Am I At Risk for Gastroparesis?


August is gastroparesis month. What is gastroparesis?

Gastroparesis is a term that describes a paralyzed stomach. It's one of the most serious and concerning gastrointestinal (GI) motility disorders, as it affects the usual automatic movement of the muscles in the stomach. Typically, forceful muscular contractions in the stomach help food migrate through the gastrointestinal (GI) system. When gastroparesis occurs, however, the stomach's ability to push food slows considerably or may come to a complete halt. This decrease in motility can prevent the proper emptying of the stomach and can cause several medical problems. The expert gastroenterologists at GI Alliance are pleased to offer medical services for gastroparesis.

What are the signs and symptoms of gastroparesis?

Around one out of every 25 patients in the United States, including young children, has gastroparesis. The condition is more common among females compared with males, and it's more prevalent among patients who are long-term diabetics. Common symptoms and indicators of gastroparesis include:

  • Abdominal bloating
  • Purging of undigested food
  • Frequent nausea
  • Poor blood sugar control
  • Heartburn or gastroesophageal reflux (the backup of stomach contents into the esophagus)
  • Poor appetite and the unintended loss of weight
  • Chronic abdominal pain
  • Feeling full very quickly when eating

Often, patients with gastroparesis may not experience any obvious indications. At times, the condition appears fleetingly and goes away by itself or improves with professional care. Some situations may be more resistant to treatment.

What factors cause gastroparesis?

The main source of gastroparesis might not be apparent. However, physicians have discovered several factors that may contribute to the condition, such as:

  • Vagus nerve damage. Diabetes, viruses, and small intestine or stomach surgery can cause to harm the vagus nerve. Significant in controlling the GI system, the vagus nerve prompts the muscles in the gut to contract and move food into the small intestine. An impaired vagus nerve can't properly signal the stomach muscles. In these cases, food can be held in the stomach for a longer period of time instead of migrating into the small bowel to digest.
  • Medications: Opioids, some antidepressants, hypertension medications, and allergy medications might cause impaired gastric emptying and produce symptoms similar to gastroparesis. Among individuals previously affected by the disease, these medications seem to make the condition worse.
  • Scleroderma: Scleroderma is a connective tissue condition impacting the blood vessels, muscles, organs, and skin.
  • Amyloidosis: Amyloidosis is a disease that occurs when deposits of protein fibers build up in organs or tissues throughout the body.

Additional health complications associated with gastroparesis are:

  1. Severe dehydration. Persistent vomiting can cause a dangerous loss of bodily fluids.
  2. Dietary deficiencies. A poor appetite and repeated purging of stomach contents may result in limited nutritional intake and interfere with the body's ability to absorb enough proteins, vitamins, and minerals.
  3. Undigested food. Food that fails to digest in the stomach could solidify into a mass called a bezoar. This type of mass could cause nausea and vomiting and might be life-threatening if it blocks food from passing out of the stomach.
  4. Unpredictable blood sugar changes. Although gastroparesis doesn't cause diabetes, repeated changes in the volume and speed of food migrating into the bowels can spike irregular blood glucose amounts. These fluctuations in blood sugar can worsen diabetes which, in turn might exacerbate gastroparesis.
  5. Decreased living quality. Gastroparesis symptoms could render it hard to work and maintain normal daily activities.

Diagnosing gastroparesis

A gastroenterologist specializes in gastric issues, like gastroparesis. After reviewing a person's health history and symptoms, a GI physician will perform a physical assessment and may order certain blood tests to evaluate glucose levels or other parameters. Additional services conducted to detect gastroparesis may include:

  • SmartPill™ motility testing system: This involves a small, digestible capsule that houses an electronic device. When the capsule is swallowed and moves through the GI tract, it forwards readings to a receiver stationed on the individual. This test tracks and records how quickly food moves through the digestive system.
  • Four-hour solid gastric emptying study: With this test, GI doctors can evaluate the amount of time it takes a meal to migrate through the stomach. Patients receive a portion of food that has a radioactive isotope. An image of the stomach is captured 60 seconds after the meal is consumed. Subsequent scans are then captured at specific times in the wake of consumption to assess how the food moves through the stomach and the rest of the digestive system.

How is gastroparesis treated?

Gastroparesis is a long-standing concern. While treatment won't likely cure the condition, it can be kept under control and managed. People living with diabetes need to make a conscious effort to monitor and control their blood sugar values to diminish complications with gastroparesis. In some instances, individuals may benefit from certain medications, including:

  • Reglan: Reglan stimulates contractions in the muscles to move food out of the stomach and lessen the chance of queasiness and vomiting. Additional effects may include loose bowels and, rarely, a serious nerve disorder.
  • Antiemetics: These medications help control nausea.
  • Erythromycin: An antibiotic, erythromycin encourages stomach contractions and helps in propelling food through the gastric tract. Other potential effects include diarrhea and the risk of developing antibiotic-resistant bacteria if taking it for a long time.

A number of people may be candidates for surgical procedures to treat gastroparesis, such as:

  • Gastric electrical stimulation: A tiny device known as a gastric stimulator is introduced into the abdomen. This stimulator contains two leads attached to the stomach muscles that produce small electric shocks. This procedure helps reduce the urge to vomit.
  • Gastric bypass: With a gastric bypass, a small pouch is formed from the upper area of the stomach. Half of the small intestine is attached directly to the newly created small stomach pouch. This surgery considerably limits the amount of food the patient can eat, and might be more helpful for a diabetic obese patient than either medication or a gastric stimulator.

Alternative forms of gastroparesis treatments include:

  • POP: Peroral pyloromyotomy (POP) is a nonsurgical procedure where a physician positions a flexible, thin instrument in the patient's mouth and advances it to the stomach. The doctor then incises the pylorus, which is the structure that empties the stomach, letting gastric contents travel into the small intestine more normally.
  • Jejunostomy/feeding tube: When gastroparesis is advanced, a jejunostomy tube or feeding tube could be suitable. With this option, a plastic tube is surgically threaded through the abdomen into the small bowel. Generally, liquid nutrients are administered through the feeding tube, which allows the nutrients to pass through the small bowel and into the blood more rapidly. This option is often a temporary treatment.
  • IV Nutrition: This is an intravenous (parenteral) feeding technique that allows nutrients to directly enter into the bloodstream via a catheter placed into a blood vessel in the chest. Like a jejunostomy feeding tube, parenteral nutrition is a temporary measure for addressing significant gastroparesis conditions.

Can dietary changes help gastroparesis?

As specified by the American College of Gastroenterology, the diet is a fundamental aspect of managing gastroparesis and also provides a natural treatment option. In addition, doctors can recommend medication and perform medical procedures to improve symptoms of gastroparesis. However, these interventions work best if consuming a specific diet. A gastroparesis diet focuses on reducing the quantity of foods that might be difficult to digest, like fibrous and fatty items. This can help ease digestion and lessen the risk of health consequences associated with gastroparesis.

If you have signs or symptoms of gastroparesis or complications related to the diagnosis of this condition, please arrange a visit with a GI doctor near you immediately. GI Alliance has over 1000 providers throughout nine states to serve your needs and support your GI health. Find a GI Alliance physician near you.