Description

Gastroparesis is a condition in which the muscles in the stomach does not move food as it should to be digested.

Most often, the muscles contract to send food through the digestive tract. But with gastroparesis, the stomach movement of the flame of motility, slow, or not working at all. This prevents the stomach from emptying well.

Often, the cause of gastroparesis is not known. It is sometimes associated with diabetes. And some people have gastroparesis after surgery or after a viral illness.

Certain medications, such as opioid pain relievers, some antidepressants, and drugs for high blood pressure, weight loss and allergies can slow the emptying of the stomach. The symptoms can be similar to those of gastroparesis. For people who already have gastroparesis, this medication can worsen the condition.

Gastroparesis affects the digestion. May cause nausea, vomiting, and abdominal pain. It can also cause problems with blood sugar levels and nutrition. There is No cure for gastroparesis. But the medication and changes in diet can provide a little relief.

Symptoms

Symptoms of gastroparesis include:

  • Vomiting.
  • Nausea.
  • Belly distension.
  • Belly pain.
  • Feeling full after eating only a few bites and a lot of time after eating a meal.
  • Vomiting of undigested food eaten a couple of hours before.
  • The acid reflux.
  • The changes in the levels of sugar in the blood.
  • Not wanting to eat.
  • The loss of weight and not getting enough nutrients, called malnutrition.

Many people with gastroparesis do not notice any symptoms.

When to see a doctor

Make an appointment with your health care professional if you have symptoms that concern you.

Causes

It's not always clear what leads to gastroparesis. But sometimes the damage to a nerve that controls the muscles of the stomach may cause. This nerve, called the vagus nerve.

The vagus nerve helps control what happens in the digestive tract. This includes counting the muscles in the stomach to contract and push food into the small intestine. Damage to the vagus nerve can't send signals to the muscles of the stomach as it should. This can cause the food to stay in the stomach longer.

Conditions such as diabetes or surgery to the stomach or the small intestine can cause damage to the vagus nerve and its branches.

Risk factors

Factors that may increase the risk of gastroparesis include:

  • Diabetes.
  • Surgery on the stomach area or in the tube that connects the throat and the stomach, called the esophagus.
  • Infection with a virus.
  • Certain types of cancer and cancer treatments, such as radiation to the chest or the stomach.
  • Certain medications that slow the speed of emptying of the stomach, such as opioid analgesics.
  • A condition that causes the skin to harden and tighten, called scleroderma.
  • Diseases of the nervous system, such as migraine, Parkinson's disease or multiple sclerosis.
  • Underactive thyroid, also called hypothyroidism.

The people assigned female at birth are more likely to get the gastroparesis people who are assigned male at birth.

Complications

Gastroparesis can cause several complications, such as:

  • The loss of body fluids, called dehydration. Repeated vomiting can cause dehydration.
  • Malnutrition. Not wanting to eat can mean that you don't get enough calories. Or your body may not be able to take a sufficient amount of nutrients due to the vomiting.
  • The food that is not digested that hardens and remains in your stomach. This food can become a solid mass called a bezoar. Bezoars can cause nausea and vomiting. That can be deadly if they keep food from passing into the small intestine.
  • Blood sugar changes. Gastroparesis does not cause diabetes. But changes in the amount and the rate of passage of food in the small intestine can cause sudden changes in blood sugar levels. These sugar in the blood of the changes you may make diabetes worse. In turn, the lack of control of blood sugar levels causes gastroparesis worse.
  • Lower quality of life. The symptoms can make it difficult to work and keep up to date with the daily activities.

Diagnosis

Several tests can help diagnose gastroparesis and to rule out other conditions that can cause symptoms similar to those of gastroparesis. Tests may include:

The gastric emptying tests

To see how fast that your stomach is empty, it can have one or more of the following tests:

  • The scan.This is the main test used to diagnose gastroparesis. This involves eating a light meal, such as eggs and toast, that has a small amount of radioactive material in it. A scanner follows the movement of the radioactive material. The scanner goes on the belly, to show the speed at which food leaves the stomach. This test takes approximately four hours. You will need to temporarily stop taking any medication that may slow gastric emptying. Ask your health care professional what not to take.
  • Breath tests.For breath tests, which consume solid foods or liquids that have a substance that your body absorbs. At the time, the substance is shown on the breath. Your health care team collects samples of your breath for a couple of hours to measure the amount of substance in his breath. The amount of substance in his breath shows how fast your stomach empties.

