Gastroparesis Awareness Month: What are the Symptoms, Causes and Diagnosis

What is Gastroparesis?

Gastroparesis is a condition where the stomach is unable to empty itself of food in the usual way. The spontaneous muscle movement, or motility of the stomach muscles is affected, and the food does not propel through the gastrointestinal tract. It disturbs a person’s normal digestion system and causes a lot of discomfort.

Symptoms of Gastroparesis

Here are some of the common symptoms people with gastroparesis experience:

• Nausea and vomiting
• Vomiting undigested food eaten a couple of hours previously
• Abdominal pain and discomfort
• Bloated feeling
• Feeling uneasy and full after having just a little food
• Acid reflux or heart burn
• Fluctuating blood sugar levels
• Lack of appetite
• Weight loss
• Malnutrition

Causes of Gastroparesis

The main cause of gastroparesis is nerve injury, especially the vagus nerve. Normally, the vagus nerve contracts the muscles in the stomach to push the food along the gastrointestinal tract. The damage to this nerve is mainly caused by diabetes. Other causes and risk factors include:

• Viral infections
• Antidepressants, certain other medications, and narcotic drugs
• Gastric surgery that injures the vagus nerve
• Amyloidosis, or collection of protein fibers that get deposited in tissues and organs
• Scleroderma, a connective tissue disorder that impacts internal organs, skin, blood vessels, and skeletal muscles
• Hypothyroidism
• Diseases of the nervous system like Parkinson’s or multiple sclerosis

Women are more susceptible to this condition than men are.

Complications of Gastroparesis

Gastroparesis often leads to several other problems like:

• Extreme dehydration caused by continuous vomiting
• Poor appetite leads to inadequate nutritional intake, causing malnutrition; nutrients are also lost while vomiting
• Food that doesn’t digest becomes solid mass and stays in the stomach; this is called a bezoar. It can cause further nausea and vomiting and can prevent food from entering your small intestine, becoming a life-threatening situation.
• Gastroparesis does not cause diabetes, but the rapid and frequent changes in the amount and speed of the food passing into the small intestine can create wildly fluctuating blood sugar levels the same as in diabetics. For diabetic patients, this means a higher intensity of all the usual problems they experience.
• Food that does not leave the stomach quickly can ferment, allowing bacterial growth.
• Reduced quality of life, as symptoms flare up suddenly, making normal tasks and routine activities difficult to perform.

Diagnosis

Your doctor will thoroughly review your symptoms and medical history, and perform a physical examination to determine the present and exact condition. The doctor may also recommend blood sugar test. Some of the additional tests include:

• 4-hour Solid Gastric Emptying Study: This test establishes how much time it takes for a meal to move through your stomach. You will be given food tagged with a radioactive isotope. Once you’ve finished eating, an image of your stomach within one minute of eating the food is taken. You can leave the room but will need to return after one hour, and then after 2 and 4 hours.
• Smart Pill: A small electronic device in a capsule will be given to you. You need to swallow this like a normal pill. As the capsule moves though your digestive tract, it relays information to a receiver regarding the speed of the movement of the food through your digestive tract.

Treatment and Management

As gastroparesis is a chronic condition, it is not really possible to cure the disease. But with treatment, it can be managed and controlled – like diabetes. One of the most important things that diabetic patients should do is to control their blood glucose levels so that the gastroparesis does not become severe.

These medications are usually prescribed for some patients:

• Reglan: This medicine is taken before eating; it causes your stomach muscles to contract, and helps the food to move out of the stomach. It also helps to reduce vomiting and nausea. Side effects include diarrhea; in very rare cases, a nerve disorder may occur.
• Erythromycin: This antibiotic drug helps the food to move along by contracting the stomach muscles. However, if taken for long, the bacteria may become resistant to the drug.
• Antiemetics: The drug helps control nausea and vomiting

Surgical Methods

Patients, who have no relief from nausea and vomiting after taking medications, may need surgery. There are different types of surgery:

• Gastric Electrical Stimulation: Mild electric shocks are sent to the stomach muscles via a gastric stimulator inserted in the abdomen. The device has two leads, attached to the stomach. The device delivers mild shocks to control vomiting.
• Gastric Bypass: A portion of the top part is made into a small pouch. Then, the small intestine is split into two halves, with the lower end attached to the pouch. This means that the patient can now eat only a limited amount of food; it is quite effective for obese diabetics.

Non-surgical Methods

• Per Oral Pyloromyotopy: Here, your doctor inserts an endoscope through the patient’s mouth and slowly moves it into the stomach. With the help of this device, the valve responsible for emptying the stomach, the pylorus, is cut; this enables food to move into the small intestine quicker.
• Feeding Tube: In the procedure called Jejunostomy, the tube is inserted into your small intestine through the abdomen surgically. You can simply insert food into the tube (liquid form), which goes straight into the intestine, bypassing the stomach. This is, however, done for a short period of time.
• IV or Parenteral Nutrition: A catheter is placed into a vein in your chest, and nutrients are directly sent into your bloodstream. This is also a temporary method, which should be used only in severe gastroparesis cases.

Have you ever experienced any of the symptoms of gastroparesis? If you have had any experience with this condition, or have undergone treatment, we want to hear from you. Drop us a line in the comment section below. Stay updated with more information on gastroparesis and other medical conditions through our Facebook and LinkedIn pages.

Thanks for reading!