Gastroparesis: What you need to know
It happens when the stomach's normally occurring contractions are not working properly. It is sometimes known as stomach paralysis.
During digestion, stomach contractions help move the partially digested food from the stomach to the small intestine. Here, further digestion and nutrient absorption occur. In people with gastroparesis, this does not occur properly.
This change interferes with how the stomach empties. The condition can lead to nausea, vomiting, and blood sugar and nutritional abnormalities.
Gastroparesis affects around 10 men and 40 women in every 100,000, but in the United States, 1 in 4 adults have symptoms that resemble those of gastroparesis.
- The cause of gastroparesis is sometimes unknown, but some common risk factors include diabetes, multiple sclerosis (MS), and chemotherapy.
- Symptoms include heartburn or acid reflux and bloating.
- Complications include dehydration and malnutrition.
- Natural remedies include eating small, frequent meals and avoiding foods that lead to bloating.
- Treatment can help relieve symptoms, but the options available will also depend on any underlying condition.
Gastroparesis happens when the stomach is not able to move food on to the small intestine.
The symptoms of gastroparesis can be mild or severe.
The cause may be unknown in some cases, but certain factors that can increase the risk.
- vagus nerve damage or surgery
- uncontrolled diabetes
- certain drugs or medications, such as tricyclic antidepressants, calcium channel blockers, clonidine, dopamine agonists, lithium, nicotine, and progesterone
- conditions such as Parkinson's disease, multiple sclerosis, amyloidosis, and scleroderma
- stomach surgery
- viral infection
- medical treatments such as radiation therapy
- certain psychological disorders
- eating disorders
- use of pain relief medications, such as codeine
- anticholinergic drugs, which block nerve signals
At times, the cause of gastroparesis is unknown. These cases are referred to as idiopathic gastroparesis. Those at the highest risk for developing idiopathic gastroparesis include young and middle-aged women.
GERD and heartburn are symptoms of gastroparesis.
The symptoms of gastroparesis include:
- heartburn or reflux disease (GERD)
- nausea or vomiting of undigested food
- feeling full-up earlier than normal
- stomach bloating or pain
- reduced appetite
- weight loss due to low-calorie intake
Symptoms are often worsened by eating solid foods, fatty foods, and foods high in fiber or by drinking high-fat or fizzy drinks.
Gastroparesis is not only an uncomfortable medical condition, but it can also cause a variety of complications.
- severe dehydration, due to vomiting
- malnutrition, as a result of poor absorption
- blood sugar abnormalities
- hardened, undigested food that can form a solid mass, which can sometimes be life-threatening
- bacterial overgrowth in the stomach due to undigested food
- reduced quality of life
Alternative therapies may provide relief to some people.
Small meals are recommended, and these should be low in fat and fiber.
- small, frequent meals
- avoiding raw or uncooked fruits and vegetables
- avoiding fibrous fruits and vegetables
- eating liquid foods such as soups or pureed foods
- eating foods low in fat
- drinking water during meals
- gentle exercise following meals, such as walking
- avoiding fizzy drinks, smoking, and alcohol
- not lying down within 2 hours after eating
Small changes in diet, such as eating soups, may help people with gastroparesis.
Treatment often involves tackling the underlying cause of gastroparesis. Some medical treatments that can alleviate the symptoms, for example, by helping the stomach to empty.
- antinausea medications, such as prochlorperazine, diphenhydramine, and thiethylperazine, or ondansetron
- drugs to increase stomach contractions like metoclopramide
- antibiotics such as erythromycin may be recommended
- injections with Botulinum toxin (Botox)
- electrical gastric stimulation, a surgical procedure where electrodes are attached to the stomach to trigger contractions
- feeding tubes or intravenous forms of nutrition may be required in some cases
If someone thinks that they are experiencing symptoms of gastroparesis, they should speak with their health provider for evaluation and treatment.
After a symptom review and physical exam, a healthcare provider may recommend certain tests and procedures to confirm a diagnosis of gastroparesis.
Tests and procedures that can be used include:
- Upper gastrointestinal endoscopy (upper GI): A flexible tube with a lighted camera is used to examine the upper gastrointestinal system, looking for any abnormal areas.
- Radiologic imaging procedures: Such procedures include the use of CT scan, MRI, and ultrasound.
- Upper GI series: Also referred to as a barium X-ray or barium swallow, this test involves drinking a liquid that coats the digestive tract and then having an X-ray. This allows doctors to see abnormal areas such as inflammation, infection, cancer, and hernias.
- Gastric emptying study: This nuclear medicine procedure allows for evaluation of the rate of stomach emptying in the presence of solid food or liquids.
- Breath test: After drinking some sugar water, the amount of gas metabolized by the body is measured in a sample of the breath.
- Gastric manometry: This test evaluates the electrical activity and smooth muscle movement of the stomach and small intestine. To do this, a thin tube is passed through the mouth and into the stomach.
- Electrogastrography: With the use of skin electrodes, an electrogastrography measures stomach electrical activity.
- The smart pill: A wireless capsule is consumed to test digestive speed. During the test, pH, temperature, and pressure changes are recorded as the pill passes through the gut.
- Scintigraphic gastric accommodation: Stomach volumes both before and after a meal are measured using radioactive material. The presence of more than 10 percent residual food within the stomach 4 hours after a meal meets the criteria for gastroparesis.
- Small intestine X-ray: This test is typically used to check for an intestinal blockage that could be causing symptoms of delayed stomach emptying. These symptoms could be confused for gastroparesis.