The scan. This is the main test used to diagnose gastroparesis. This involves eating a light meal, such as eggs and toast, that has a small amount of radioactive material in it. A scanner follows the movement of the radioactive material. The scanner goes on the belly, to show the speed at which food leaves the stomach.

This test takes approximately four hours. You will need to temporarily stop taking any medication that may slow gastric emptying. Ask your health care professional what not to take.

Breath tests. For breath tests, which consume solid foods or liquids that have a substance that your body absorbs. At the time, the substance is shown on the breath.

Your health care team collects samples of your breath for a couple of hours to measure the amount of substance in his breath. The amount of substance in his breath shows how fast your stomach empties.

Upper part of the gastrointestinal tract (GI) endoscopy

This procedure is used to see the tube that connects the throat and the stomach, called the esophagus, stomach and beginning of the small intestine, called the duodenum. It uses a tiny camera on the end of a long, flexible tube.

This test can also diagnose other conditions which may have symptoms of gastroparesis. Examples are the disease peptic ulcer and pyloric stenosis.

Ultrasound

This test uses high-frequency sound waves to produce images of structures inside the body. The ultrasound can help diagnose if the problems with the gallbladder or kidneys could be causing the symptoms.

Treatment

The treatment of gastroparesis begins with the search for and treatment of the condition that is causing it. If diabetes is the cause of gastroparesis, your health care professional can work with you to help you control your blood sugar levels.

Changes to your diet

Get enough calories and nutrition, while the improvement of symptoms is the main goal in the treatment of gastroparesis. Many people can manage gastroparesis with changes in the diet. Your healthcare provider may refer you to a specialist, called a dietitian.

A dietitian can work with you to find the foods that are more easy to digest. This can help you to get enough nutrition from the food that you eat.

A dietitian can have try the following:

  • Eating smaller meals more often.
  • Chew food well.
  • Eat well-cooked fruits and vegetables instead of raw fruits and vegetables.
  • Do not eat fruits and vegetables with lots of fiber, such as oranges and broccoli. These can be converted into a solid mass that remains in the stomach, called a bezoar.
  • Choose your most foods that are low in fat. If you eat fat, don't bother, add small portions of fatty foods in your diet.
  • Eat soups and purees if liquids are easier to swallow.
  • Drinking around 34 to 51 ounces (1 to 1.5 liters) of water per day.
  • Exercise gently, like for example, take a walk after eating.
  • Do not drink soft drinks, called carbonated beverages or alcohol.
  • Do not smoke.
  • Do not lie down for two hours after a meal.
  • Taking a daily multivitamin.
  • Do not eat and drink at the same time. Space them out for about an hour.

Ask your dietitian for a list of suggested foods for people with gastroparesis.

Drugs

Medications for the treatment of gastroparesis may include:

  • Medicines to help the muscles of the stomach work.Metoclopramide is the only medicine of the united states Food and Drug Administration (FDA) - approved for the treatment of gastroparesis. Metoclopramide pill (Reglan) have a risk of serious side effects. But theFDArecently approved a metoclopramide nasal spray (Gimoti) for the treatment of diabetic gastroparesis. The nasal spray has fewer side effects than the pill. Another medicine that helps the stomach muscles work is erythromycin. It is possible that work as well over time. And can cause side effects such as diarrhea. There is a new medicine, domperidone, which relieves the symptoms of gastroparesis. But theFDAdoesn not approve the medicine, except when other treatments have failed. To prescribe the medicine, health care professionals should apply to theFDA.
  • Medicines to control nausea and vomiting. Medications that help relieve nausea and vomiting include diphenhydramine (Benadryl) and ondansetron. Prochlorperazine (Compro) is used for nausea and vomiting that does not go away with other medications.

Medicines to help the muscles of the stomach work. Metoclopramide is the only medicine of the united states Food and Drug Administration (FDA) - approved for the treatment of gastroparesis. Metoclopramide pill (Reglan) have a risk of serious side effects.

