Gastroparesis

Gastroparesis Treatment

In layman’s terms, gastroparesis is a delayed gastric emptying problem. It affects the spontaneous movement of motility (stomach muscles). It is an uncommon condition that will affect 10 men out of 100,000 people, and 40 women out of 100,000, according to the National Institute of Diabetes and Digestive and Kidney Diseases. It is more common to have symptoms of gastroparesis, which can affect one in four adults in the United States. However, gastroparesis treatment is important for patients with gastroparesis who do have the condition. Not only does it affect the quality of life, but it can lead to serious complications without gastroparesis treatment.

What Is Gastroparesis?

A good way to describe gastroparesis is that it is the partial paralysis of the stomach. The stomach muscles that move food are typically strong, but with this condition, the muscles are weak and uncoordinated, which slows down the movement of food through your digestive system. Those with diabetes develop gastroparesis more than any other group, gender, or ethnicity (diabetic gastroparesis). Gastroparesis is often mistakenly diagnosed in people who have other gastrointestinal disorders, such as acid reflux and GERD. In those without diabetes, gastroparesis should be carefully diagnosed.

What Are the Symptoms of Gastroparesis?

Gastroparesis is often misdiagnosed because it shares symptoms with other gastrointestinal disorders. There are several hallmark symptoms of gastroparesis, including:

• Heartburn
• Gastroesophageal reflux (when stomach contents are backed up in the esophagus)
• Loss of appetite
• Unexplained weight loss
• Blood sugar abnormalities
• Nausea and vomiting
• Feeling full too quickly when eating (early satiety)
• Abdominal pain
• Abdominal bloating

If you’re experiencing several of these symptoms, it’s wise to consult your gastroenterologist, as treating gastroparesis is imperative. Also, these symptoms may be indicative of a different gastrointestinal complication.

What Causes Gastroparesis?

The cause of gastroparesis is a nerve injury, caused by damage to the vagus nerve. When it is working properly, the job of the vagus nerve is to tighten your stomach muscles to move food through faster. Damage to the vagus nerve is typically caused by diabetes, which is usually comorbid with gastroparesis. When the nerve is damaged, food moves too slowly from your stomach to your intestines, which causes symptoms and discomfort when the stomach empties. There are certain risk factors for gastroparesis, which would give you a greater chance of developing it. The number-one risk factor is diabetes, but there are others, such as:

• Hypothyroidism (underactive thyroid)
• Parkinson’s disease
• Multiple sclerosis (MS)
• Scleroderma (connective tissue disease)
• Taking medications that slow gastric emptying, such as opioids
• Viral infections
• Esophageal or abdominal surgery

Also, women are more likely to develop gastroparesis than men are, as already mentioned.

What Are the Risks Associated with Gastroparesis?

If there is no gastroparesis treatment, other problems may occur, particularly if vomiting is a persistent symptom. This can lead to malnutrition and dehydration, both of which must also be treated. Also, undigested food can remain in your stomach. This can contribute to a blockage or bacterial growth. The blockage is a hard, solid mass called a bezoar. These can be life-threatening if there is no gastroparesis treatment.

Even if you don’t have diabetes, there can also be unpredictable blood sugar spikes and falls. This is because of the change in the amount and rate of food passing into the small intestine. For patients with diabetes, erratic blood sugar and its related symptoms are much worse.

When Should You Speak to a Doctor About Gastroparesis?

If you’re experiencing several gastroparesis symptoms, then you seek health care. In order to diagnose the problem, your physician may run one of several diagnostics to see if you have the condition. These can include:

• Gastric emptying tests. These tests show your gastroenterologist how quickly food moves through your stomach. There are two common tests:
  • Breath tests. During this test, you’ll consume liquid or food that has an additive that your body absorbs. Within a few hours, that substance can be detected in your breath. The lab will take several samples of your breath to measure the amount of the substance. Based on this amount, your gastroenterologist can see how quickly food moves through the digestive system.

• Scintigraphy. This is a test your physician will likely choose first. For this test, you’ll consume a small meal (such as eggs) that is tagged with a radioactive isotope. After the meal is consumed, a scanner is placed on the abdomen that monitors how fast the meal moves through.
• SmartPill. For this diagnostic, you’ll consume a pill that has a small electronic device inside of it. The electronic device sends signals to an external receiver to see how quickly food moves.
• Upper GI endoscopy. This test allows your gastroenterologist to view your digestive tract. After you receive light sedation, a long, flexible tube is inserted into the throat and down through the stomach. It can examine as far as the top of the small intestine (duodenum). A tiny camera is attached to the end, which takes pictures of your digestive tract.
• Ultrasound. Ultrasound uses high-frequency sound waves to examine parts of the body. If your physician suspects you may have an issue with your kidney or gallbladder, they may order this test.

If you receive a diagnosis of gastroparesis, there are several treatment options. Your doctor may recommend a change in diet and lifestyle first. This would involve eating smaller meals, chewing food thoroughly, choosing cooked fruits and vegetables over raw ones, eating a low-fat diet, walking after you eat, avoiding alcohol, smoking, and carbonated beverages, and not eating right before lying down. This can help relieve nausea and vomiting as well as other symptoms. Your physician may also recommend medications, such as erythromycin or antiemetics.

However, sometimes more invasive gastroparesis treatment is needed. There are several options for treatment:

• Gastric electrical stimulation. A device uses electrical stimulation in order to make the stomach muscles move more efficiently. Because of potential side effects, the Food and Drug Administration (FDA) has only approved this treatment for those who have tried other options, such as diet changes or medications.
• A jejunostomy tube. This is a feeding tube that is placed in the small intestine. These are usually temporary treatments and are utilized when there are erratic blood sugar levels or the gastroparesis is severe.
• Botulinum toxin. More commonly known as BOTOX®, it is used in some patients who have increased pyloric tone. It can help empty stomach contents more quickly.