
- Pain medications: These are used to treat stomach pain.
- Erythromycin: This antibiotic also helps improve gastric emptying.
- Antiemetics: These medications prevent nausea.
If you have diabetes you may be advised to check blood sugar levels more often to keep them under control. You may have to split your insulin dose so that it is administered before and after meals.
If conservative methods fail to relieve the symptoms, surgery will be recommended. This includes:
- Electrical gastric stimulation: This involves the attachment of electrodes to the stomach to increase muscle contractions.
- Feeding tube: This helps to deliver liquid nutrition directly to the intestine in cases of inability to tolerate food or liquid due to severe gastroparesis. A feeding tube may be passed through the nose or mouth or through an incision in the abdomen to reach the intestine (jejunostomy).
- Venting gastrostomy: A tube may be passed into the stomach through an opening in the abdomen (gastrostomy)to relieve pressure in the stomach.
- Gastrojejujunostomy: A passage may be created from your stomach to your intestine to promote gastric emptying.
- Peroral pyloromyotomy: An endoscope is inserted through the mouth into the stomach and instruments passed through the endoscope are used to make a cut in the valve (pylorus) between the stomach and intestine to help improve the passage of food.
- Laparoscopic gastric bypass: This is a minimally invasive procedure in which a small pouch is created by stapling the stomach along its upper portion and connecting the pouch to the small intestine.
- Gastroesophageal Reflux Disease (GERD)
- Irritable Bowel Syndrome
- Inflammatory Bowel Disease
- Crohn's Disease
- Bowel Incontinence
- Unintentional Weight Loss
- Upper Gastrointestinal Disease
- Swallowing Disorders
- Oesophageal Motility Disorder
- Gastric Disease
- Gastric Ulcers
- Peptic Ulcer
- Gallbladder Disease
- Liver Disease
- Fatty Liver Disease
- Hepatitis A
- Hepatitis B
- Hepatitis C
- Liver Masses
- Hepatobiliary Disease
- Pancreatobiliary Diseases
- Evaluation of Gastrointestinal Malignancy or Pre-Malignant Conditions
- Liver Cancer
- Pancreatic Cancer
- Biliary Tract Cancer
- Polyp to Colon Cancer Progression
- Small Intestinal Bacterial Overgrowth (SIBO)
- Eosinophilia and Eosinophil-Associated Gastrointestinal Disorders (EGIDs)
- Inflamed or Irritable Bowel
- Coeliac Disease
- Diverticular Disease
- Upper Gastrointestinal Bleeding
- Lower Gastrointestinal Bleeding
- Rectal Bleeding
- Prevention of Gastrointestinal Diseases