Gastroparesis is a condition in which the muscles in your stomach don’t function properly. In most individuals, strong muscular contractions move food through your digestive tract. However, in patients with gastroparesis, the muscles in the stomach don’t work properly, which prevents the stomach from emptying as it should. This can interfere with digestion, cause nausea and vomiting, and negatively affect blood sugar levels and nutrition.
Click on the statements/questions below to reveal the answers to the causes, symtoms and signs of this particular disease.
There isn’t always a clear-cut cause that can be identified. However, it is believed that gastroparesis can be caused by damage to the vagus nerve. In some cases, this nerve can be damaged by surgery to the small intestine or by diseases such as diabetes.
The vagus nerve helps signal the muscles in your stomach to contract and push food into the small intestine. When the nerve doesn’t send these signals, food remains in your stomach longer than normal instead of moving into the small intestine.
Risk factors for gastroparesis include:
- uncontrolled diabetes
- uncontrolled hypertension (high blood pressure)
- abdominal surgery
- medications that slow the rate of stomach emptying (includes some narcotic pain medications and antidepressants)
- some cancer treatments
- anorexia and bulimia
- Parkinson’s disease
- viral infections
- amyloidosis (see sidebar)
Symptoms vary from person to person, but may include:
- heartburn or GERD
- vomiting undigested food
- feeling full quickly when eating
- abdominal bloating
- poor appetite
- weight loss and malnutrition
- changes in blood sugar levels
Complications also vary and may include bacterial growth in the stomach due to fermented food that has remained in the stomach too long. Food in the stomach can also harden into a bezoar, which is a solid collection of matter – these bezoars can cause obstructions in the stomach that keep food from moving into the small intestine. Bezoars can cause vomiting and can sometimes be life-threatening.
Weight loss and malnutrition are both symptoms and complications of gastroparesis. Finally, diabetics who have gastroparesis may have more difficulty regulating blood sugar.
After taking a medical history, listening to you describe your symptoms and a general medical exam, your physician may order one or more of the following tests to determine if you have gastroparesis.
Barium X-ray: You drink a liquid (barium) that covers your esophagus, stomach and small intestine, and then shows up on an X-ray. This test is also known as an upper GI (gastrointestinal) series or barium swallow test.
Barium Beefsteak Meal: You eat a meal with barium in it, and the physician observes your stomach on an X-ray as it digests the meal. The rate of digestion tells your doctor how quickly your stomach is emptying.
Radioisotope Gastric-emptying Scan: You eat food that contains a radioisotope (a radioactive substance) and then lie under a scanning machine. If the scan shows that more than half of the food is still in your stomach after two hours, you are likely be diagnosed with gastroparesis.
Gastric Manometry: A thin tube that is passed through your mouth and into your stomach measures the stomach's electrical and muscular activity to determine the rate of digestion.
Electrogastrography: This test measures electrical activity in the stomach using electrodes placed on the skin.
Ultrasound: This non-invasive test uses sound waves to create images of body organs.
Upper Endoscopy or EGD: This procedure involves passing a thin tube (endoscope) down your esophagus to examine the lining of your stomach. For more information on EGD (also known as esophagogastroduodenoscopy), you can visit the Procedures section of our site.
One of the best ways to prevent symptoms is through dietary changes. These include eating 6 small meals a day instead of 3 larger ones, avoiding foods that are high in fat and fiber, choosing easier to digest consistencies (applesauce instead of an apple with the skin on it), eating cooked fruits and vegetables instead of raw ones, avoiding fibrous vegetables such as broccoli, eating soup or pureed foods and drinking plenty of water with meals. Gentle exercise, such as walking, after a meal may also help.
Medications are sometimes used to treat your gastroparesis. Anti-emetic medications (drugs to control nausea and vomiting) may be prescribed. One example is ondansetron (Zofran). Your physician may prescribe a specific antibiotic (Erythromycin) or other medications that stimulate the stomach muscles such as Reglan (metoclopramide). Be sure to discuss side effects with your doctor.
In severe cases of gastroparesis, a feeding tube (jejunostomy tube), may be used. The tube is inserted into through your abdomen into your small intestine during a surgical procedure called a PEG. To feed yourself, you put nutrients into the tube. Because the nutrients bypass the stomach and go directly to the small intestine where they are absorbed, they get into your bloodstream more quickly. For most patients, this feeding tube is a temporary measure.
Another option for temporary treatment is intravenous (IV) nutrition. When using this feeding method, the nutrients go directly into your bloodstream through a catheter put into a vein in your chest.