What is Gastroparesis? Symptoms, Causes, Diagnosis

Gastroparesis also called delayed gastric emptying, is a condition in which food stays in the stomach for a very long time.

In healthy people, when the stomach is functioning normally, contractions of the stomach help to crush ingested food and then move the crushed food into the small intestine where further digestion and absorption of nutrients takes place. When a person is suffering from gastroparesis, their stomach is unable to contract normally, and therefore cannot crush food nor move food into the small intestine properly. This can result in life-threatening complications. Gastroparesis can occur as a separate problem or it can be correlated with weakness of the muscles of other parts of the intestine, including the small intestine, colon, and esophagus.

The symptoms of gastroparesis include:

  • Feeling full soon after starting a meal
  • Feeling full long after eating a meal
  • Nausea
  • Upset stomach
  • Throwing up undigested food
  • Weight loss
  • Trouble controlling blood sugar
  • Belly pain
  • Vomiting
  • Too much bloating
  • Too much belching
  • Pain in your upper abdomen
  • Heartburn
  • Poor appetite

Causes of gastroparesis:

The most common disease-causing gastroparesis is diabetes. Type 1 and type 2 diabetes can damage the vagus nerve, a nerve that controls the stomach’s muscles. As a result blood glucose levels stay high for too long. High blood glucose causes chemical changes in nerves. It damages the blood vessels that bring them much-needed oxygen and nutrients.

Gastroparesis can also result from damage to the vagus, which can happen during surgery on the esophagus and stomach. Scleroderma is an example of a disease during which gastroparesis is caused due to damage to the stomach’s muscles. Sometimes, gastroparesis is caused by reflexes within the nervous system. For instance, when the pancreas is inflamed. In such cases, neither the nerves nor the muscles of the stomach are damaged, but messages are sent through nerves from the pancreas to the stomach. That prevents the muscles from working normally.

Other causes of gastroparesis include

  • Hypothyroidism 
  • Certain nervous system disorders such as Parkinson’s disease, multiple sclerosis
  • Medications (such as anti-inflammatory drugs)
  • Viral infections of your stomach
  • People with eating disorders such as anorexia nervosa or bulimia
  • Imbalances of minerals in the blood such as potassium, calcium or magnesium

In most of the patients, there is no exact cause of gastroparesis. This condition is termed idiopathic gastroparesis. Certainly, idiopathic gastroparesis is the second most frequent cause of gastroparesis after diabetes.

Diagnosing Gastroparesis: 

Your doctor will review your symptoms and medical history and complete a physical examination, including blood tests. If he or she finds it likely that you have gastroparesis or is unsure and wants to rule out other diseases and disorders, there are a few tests available. This is particularly important with gastroparesis because many of the symptoms are similar to other disorders, such as gastritis.

  • Gastric emptying scintigraphy: Your doctor can measure the speed at which food is digested through gastric emptying scans. It involves eating a bland meal (such as eggs or an egg substitute) that contains a small, harmless amount of radioactive material that allows technicians to monitor the rate at which it passes through the digestive system by systematically using a camera to check where the radioactive meal is. If it stays in the stomach for too long, the person has chances of having gastroparesis.
  • Upper gastrointestinal series: A white, chalky barium drink is consumed in front of an x-ray machine after fasting. Barium coats the inside of the stomach, making signs of gastroparesis show up more clearly on x rays allowing the technicians to see details in the gastrointestinal tract. This can help them find any irregularities in stomach function. If the x-ray shows food in the stomach even after fasting, the person most likely has gastroparesis.
  • Endoscopy: The doctor will carefully pass the long, thin tube called an endoscope through the mouth and escort it down the esophagus into the stomach. A small camera fixed on the endoscope will send a video image to a monitor, allowing close inspection of the lining of your upper gastrointestinal tract. The endoscope pumps air into your stomach making it easier to see.
  • Ultrasound: It uses a device to bounce sound waves to produce images of structures within your body. This can help diagnose whether problems with your gallbladder or your kidneys could be causing your symptoms.
  • Electrogastrogram: In suspected patients, an electrogastrogram is used. Numerous electrodes are taped onto a patient’s abdomen over the stomach. The electrical signals coming from the stomach that reach the electrodes on the abdomen are registered at rest and after a meal. In normal people, there is a usual electrical rhythm and the power of the electrical current raises after the meal. people by affected gastroparesis, the rhythm is abnormal and there is no increase in electrical power after the meal.

