About Gastroparesis (Delayed Gastric Emptying)
The causes of gastroparesis include:
- Dysfunction of the nerves in parts of the body that help digest food
- Structural abnormalities in the stomach or digestive tract
Risk factors of gastroparesis include:
- Diabetes or high blood sugar
- Medication use (narcotics, antidepressants, dopamine agonists, etc.)
- Post-viral syndromes
- Neurologic diseases (Parkinson's disease, multiple sclerosis)
- Post-surgical conditions
- Connective tissue diseases like amyloidosis (a condition where protein builds up in the body) and scleroderma (a condition that causes the skin or body tissue to become hard)
- Previous surgery on the stomach or esophagus
- History of cancer treatment
- Autoimmune conditions
- Poor diet
- High stress levels
It's important to note that these risk factors may vary from person to person. If you suspect you have gastroparesis or are concerned about your risk factors, it's best to speak with a healthcare provider for a thorough evaluation and personalized advice.
The most common early symptoms of gastroparesis include:
- Nausea
- Vomiting
- Feeling excessively full even after eating a small amount
As gastroparesis progresses or reaches a higher severity, other common symptoms that may occur include:
- Discomfort or cramping in the stomach area
- Bloating
- Unintentional loss of weight
- Loss of appetite
- Blood sugar fluctuations
- Acid reflux or heartburn
It's important to note that symptoms can vary from person to person and may be influenced by factors such as diet and overall health. If you experience any of these symptoms, it is advisable to speak with your healthcare provider for a proper diagnosis and management plan.
To diagnose gastroparesis, healthcare providers commonly perform the following examinations, tests, and procedures:
- Medical history review: Your healthcare provider will ask about your symptoms, medical history, and any medications you are taking.
- Physical exam: The healthcare provider will perform a physical exam to look for signs of a medical problem, such as pain or swelling.
- Lab tests: Blood tests can show signs of dehydration, malnutrition, inflammation, infection, and blood glucose levels.
- Upper gastrointestinal (GI) endoscopy: This procedure uses a flexible tube with a camera to examine the upper GI system for any abnormalities.
- Imaging tests: Procedures like CT scan, MRI, and ultrasound can help identify problems in the digestive tract that may be causing symptoms.
- Tests to measure stomach emptying: Gastric emptying study is a nuclear medicine procedure, a procedure that uses radioactive materials to take pictures inside the body, that evaluates the rate of stomach emptying using solid food or liquids.
- Breath test: This test measures the amount of gas metabolized (broken down) by your body after drinking sugar water.
To determine the stage or severity of gastroparesis, additional examinations, tests, and procedures may include:
- Gastric manometry: This test evaluates the electrical activity and movement of the stomach and small intestine using a thin tube passed through the mouth.
- Electrogastrography (EGG): This non-invasive (does not require cutting into the body or causing any pain) test measures the electrical activity of the stomach muscles.
- 24-hour pH monitoring: This test measures acid reflux from the stomach into the esophagus over a 24-hour period.
- Smart pill test: Ingesting a capsule-sized device that measures pressure, pH levels, and temperature throughout the digestive tract.
It's important to consult with your healthcare provider about which tests are appropriate for your individual situation.
The goals of treatment for gastroparesis are to address the symptoms that bother the individual the most and improve overall quality of life. Treatment options may include:
- Medications:
- Stomach movement medications: Erythromycin, metoclopramide, and prucalopride can help speed up stomach emptying.
- Neuromodulators (nerve signal helpers): Certain antidepressants and neuropathy medications, may target disordered gut-brain interaction and improve sensation in the gastrointestinal tract.
- Antiemetic medications can control nausea and vomiting associated with gastroparesis.
- Therapeutic procedures:
- Endoscopy techniques, like per-oral pyloroplasty, can disrupt the valve between the stomach and small intestine (pylorus) to improve stomach emptying.
- Laparoscopic pyloroplasty is a surgical approach that reshapes the pylorus muscle to aid faster stomach emptying.
- Gastric electrical stimulation involves implanting a gastric stimulator to enhance signaling between the gut and brain.
- Health behavior changes:
- Improving control of underlying conditions (health conditions you already have that may not show obvious signs) like diabetes can help manage gastroparesis symptoms.
- Dietary changes, such as consuming low-fat and low-fiber foods, smaller and more frequent meals, and working with a dietitian to develop an appropriate meal plan.
- Engaging in gentle physical activity after meals may help relieve symptoms.
It's important to discuss these treatment options with a healthcare provider to determine which approach is best for individual needs. Remember, medication dosing may be affected by many factors, so it's essential to speak with a healthcare provider for personalized advice. Other side effects can occur with medications, so it's important to read the information provided or speak with a healthcare provider for additional details.