Gastroparesis is a condition that affects the nerves and muscles in your stomach, resulting in abnormally slow digestion. It often develops as a complication of diabetes.
The condition can lead to both short-term discomfort during digestion and longer-lasting health effects. There are various treatment options to make life with gastroparesis more manageable and prevent more serious complications. Here’s what to know.
What is gastroparesis?
Many factors play a role in the digestive process, including the proper activation of stomach nerves and muscles. Gastroparesis is essentially a paralysis of the stomach. When you have this condition, your stomach muscles don’t contract strongly or quickly enough to move food out of your stomach and into your small intestine. This causes food to sit in the stomach for too long, resulting in discomfort during digestion.
Symptoms
Gastroparesis is characterized by digestive discomfort, and several key symptoms develop during and after meals. Many people with the condition feel immediately full after eating even a small amount of food, and the feeling of fullness lasts much longer than normal. Other short-term but recurring symptoms include:
Nausea, vomiting, and regurgitating undigested food
Abdominal pain and bloating
Acid reflux
Constipation
When food eventually moves out of the stomach, it does not always pass completely. The food that remains in the stomach can develop into a mass of undigested or partially digested food called a bezoar.
Gastroparesis can also cause longer-term complications such as:
Severe dehydration
Malnutrition as a result of either inadequate calorie consumption or incomplete absorption of nutrients
Weight loss
Severe fluctuations in blood sugar levels
Causes and risk factors
Gastroparesis typically originates from damage to the nerves that activate the stomach muscles. It is also possible for the stomach muscles to be damaged themselves. Both nerve damage and muscle damage produce the same effect of weakened muscle contractions.
The most common cause of gastroparesis is diabetes, which can cause nerve damage if left untreated. Another common cause is surgery of the stomach, small intestine, or esophagus, which can also lead to impaired nerves.
Other potential but less common causes include:
Autoimmune diseases
Medications known to slow the emptying of the stomach, including some narcotic pain medications
Neurological diseases such as Parkinson’s disease or multiple sclerosis
Endocrine disorders including hypothyroidism, or an underactive thyroid
Cystic fibrosis
Many cases of gastroparesis do not have a clear identifiable reason for the condition, even if it stems from one of the causes above. These cases are referred to as idiopathic.
Diagnosis
The diagnosis process includes a discussion of your symptoms and health history with your provider, imaging tests, and potentially gastric motility tests, which assess the function of your stomach muscles.
Imaging tests such as an endoscopy, CT scan, MRI, or abdominal ultrasound are used to determine if your symptoms are caused by a physical obstruction to your stomach. If the tests rule out a structural issue, the most common next step is a gastric emptying study to evaluate your stomach muscle motility.
Treatment
Several treatment options, including medication, dietary changes, and surgery, can stimulate more effective contractions of the stomach muscles to improve gastroparesis symptoms.
Medication
Prokinetics, a class of medications that support gastrointestinal motility, are typically the first-line treatment for gastroparesis. Metoclopramide is currently the only FDA-approved medication for gastroparesis. In addition to stimulating stomach muscle activity, it can also relieve nausea. Known side effects include tremors and muscle twitching. Your provider can help you assess the risks and benefits of taking this medication so that you can make informed decisions about treatment.
Additionally, the antibiotics erythromycin and azithromycin, which can also act as prokinetics, are sometimes prescribed off-label to treat gastroparesis.
Other medications may be used to treat specific symptoms of gastroparesis, including:
Prucalopride, a serotonin agonist that can help relieve constipation
Proton pump inhibitors such as omeprazole (Prilosec®), which can help relieve acid reflux
Pain relief medications for severe stomach pain
Diabetes medications for blood sugar management
Dietary changes
Your doctor may suggest dietary changes such as increasing your fiber intake and lowering your fat intake. Individualized nutritional therapy is often recommended for people who experience malnutrition as the result of gastroparesis.
Surgery
Surgical procedures are typically recommended only if other treatment options haven’t been effective.
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This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.
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