What are the symptoms of gastroparesis?
Common symptoms include:
- Indigestion.
- Bloated stomach.
- Feeling full very quickly and/or for a long time.
- Upper abdominal pain.
- Nausea and vomiting.
- Regurgitating (spitting up) whole pieces of undigested food.
- Loss of appetite.
- Acid reflux and heartburn.
- Blood sugar fluctuations.
- Constipation.
What does gastroparesis feel like?
When your stomach muscles aren’t working right, food sits in your stomach for a long time after you eat it. You may feel full almost immediately and for a long time after eating. You may have a stomachache, feel nauseous or throw up. Your stomach may feel bloated or distended (stretched) and you may have acid reflux as a side effect. When stomach acid backwashes into your esophagus, it can feel like heartburn.
Is gastroparesis painful?
Gastroparesis symptoms vary between people. A small subset of people report persistent stomach pain that interferes with their daily life. But how much pain people feel doesn’t appear to be connected to how severe their gastroparesis is, or how slowly their stomach empties. Some people may feel more pain because their nerves are more sensitized. This may be related to the cause of their gastroparesis.
How does gastroparesis affect your bowel movements (poop)?
Gastroparesis slows down your whole digestive process, which can delay your bowel movements. It can also deliver large, undigested pieces of food to your intestines, which are more difficult to pass through. While gastroparesis doesn’t directly affect muscle movements in your intestines, some conditions that cause it can. So some people experience gastroparesis and constipation at the same time.
What is the main cause of gastroparesis?
Damage to the nerves that activate your stomach muscles is the main cause of gastroparesis. Less commonly, it’s the muscles themselves that are damaged. The overall result is that the muscle contractions that churn food in your stomach and then squeeze it out through the bottom are impaired. This leads to indigestion and delayed gastric emptying — food sitting too long in your stomach.
What are the specific causes of gastroparesis?
Known causes include:
Diabetes
Around one-third of people with diabetes (Type 1 or Type 2) develop gastroparesis. Diabetes-related gastroparesis is a type of diabetes-related neuropathy. It happens when high blood sugar levels damage your nerves. High blood sugar levels also damage the blood vessels that carry oxygen to your tissues, so your stomach nerves and muscles are both affected.
Surgery
Surgery on or near your stomach can injure the vagus nerve that runs through your stomach and coordinates its movements. Post-surgical gastroparesis can develop any time after surgery. Sometimes it happens right away, but it can also develop months (or even years) later. Common surgical procedures that have caused post-surgical gastroparesis include:
Infections
Gastrointestinal infections can trigger gastroparesis. Viral infections such as norovirus and rotavirus are more common causes, but bacterial infections can cause it too. Scientists aren’t sure whether it’s the infections themselves that damage your stomach nerves or if the immune cells meant to kill the infection damage your nerves by mistake.
Autoimmune disease
In autoimmune disease, your immune system sends antibodies to attack your own body cells, mistaking them for an infection. New research indicates that these autoantibodies may damage the nerves in your stomach. You may have autoimmune gastroparesis even if you have no other symptoms of autoimmune disease, or if your other symptoms are unrelated to your stomach.
Drugs
Certain medications and recreational drugs can block the nerve signals that activate your stomach muscles. This can lead to temporary gastroparesis. Some of these medications are prescribed for conditions also linked to gastroparesis, such as diabetes. If you already have gastroparesis, or you’ve had it before, these are medications to avoid. They include:
- Opioids (narcotics).
- Nicotine.
- Marijuana.
- Tricyclic antidepressants.
- Progesterone.
- Anticholinergics (allergy medications).
- Calcium channel blockers (for high blood pressure).
- Amylin analogs / GLP-1 antagonists (to treat Type 2 diabetes).
- Cyclosporine (to prevent organ transplant rejection).
- Clonidine (to treat high blood pressure).
- Lithium (to treat bipolar disorder).
- Antipsychotic medications.
Other causes
Less common causes of gastroparesis include:
- Neurological diseases. Conditions affecting your nervous system may cause your stomach nerves to malfunction, like Parkinson’s disease, multiple sclerosis or autonomic dysfunction.
- Collagen-vascular diseases. Chronic inflammatory connective tissues diseases can degenerate your stomach muscles, including amyloidosis, scleroderma, lupus and Ehlers-Danos syndrome.
- Endocrine disorders. Conditions affecting your endocrine system can cause chemical nerve damage, including thyroid disease, adrenal disorders, electrolyte imbalances and kidney failure.
- Cystic fibrosis. Cystic fibrosis causes mucus to build up in your gastrointestinal tract, slowing down motility throughout. An estimated one-third of people with CF have gastroparesis.
What are the complications of gastroparesis?
Complications of gastroparesis can include:
Weight loss, malnutrition and dehydration
Chronic nausea and vomiting, or simply the loss of appetite, can lead to weight loss and malnutrition. If you vomit frequently, it can also lead to dehydration and electrolyte deficiencies. You may need to recover in the hospital with nutritional therapy and fluid replacement.
Acid reflux complications
Gastroparesis causes abdominal distension, which makes it easier for stomach acid to escape out of the top of your stomach into your esophagus. Chronic acid reflux can cause complications for your esophagus, like heartburn and inflammation (esophagitis).
Blood sugar complications
Gastroparesis interrupts the regular, controlled flow of food through your digestive system. This can also interrupt the regular, controlled release of glucose into your bloodstream. When food sits for too long in your stomach, your blood sugar may drop too low. When food finally releases, your blood sugar may spike. These fluctuations are especially complicated for people with diabetes, and they can make gastroparesis worse.
Bezoar and gastric outlet obstruction
A bezoar is a compacted, hardened mass of food stuck in your stomach. It forms out of pieces that were left behind when your stomach emptied. A bezoar may become too big to pass through the outlet at the bottom of your stomach. It can also block it and make it hard for any other food to pass through. Healthcare providers treat bezoars with medication to dissolve it, or if necessary, surgery to remove it.
