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Gastroparesis

This condition is seen in the Stomach, where food, after it is eaten, enters the stomach and moves much slower than it should. It can also be referred to as “stomach paralysis.”

Nerves and muscles in the stomach are affected, interfering with muscle activity or peristalsis. The food slows down as it moves into the Small Intestines.

The processing and digestion of the food is largely affected, leading to symptoms and problems within the stomach.

Symptoms:

–  Bloating
–  Indigestion
–  Always feeling full
–  Abdominal discomfort and pain
–  Nausea
–  Vomiting
–  Food regurgitation
–  Decreased appetite
–  Heartburn
–  Constipation
–  Changes in blood sugar

Potential Causes

– It is not necessarily clear in most cases what leads to gastroparesis

–  Damage to the nerve that controls the stomach muscles – Vagus Nerve

–  Surgery to the stomach or small intestines can put someone at risk

–  Diabetes can affect the stomach in some cases.

Risk factors

1.) Diabetes

2.) Viral Infection

3.) Certain Medications that slow rate of stomach emptying

4.) Scleroderma – condition that causes skin to harden and tighten

5.) Migraines, Parkinson’s disease, Multiple Sclerosis, or other Nervous System diseases.

6.) Hypothyroidism

7.) Others

Complications

1.)  Malnutrition:  The individual may not want to eat, leading to a significant decrease in intake calories

2.)  Dehydration:  Lack of drinking fluids, plus repeated vomiting can be problematic

3.)  Food that hardens:  If food is not digested and it sits in the stomach it can become a solid mass, called a bezoar. Food can back up if blockage of the small intestines occurs.

4.)  Blood sugar changes: Diabetes isn’t caused by this condition, but changes in the blood sugar levels can be seen due lack of digested food.

5.) Changes in quality of life: Symptoms can make work and life hard with daily pains or concerns

Diagnosis

Scintigraphy is the main test to diagnose this condition. You eat a light meal, with some small amount of radioactive material. A scan will follow the movement of food as it goes through your intestines. The test takes 4 hours.

Breath tests: Samples are taken every few hours to measure amount of food. The amount should decrease over time.

Upper GI Endoscopy:  A camera is placed through the mouth and into the stomach.

Ultrasound

Treatment

1.) Diet changes 

– Eating smaller amounts more often
–  Chew food well
–  Avoid raw fruits and vegetables
–  Cook vegetables
–  Avoid Oranges and Broccoli
–  Low-fat foods
–  Soups
–  Pureed foods
–  Drink 34-51 ounces of water a day
–  Take a walk after eating
–  Avoid Carbonated Drinks
–  Avoid Alcohol
–  Don’t smoke
–  Don’t lie down for 2 hours after eating
–  Take a multivitamin daily
–  Avoid eating and drinking at the same time – space them out

2.) Medications

a.)  Metoclopramide – the only medication approved – but there are risk of serious side effects

b.)  Metoclopramide nasal spray (Gimoti) – recently approved for Diabetic gastroparesis

c.)  Erythromycin – might work to help the stomach muscles work

d.)  Domperidone – Only to be used when all other treatments have failed

e.)  Benadryl, Zofran (Ondansetron), Compro (Prochlorperazine) – can help with vomiting

3.) Surgical Treatment

–  A Feeding tube – called a jejunostomy tube may be placed in the small intestines

–  A gastric venting tube – relieves pressure from gastric contents

–  Feeding tube that goes in through mouth or nose – short term