What is Gastroparesis?


By: Juliana Porreca


Digestive Disorders are among the most difficult to diagnose. Oftentimes, the surface level symptoms are treated, but the cause is never identified. Due to many gastrointestinal conditions sharing identical symptoms, the patient ends up getting a blanket diagnosis of IBS. However, in rare cases, the actual cause of these gastrointestinal issues is a condition called Gastroparesis. Let’s explore this little known disease.


Let’s start with the basics: what is Gastroparesis and what are the symptoms? According to the Mayo Clinic, Gastroparesis is a condition that affects


the normal spontaneous movement of the muscles in the stomach. In people without this condition, strong muscular contractions push food through the digestive track. In people with this disease however, the stomach’s vagus nerve has endured damage and the motility is slowed down or stopped all together, preventing the stomach from emptying the way it should. The symptoms that this partial paralysis of the stomach causes are vomiting, nausea, abdominal bloating, abdominal pain, the feeling of fullness after eating just a few bites, vomiting undigested food eaten hours earlier, acid reflux, changes in blood sugar levels, lack of appetite, weight loss, and malnutrition. These symptoms differ in intensity and frequency depending on the severity of each individual’s case.


The cause of the nerve damage that led to the development of gastroparesis goes unknown in most cases; although, it is more common in those with diabetes due to blood sugar staying high for too long. Other causes of gastroparesis include eating disorders, stomach or esophagus surgery, chronic fatigue syndrome, some narcotics, nervous system disorders such as abdominal migraine and Parkinson’s Disease, metabolic disorders, and viral illnesses (such as viral gastroenteritis). Gastroparesis is not hereditary, but it does appear to be more common in women. Out of 100,000 people, about 10 men and 40 women have gastroparesis, making this a rare disease (NIH).


Gastroparesis is usually diagnosed one of these two ways: either by a scintigraphy or breath tests. A scintigraphy, also known as a gastric emptying test, involves the patient eating a light meal containing radioactive material and then being scanned hourly until the food passes through their digestive system. This test identifies if the stomach is emptying at a normal pace. The breath tests are conducted after the patient consumes either a solid or a liquid. Samples of their breath are then collected over a few hours, measuring the amount of substance that is present in their breath. Ultrasounds and upper GI endoscopies can also be helpful in diagnosing this disorder and ruling out other causes of the symptoms (Mayo Clinic).


Gastroparesis is not curable; however, the symptoms are manageable in a handful of different ways. Dietary changes and maintaining adequate nutrition is at the forefront of any treatment plan for this disease. Dietitians suggest eating smaller meals more frequently, chewing food thoroughly, eating only well-cooked fruits and vegetables, avoiding fibrous and hard to digest foods, avoiding fatty foods, getting nutrition from liquids, drinking a lot of water, exercising after eating, avoiding carbonation and alcohol, taking multivitamins, and avoiding lying down for two hours after a meal. A medication called Metoclopramide can be used to stimulate the stomach muscles; however, it has a risk of serious side effects like Tardive Dyskinesia and Neuroleptic Malignant Syndrome, which can lead to death. Erythromycin is another treatment avenue, but it loses its effectiveness over time and causes side effects of its own. Recently, a newer medication, domperidone, with fewer side effects was developed, but it is only available with restricted access (Healthline). The medications prescribed to treat the nausea and vomiting caused by gastroparesis are diphenhydramine, Zofran, and Prochlorperazine.


In more serious cases when the patient is completely unable to tolerate any food or liquids, surgical avenues can be explored. A feeding tube can be placed in the small intestine and a gastric venting tube can also be put in place to help relieve pressure from gastric contents. Some people require an IV feeding tube that goes directly into a vein in the chest. There are a few new treatment methods under investigation including a surgically implanted device that provides gastric electrical stimulation and a stent placed where the stomach connects to the small intestine in order to keep the connection open. One of the most promising new treatment options on the horizon is endoscopic pyloromyotomy, a procedure that involves making an incision in the valve or muscular ring between the stomach and small intestine called the pylorus (Mayo Clinic). Larger studies are needed before these treatments are open to the public.


All in all, gastroparesis is a rare gastrointestinal disorder that affects the muscular movement of the stomach and varies in severity from patient to patient. This disease is treatable, but not curable. Through diet management, those with gastroparesis can lead relatively normal and enjoyable lives. They can avoid the likelihood of serious complications by working closely with their doctors and making sure to maintain proper nutrition. If you or someone you love suffer from undiagnosed digestive issues, talk with your doctor about being tested for Gastroparesis to take back control of your life and well-being.





Sources:

“Gastroparesis.” Cedars, www.cedars-sinai.org/health-library/diseases-and-conditions/g/gastroparesis.html.

“Digestive Disease and Disorder Symptom Chart.” Gastrointestinal Society, 10 Aug. 2020, badgut.org/information-centre/symptom-chart/#:~:text=Digestive%20disorders%20can%20be%20difficult,coming%20to%20a%20correct%20diagnosis.

“Definition & Facts for Gastroparesis.” National Institute of Diabetes and Digestive and Kidney

Diseases, U.S. Department of Health and Human Services, www.niddk.nih.gov/health-

information/digestive-diseases/gastroparesis/definition-facts#:~:text=Gastroparesis is not common.,the United States2, 3.

Illinois, University of. “Metoclopramide | Side Effects, Dosage, Uses, and More.” Healthline,

Healthline Media, 16 Mar. 2018, www.healthline.com/health/metoclopramide-oral-

tablet#important-warnings.

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