Gastroparesis – Symptoms, Causes, Diagnosis & Treatment
The condition of Gastroparesis is related to the most important organs in the digestive system of human body: The stomach, which is a muscular sac about the size of melon and expands when we eat or drink, to hold the food or liquid as much of a gallon. Once the stomach crushes out the food then the spontaneous strong muscular contractions pushes the food toward the pyloric valve leading to the upper portion of the small intestine, called duodenum. When these spontaneous movements of muscles (motility) do not function properly or their muscular contractions become weak then it leads to a condition called Gastroparesis. In this condition, your stomach’s motility starts working poorly or not at all which prevents the stomach to empty properly thus, interfering the normal process of digestion. There is no known cure for Gastroparesis but dietary changes and certain medications can help manage the symptoms and offer relief from them.
Here’s what you need to know about the symptoms, causes, risk factors, complications, diagnosis and treatment for Gastroparesis.
What are the symptoms of Gastroparesis?
The Gastroparesis symptoms can be mild or severe and they include:
- Upper abdominal pain and swollen abdomen
- Abdominal bloating
- Feeling fullness after eating very little
- Vomiting undigested food
- Loss of appetite
- Malnutrition and weight loss
- Changes in blood sugar level
Immediately book an appointment with the doctor if you have any of these signs and symptoms that also worry you and your daily activities.
What are the causes of Gastroparesis?
In most of the cases, the problem is caused by the damage to a nerve called as Vagus Nerve that controls the stomach muscles. Vagus nerve plays important function in your digestive system by sending the signals to the stomach muscles to contract and push the food into the small intestine. When Vagus nerve gets damaged, then it can’t send the signals to stomach muscles which results in weak muscular contractions leading to the food to remain in stomach for longer time. Vagus nerve can be damaged due to Diabetes or any surgery to your stomach or small intestine.
What factors increase the risk of developing Gastroparesis?
There are various factors that make it hard for your stomach to empty properly and these include:
- Viral infection
- Abdominal or esophageal surgery
- Certain Cancer treatments such as radiation therapy
- Some medications that slow down the rate of stomach emptying, such as narcotic pain medications
- Scleroderma (a connective tissue disease)
- Nervous system diseases such as Parkinson’s disease or multiple sclerosis
- Hypothyroidism (underactive thyroid)
What are the complications of Gastroparesis?
It can cause severe complications, if left untreated, which include:
- Continuous vomiting can cause dehydration.
- Poor appetite can cause malnutrition.
- Undigested food that remains in the stomach may become hard to form a solid mass called as bezoar. The bezoars can cause nausea and vomiting and they can also be life-threatening if they prevent the food to pass into the small intestine.
- The inconsistency in the food passage to small intestine can cause changes in blood sugar levels making diabetes worse. The poor control of blood sugar levels makes the disease severe.
How is Gastroparesis diagnosed?
The doctor will review your symptoms, ask questions about your medical history and performs a physical exam while recommending certain blood tests including blood sugar levels.
In order to rule out the other possible causes of your symptoms, the doctor performs various tests which include:
- Ultrasound is used to create images of internal organs through sound waves and can be used to rule out the possibility of gall bladder disease and pancreatitis.
- A barium X-ray in which you need to drink a liquid (barium) which coats your esophagus, stomach and small intestine and shows up on X-ray. It helps the doctor to see if your stomach is emptying or any other abnormalities.
- Upper GI Endoscopy for Gastroparesis is a test, in which the doctor inserts a long, thin and flexible tube through your throat into the stomach to see the lining of it.
Once the doctor rules out all other possible causes of your symptoms then he/she will perform tests to confirm Gastroparesis and these include:
- Gastric scintigraphy: It is most important test in the diagnosis of the problem. It is a gastric-emptying test in which you need to eat a light meal that contains small amount of radioactive substance. After that you lie under scanning machine and the scanner detects movement of radioactive substance and monitors the rate at which the food leaves your stomach.
- Smart pill test: It is a capsule containing a device that you need to swallow. The device sends back the information as how fast it is travelling through your digestive system.
How is Gastroparesis treated?
The Gastroparesis treatment begins with identifying and treating the underlying cause of the condition. If it is caused by diabetes then the doctor works with you to control this underlying cause. Beyond this, there are other treatment options that the doctor recommends to manage the symptoms and these include:
The doctor prescribes medications according to your symptoms. These medicines include prochlorperazine (Compro) and diphenhydramine (Benadryl) for controlling nausea and vomiting. Medicines such as metoclopramide (Reglan) and erythromycin (Eryc, E.E.S) stimulate stomach muscles and helps with digestion. A doctor’s prescription is necessary before taking these medicines.
If you’re unable to tolerate any food or liquid then surgery is the best option, which includes a feeding tube that is placed in small intestine. The feeding tubes are passed through your nose or mouth or directly to small intestine through the skin. This tube is temporary and it is needed when the condition becomes severe or when blood sugar levels can’t be controlled with any other method.
Your doctor may refer you to a dietician or nutritional expert with whom you can discuss and he/she suggests those foods that your body can easily digest so that you can get more nutrients from the food. These dietary suggestions may include:
- Eat mostly low-fat foods
- Eat well-cooked vegetables and fruits rather than raw vegetables and fruits
- Eat smaller meals more frequently
- Drink water during the meal
- Chew food thoroughly
- Exercise gently after completing your meal such as you can go for a walk
- Avoid fruits and vegetables that contain fiber such as oranges and broccoli
- Avoid alcohol, smoking and carbonated drinks
Book an appointment with physicians at GI Endoscopy Practice NJ:
If you’re experiencing symptoms of Gastroparesis then you can consult board certified physician at GI Endoscopy Practice, who are experienced, trained and capable to treat patients with digestive tract diseases. They use latest technology to perform advanced tests for diagnosing the condition. Our physician and team members work together as one team to provide best Gastroparesis treatment to the patients in NJ.