Management of Gastroparesis:

There’s no cure for gastroparesis. It’s a chronic, long-term condition that can’t be reversed. But while there isn’t a cure, your doctor can come up with a plan to help you manage symptoms and reduce the likelihood of serious complications.

Gastroparesis is managed by making simple dietary changes, consuming medications. If the condition gets worse, surgery is done

  • Lifestyle and Dietary Changes

If a person has mild gastroparesis, a few changes in diet can largely reduce symptoms. Most of these changes focus on reducing the amount of food you eat at once because overeating makes it even more difficult for your stomach to empty. Rather than two or three large meals, consuming small meals throughout the day can help. Going on a liquid diet consuming soups and smoothies can be a huge relief. Chewing each bite thoroughly and consuming non-fizzy liquids with meals can make digestion easier. Avoiding or limiting high fiber and high-fat foods can reduce discomfort since these foods typically take longer to digest. For some individuals, supplemental nutrition beverages can help ensure adequate nutrient intake.

  • Diabetes

If you have diabetes, make sure to keep glucose tablets or hard candies on hand. Eating them can raise blood sugar as they are easily absorbed. Consult with a dietician so that you meet your nutrition requirements when you have gastroparesis.

  • Medications

The medications available for gastroparesis don’t treat the underlying disease, but they help to alleviate symptoms such as nausea and upset stomach.

  • Surgery

For those who are unable to get symptoms under control through dietary changes and medications, there are a few surgical options that may offer relief.

Jejunostomy (J-tube) is a surgical procedure that places a feeding tube through the abdominal wall directly into the small intestine, bypassing the stomach. The feeding tube delivers nutrients in a specially formulated liquid food directly into the jejunum, the part of the small intestine where most nutrients are absorbed into the body. Parenteral nutrition bypasses the digestive system. It involves the delivery of fluids, electrolytes, and liquid nutrients into the bloodstream through a tube surgically placed in a vein (intravenous or IV).

  • Gastric electrical stimulator

It is an implanted device that uses mild, controlled electrical pulses to stimulate the smooth muscles in the digestive tract and speed up gastric emptying. However, this treatment does not work for everyone and is not available in all areas.

  • Botox

Botox is injected in the sphincter that connects the stomach to the small intestine. It helps relax the sphincter so that food can be moved easily into the small intestine. Botox injections don’t work for everyone, they are only a temporary solution, and can become less effective in subsequent injections.

For some people, gastroparesis affects the quality of their life but is not life-threatening. They might be unable to complete certain activities or work during flare-ups. Others, however, face potentially deadly complications.

Complications of Gastroparesis:

  • Diabetes

Gastroparesis can make diabetes more serious because the slow movement of food from the stomach to the intestines can cause variable changes in blood sugar. Blood sugar can drop as food remains in the stomach, and then spike when the food finally travels to the intestines. These changes make it extremely difficult to control blood sugar, which can lead to serious problems such as heart attack, stroke, and damage to vital organs.

  • Dehydration and malnutrition

Persistent vomiting with gastroparesis can also lead to life-threatening dehydration. Because the condition affects how well the body absorbs nutrients, it can lead to malnutrition, which is also potentially life-threatening.

  • Blockages

Some people with gastroparesis even develop masses in their stomach caused by undigested food. These masses known as bezoars can cause a blockage in the small intestines. If not immediately treated, blockages can cause a dangerous infection.

  • Complication of cancer

Gastroparesis doesn’t cause cancer, but it can happen as a complication of cancer. Symptoms of gastroparesis are attributed to chemotherapy-induced nausea and vomiting or cancer cachexia after a cancer diagnosis. Cancer cachexia refers to weight loss and muscle loss that occurs in those who have advanced cancer.

Medserg has helped 1000 of patients in fighting this disease. We are associated with some of the most reputed internationally accredited hospitals in India run by extremely compassionate & competent medical authorities in various specialties. We have teamed up with top hospitals in India to provide you with the best treatment and facilities.

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