Gastroparesis (also called delayed gastric emptying) happens when the stomach takes longer than normal to empty of food. This is due to a problem with motility (the movement of the muscles in the digestive tract). For many people, gastroparesis is a lifelong condition. But treatment can help relieve symptoms and prevent complications. Read on to learn more about gastroparesis and how it can be managed.
How gastroparesis develops
With normal motility, signals from nerves tell the stomach muscles when to contract. These muscles move food from the stomach into the duodenum (the first part of the small bowel). With gastroparesis, the nerves or muscles are damaged. This causes motility to slow down or stop completely. As a result, food cannot move from the stomach properly. This delayed emptying can cause nausea, vomiting, and other symptoms. Malnutrition can result. Bezoars (hardened lumps of food) can form in the stomach and cause other complications as well.
Causes of gastroparesis
Gastroparesis can be caused by any of the following:
Surgery involving any of the digestive organs, such as the stomach and bowels
Certain medicines, such as strong pain medicines (narcotics)
Certain conditions, such as systemic scleroderma, Parkinson disease, and thyroid disease
After a viral illness
In many cases, the cause of gastroparesis cannot be found.
Signs and symptoms of gastroparesis
These can include:
Nausea and vomiting
Feeling full quickly when eating
Loss of appetite
High and low blood sugar levels (in people with diabetes)
Your healthcare provider will ask about your symptoms and health history. You’ll also be examined. In addition, blood tests and X-rays are often done to check your health and rule out other problems. To confirm the problem, you may need other tests as well. These can include:
Upper endoscopy. This is done to see inside the stomach and duodenum. For the test, an endoscope is used. This is a thin, flexible tube with a tiny camera on the end. It’s inserted through the mouth and down into the stomach and duodenum.
Upper gastrointestinal (GI) series. This is done to take X-rays of the upper GI tract from the mouth to the small bowel. For the test, a substance called barium is used. The barium coats the upper GI tract so that it will show up clearly on X-rays.
Gastric emptying scan. This is done to measure how quickly food leaves the stomach. For the test, a meal containing a harmless radioactive substance (tracer) is eaten. Then scans of the stomach are done. The tracer shows up clearly on the scans and shows the movement of the food through the stomach.
Antroduodenal manometry. This test gives pressure measurements of the stomach and small intestine to check how the contractions are working.
Newer tests. These are being created and include breath tests and wireless capsule studies
The goal of treatment is to help you manage your condition. Treatment may include one or more of the following:
Dietary changes. You may need to make changes to your eating habits and daily diet. For instance, your healthcare provider may instruct you to eat small meals throughout the day. Doing this can keep you from feeling full too quickly. You may be placed on a liquid or “soft” diet. This means you’ll eat liquid foods or foods that are mashed or put through a blender. In addition, you may need to avoid foods high in fats and fiber. These can slow digestion. For more help with your diet, your healthcare provider can refer you to a dietitian. In severe cases, you may need a feeding tube. This sends liquid food or medicine directly to your small bowel, bypassing the stomach.
Treating diabetes. If you are diabetic, it is important to control your blood sugar. High sugar levels worsen gastroparesis.
Medicines. These can help manage symptoms, such as nausea and vomiting. They can also improve motility. Each medicine has specific risks and side effects. Your doctor can tell you more about any medicine that is prescribed for you.
Surgery. You may need to have a tube surgically inserted into the stomach. The tube removes excess air and fluid. This can relieve severe symptoms of nausea and vomiting. In rare cases, other surgery may be needed on the stomach or small bowel. This is to create a new passageway for food to be emptied from the stomach.
Gastric electrical stimulation. This treatment is done less often and may not be available. Your healthcare provider can tell you more about this treatment if it is a choice for you.
Diabetes and gastroparesis
If you have diabetes, gastroparesis can make it harder to manage your blood sugar level. You’ll need to take extra steps in your treatment to prevent complications. Work with your healthcare provider to learn what you can do to protect your health. For more information, contact the American Diabetes Association, www.diabetes.org.
With treatment, most people can manage their symptoms and maintain their usual routines. If your symptoms are moderate to severe, you may need to see your healthcare provider more often for checkups. Also, other treatments will likely be needed.
March 21, 2017
Fraser, Marianne, MSN, RN,Lehrer, Jenifer, MD