But the FDA has recently approved a metoclopramide nasal spray (Gimoti) for the treatment of diabetic gastroparesis. The nasal spray has fewer side effects than the pill.

Another medicine that helps the stomach muscles work is erythromycin. It is possible that work as well over time. And can cause side effects such as diarrhea.

There is a new medicine, domperidone, which relieves the symptoms of gastroparesis. But the FDA does not approve the medicine, except when other treatments have failed. To prescribe the medicine, health care professionals should apply to the FDA .

Surgical treatment

Some people with gastroparesis may be unable to have any food or liquids. Then, health professionals may suggest that the feeding tube called a jejunostomy tube, it will be placed in the small intestine. Another option is a gastric tube ventilation to help relieve the pressure of the gastric contents.

The feeding tube can be passed through the nose or the mouth or directly into the small intestine through the skin. Most often, the tube is placed for the short-term. A feeding tube is only for gastroparesis that is severe, or when no other method controls the levels of sugar in the blood. Some people may need a feeding tube that goes into a vein in the chest, intravenous (IV) feeding tube.

The treatments in the study

Researchers continue to search for new drugs and procedures for the treatment of gastroparesis.

A new drug in development is called relamorelin. The results of a phase 2 trial found that the drug may accelerate gastric emptying and the ease vomiting. The FDA has not yet approved the medicine, but the study is ongoing.

Researchers are also studying new therapies that involve a thin tube, called an endoscope. The endoscope enters the esophagus.

A procedure known as endoscopic pyloromyotomy, involves making a cut in the ring of muscle between the stomach and the small intestine. This ring of muscle called the pylorus. Opens a channel from the stomach to the small intestine. The procedure is also called gastric peroral endoscopic myotomy (G-POEM). This procedure shows promise for gastroparesis. More studies are needed.

Gastric electrical stimulation

In the gastric electrical stimulation, a device that is put into the body with the surgery gives the electrical stimulation of the muscles of the stomach to move food better. The study results have been mixed. But the device seems to be most useful for people that have diabetes and gastroparesis.

The FDA allows the device to be used by those who cannot control their gastroparesis symptoms with changes in diet or medications. Larger studies are needed.

Lifestyle and home remedies

If you smoke, stop. Their gastroparesis symptoms are less likely to improve with time if you keep smoking.

Alternative medicine

Some alternative therapies have been used for the treatment of gastroparesis, including acupuncture. Acupuncture involves placing very thin needles through the skin at certain points on the body. During a treatment called electro-acupuncture, a small electric current is passed through the needles. Studies have shown that these treatments can relieve the symptoms of gastroparesis over a sham treatment done.

Preparing for your appointment

It is likely that you first consult your primary health care provider. You can then be sent to a doctor who specializes in diseases of the digestive system, called a gastroenterologist. You can also see a specialist called a dietitian who will help you choose foods that are easier to digest.

What you can do

When you make the appointment, ask if there is something that you need to do before, such as restrict your diet or stop taking certain medications. Have a family member or friend to the appointment, if possible, to help you remember the information that is obtained.

Make a list of:

  • Their symptoms. Include any that doesn't seem linked to the reason of their appointment and when they began.
  • Key of the personal information. Include other medical conditions you have, and the recent life changes and major stresses.
  • All medications, vitamins or supplements that you take. Include the dose and how often you take.
  • Questions to ask your health care team.

For gastroparesis, some basic questions to ask include:

  • What is the most likely cause of my symptoms?
  • What tests do I need?
  • Is this condition likely to be of long duration?
  • What treatment do you suggest?
  • There are certain foods that I eat that are easier to digest?
  • I have other health conditions. How can I manage these conditions?
  • Are there brochures or other printed material I can have? What websites do you suggest?

Be sure to ask all the questions that you have.

What to expect from your doctor

Your health care professional may ask:

  • Do your symptoms come and go, or do not always have?
  • How bad are the symptoms?
  • Nothing seems to make your symptoms better or worse?
  • Did your symptoms start suddenly, such as after food poisoning?
  • What surgeries have you had?
Symptoms and treatment of Gastroparesis