Gastroparesis is a disorder that affects the natural movement of the muscles in the stomach. Generally, strong muscular contractions move food via the gastrointestinal tract, but with gastroparesis, the stomach’s motility is slowed down or does not function at all preventing stomach from emptying food properly. This condition interferes with the normal digestion process, which may lead to nausea, vomiting and abdominal cramp. There is no complete cure or treatment for gastroparesis, however dietary modification, together with medications can provide some respite.
The exact cause of gastroparesis is not very clear, it may be caused due to damage to a nerve that controls the stomach muscles (vagus nerve). This nerve support to manage complex processes and functions in the gastrointestinal tract such as signalling the muscles in the stomach to contract and move food into the small intestine. When the vagus nerve is damaged it cannot send signals normally to your stomach muscles, which may cause food to stay for a longer duration in the stomach, than moving into the small intestine for digestion. Sometimes gastroparesis may develop due to complication of uncontrolled diabetes and in some cases, people may develop after surgery. Sometimes taking certain medications for a long duration such as antidepressants, hypertensive and allergy medications can lead to slow gastric emptying and may cause similar symptoms. For patients suffering from gastroparesis taking these medications can worsen their condition.
Some of the most common signs and symptoms of gastroparesis include:
A feeling of fullness after eating just one or two bites
Vomiting undigested food consumed a few hours earlier
Fluctuations in blood sugar levels
Most people with gastroparesis don’t show any clear signs and symptoms.
Some of the contributing factors that can increase your risk of gastroparesis include:
Infection due to a virus
Certain medications that slow the rate of gastric emptying
Parkinson's disease or multiple sclerosis
Women are more prone than men
Dehydration: Severe persistent vomiting can cause dehydration.
Malnutrition: Lack of appetite may reduce the total amount of calories consumed, or the person may be unable to absorb nutrients due to vomiting.
Undigested foods harden stomach: Accumulation of undigested food can harden into a solid mass called a bezoar, this may cause nausea and vomiting and sometimes it be may be life-threatening if it prevents food from passing into the small intestine.
Fluctuating Blood Sugar: Constant changes in the amount of food travelling into the small bowel can lead to a spike in blood sugar levels and can aggravate the condition.
Poor quality of life: Symptoms associated with gastroparesis can make it hard for people to carry out daily routines.
The physician may recommend certain blood works to help diagnose the condition and rule out conditions that may lead to similar symptoms.
Gastric emptying tests: This test determines how fast the stomach empties its contents. Some of the other similar test that is recommended includes:
Scintigraphy: It is one of the most important tests which involves eating a light meal that contains a small amount of radioactive material, where the scanner detects the movement of the radioactive material is fixed over the abdomen to check the rate at which food leaves the stomach.
Breath Test: The patient should take a solid or liquid food that contains a substance that the body absorbs. Eventually, this substance can be detected in the patient’s breath. Samples of breath are collected over a few hours and the amount of substance in your breath is measures.
Endoscopy and ultrasound abdomen are also done to help diagnose if other conditions are causing the symptoms.
The main goal of treatment for gastroparesis is to identify the underlying condition that is causing it. If diabetes is a causative factor then the doctor may first treat to regulate blood sugar levels.
Dietary modification can greatly help people with gastroparesis to manage their condition. The doctor may refer the patient to a certified dietician to help them modify diet habits and correct nutritional deficiency.
Medications are also prescribed to ease vomiting, diarrhoea and abdominal pain.
Surgery: For some people with gastroparesis who are unable to tolerate any food or liquids then doctors may suggest a feeding tube to be placed in the small intestine, the feeding tube is used temporarily only when the condition is very severe. The gastric venting tube is fixed to help the patient ease pressure from hardening gastric contents.