Gastroparesis
Gastroparesis refers to delayed emptying of the stomach. Normally, the stomach muscles contract to push food along, and the gastric pylorus (which is the gateway leading to the small intestine) relaxes in order for the food to pass into the duodenum (the first part of the small intestine). A major nerve known as the Vagus nerve is responsible for the control of this movement of food from the stomach through the gastrointestinal tract.
What Causes Gastroparesis?
Any condition which damages the vagus nerve can result in delayed emptying of the stomach. The most common cause of gastroparesis is diabetes mellitus . Chronic high sugar levels cause damage to blood vessels and nerves, the vagus nerve being one that is commonly affected.
Other causes of gastroparesis include:
• Damage to the vagus nerve in abdominal surgery
• Fibromyalgia
• Parkinson's disease
• Acute illness of any kind causing transient gastroparesis
• Cancer drugs affecting gastric emptying
What are the Symptoms of Gastroparesis?
Symptoms may vary in type and severity. Some are only affected when eating solid foods, high-fibre foods, fatty foods, or very large meals. Others may develop symptoms regardless of what they eat, although certain foods typically make the symptoms worse.
Commonly experienced symptoms include:
• Feeling full without eating very much
• Abdominal bloatedness
• Feeling as if food is not being digested
• Heartburn
• Nausea
• Vomiting of undigested food. This can be delayed several hours after a meal.
• Poor appetite
• Weight loss
• Pain in the upper abdomen
How is it Diagnosed?
After taking a clinical history and performing a physical examination, your doctor may order some investigations.
Blood tests: to check for diabetes, electrolyte imbalances, signs of infection as a cause of gastroparesis
Ultrasound: to rule out gallbladder disease as a cause of symptoms
Other tests: Barium meal, gastric emptying scintigraphy, breath testing, SmartPill®
How is Gastroparesis Treated?
Treatment is generally symptomatic, as gastroparesis tends to be a chronic condition. Conditions which have led to, or which can worsen gastroparesis, also need to be addressed. For instance, diabetes will have to be well controlled, to prevent or slow down further damage to the vagus nerve.
The following medication are often used to treat the symptoms of gastroparesis:
• Metoclopramide (maxolon)
• Domperidone (motilium)
Lifestyle and Dietary Changes:
• Eat small, more frequent meals
• Avoid foods high in fat and fibre content
• Eat softer, more easily digestible foods
Further Reading
The article above is meant to provide general information and does not replace a doctor's consultation.
Please see your doctor for professional advice.