Gastroparesis (Gastro meaning stomach and paresis meaning partial paralysis) is a condition in which your stomach cannot empty itself of food in a normal fashion. It is caused by damage to the vagus nerve, which regulates the digestive system. Normally, the nerves on the stomach wall (vagus) sends a signal for contraction and the stomach empties itself. But when this nerve becomes damaged, the food cannot move ahead properly. Food movement eventually slows down or stops.
However, the causes of gastroparesis can include:
- Uncontrolled diabetes (as high levels of blood glucose may effect chemical changes in the nerves)
- Anorexia nervosa or Bulimia nervosa
- Connective tissue diseases like Scleroderma
- Gastric surgery with injury to the vagus nerve
- Medications such as narcotics and some antidepressants
- Parkinson’s disease
- Rare conditions such as: Amyloidosis (deposits of protein fibers in tissues and organs)
Symptoms:
- Heartburn or GERD
- Nausea
- Vomiting undigested food
- Feeling full quickly when eating
- Abdominal pain and bloating
- Palpitation
- Poor appetite and weight loss
- Poor blood sugar control
What it can lead to:
- Fluctuations in blood glucose due to unpredictable digestion times (in diabetic patients)
- General malnutrition due to the symptoms of the disease (which frequently include vomiting and reduced appetite)
- Stagnant food can solidify with time and form Bezoars causing intestinal obstruction.
- Stomach infection due to bacterial growth in undigested food
Diagnosis:
- Physical exam, blood test and sugar test
- Barium X-ray : You drink a liquid (barium), which coats the esophagus, stomach, and small intestine and shows up on X-ray. This test is also known as an upper GI (gastrointestinal) series or a barium swallow. This would show the obstruction.
- Ultrasound
- Endoscopy
Treatment:
- Dietary modifications (low-fiber diet and may be restrictions on fat and/or solids). Eating smaller meals, spaced two to three hours apart has proved helpful. Avoiding foods that cause the individual problems, such as pain in the abdomen, or constipation, such as rice or beef, will help avoid symptoms
- Prokinetics like metoclopramide (Reglan, Maxolon, Clopra), cisapride (Propulsid)
- Insulin dose adjustments
- Stomach pacemakers
- Botox injections
- Antiemetics: These are drugs that help control nausea
- Feeding tube, or jejunostomy tube
Gastroparesis is a tough disease to manage. The more informed you are about this condition, the better you will be able to handle it.
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