Gastroparesis

Overview

Gastroparesis is a condition that affects the normal spontaneous movement of the muscles (motility) in the stomach. When the stomach's motility slows down or stops altogether, it prevents proper emptying of food. The cause of gastroparesis is often unknown, but can sometimes be a complication of diabetes or a result of certain medications, such as opioid pain relievers, antidepressants, and high blood pressure and allergy medications. Damage to the vagus nerve, which controls the stomach muscles, can also lead to gastroparesis. Complications may include severe dehydration, malnutrition, undigested food hardening, and unpredictable blood sugar changes in people with diabetes.

Understanding the disease

Symptoms

Symptoms of gastroparesis include vomiting, nausea, abdominal bloating, abdominal pain, a feeling of fullness after eating just a few bites, vomiting undigested food eaten a few hours earlier, acid reflux, changes in blood sugar levels, lack of appetite, and weight loss or malnutrition. Some people with gastroparesis may not have noticeable signs or symptoms. It is recommended to see a doctor if you have any signs or symptoms that worry you. Gastroparesis is caused by damage to a nerve that controls the stomach muscles (vagus nerve) or other conditions such as diabetes, surgery, certain medications, and nervous system diseases.

Risk Factors

Risk factors for developing gastroparesis include:

• Diabetes
• Abdominal or esophageal surgery
• Infection, usually from a virus
• Certain medications that slow the rate of stomach emptying, such as narcotic pain medications
• Scleroderma - a connective tissue disease
• Nervous system diseases, such as Parkinson's disease or multiple sclerosis
• Underactive thyroid (hypothyroidism)
• Being female (gastroparesis is more common in women than men) Note that these risk factors can increase the likelihood of developing gastroparesis, but they do not necessarily mean that someone will develop the condition.

Development

Gastroparesis can develop due to a variety of factors. In some cases, it may be caused by damage to the vagus nerve, which controls the stomach muscles. A damaged vagus nerve can prevent the normal signaling of muscles in the stomach, causing food to remain in the stomach longer than usual. This condition is often associated with diabetes, abdominal or esophageal surgery, infection (usually from a virus), certain medications that slow stomach emptying, scleroderma, and nervous system diseases such as Parkinson's disease or multiple sclerosis. In addition, women are more likely to develop gastroparesis than men.

Assessment and Diagnosis

Triage

You should see a doctor if you have any signs or symptoms of gastroparesis that worry you. These signs and symptoms include vomiting, nausea, abdominal bloating, abdominal pain, feeling full after eating just a few bites, vomiting undigested food, acid reflux, changes in blood sugar levels, lack of appetite, weight loss, and malnutrition. Even if you don't have any noticeable signs or symptoms, it's still a good idea to consult a doctor if you suspect you might have gastroparesis.

Diagnosis

To diagnose gastroparesis, doctors use several tests, including gastric emptying tests and ultrasound. Gastric emptying tests help determine how fast your stomach empties its contents. One such test is scintigraphy, which involves eating a light meal containing a small amount of radioactive material. A scanner then monitors the rate at which food leaves your stomach. Other tests include breath tests and upper gastrointestinal (GI) endoscopy. It's essential to stop taking any medications that might slow gastric emptying and consult your doctor about any potential digestion-slowing medications you are taking.

Management and Treatment

Complications

Gastroparesis can cause several complications, such as severe dehydration from ongoing vomiting, malnutrition due to poor appetite or inability to absorb nutrients, and undigested food hardening in the stomach, which can form a solid mass called a bezoar, potentially leading to nausea, vomiting, and blockage of food passage to the small intestine.

Treatment

Gastroparesis is a condition that affects the normal spontaneous movement of the muscles in your stomach, causing delayed gastric emptying. Treatments for gastroparesis typically involve dietary changes and medications.

1. Medications: Doctors may prescribe medications to help manage gastroparesis symptoms. These medications can include metoclopramide, domperidone, erythromycin, or alginate. These medications work by increasing stomach contractions, improving the movement of food through the digestive tract, and reducing nausea.
2. Dietary changes: Making changes to your diet can help manage gastroparesis symptoms. Some dietary modifications include: a. Eating smaller, more frequent meals: Instead of three large meals, eat five or six smaller meals throughout the day. b. Avoiding trigger foods: Certain foods may worsen symptoms, such as fried or spicy foods, fatty or greasy foods, or foods high in fiber. Identify and avoid these trigger foods. c. Staying hydrated: Drink plenty of fluids, especially water, to help prevent dehydration from vomiting. d. Avoiding caffeine and alcohol: These substances can worsen nausea and gastric symptoms. e. Using soft, bland foods: Opt for soft, easy-to-digest foods like bananas, rice, applesauce, and toast (BRAT diet).
3. Lifestyle modifications: Certain lifestyle changes may help alleviate gastroparesis symptoms. These include: a. Quitting smoking: Smoking can slow gastric emptying and worsen gastroparesis symptoms. b. Managing blood sugar levels: For people with diabetes, maintaining tight blood sugar control can help prevent gastroparesis from worsening. c. Reducing stress: Stress can exacerbate gastroparesis symptoms, so practice stress-reducing activities like yoga, meditation, or deep breathing exercises. While there is no cure for gastroparesis, these treatments can help alle

Preparing for medical consultation

To prepare for an appointment for gastroparesis, you should:

1. Be aware of any pre-appointment restrictions: At the time you make the appointment, ask if there's anything you need to do in advance, such as restricting your diet.
2. Write down any symptoms you're experiencing: Include any symptoms related to gastroparesis, as well as any that may seem unrelated to the condition.
3. Write down key personal information: Provide details about other medical conditions, major stresses, or recent life changes that could be relevant to your gastroparesis.
4. Make a list of all medications, vitamins, or supplements that you're taking: This should include any prescription medications, over-the-counter drugs, and dietary supplements, as well as the dosages.
5. Consider bringing a family member or friend: It may be helpful to have someone accompany you to the appointment to help remember information or provide support.