Articles Gastroparesis

Summary: Gastroparesis is a chronic digestive health problem that impacts the ability of the stomach to process and move food into the small intestine.

August is designated as Gastroparesis Awareness Month. At GI Associates & Endoscopy Center in Jackson, MS, our board-certified gastroenterologists provide treatment for gastroparesis and wish to educate patients about this concerning the disease.

The term gastroparesis indicates an immotile stomach. It is one of the most severe and concerning intestinal motility issues as it affects the normal automatic movement of the stomach muscles. Generally, forceful muscular contractions move food along the gastrointestinal (GI) system. If gastroparesis develops, however, the stomach's ability to propagate food is significantly impaired or may even come to a halt. This can interfere with the proper emptying of the stomach and could cause additional medical problems.

What are the signs and symptoms of gastroparesis?

Approximately one out of every 25 patients in the United States, even children, experiences gastroparesis. It is more commonly seen in females and in patients who are long-term diabetics. Signs and symptoms of gastroparesis often include:

  • Frequent nausea
  • Vomiting of undigested food
  • Inconsistent blood sugar levels
  • Long-term abdominal pain
  • Acid reflux or heartburn
  • Poor appetite and unintended weight loss
  • Feeling full even after eating very little
  • Bloating

A number of patients with gastroparesis do not have any noticeable signs and symptoms. In some cases, the condition appears for a brief time and goes away naturally or decreases with treatment. Some cases of gastroparesis may be refractory, or resistant to medical treatments.

What might cause gastroparesis?

The main source of this GI condition is not always clear. However, physicians have identified several factors that can contribute to gastroparesis:

  • Amyloidosis: This condition occurs when protein fibers accumulate in organs or tissues throughout the body.
  • Medications: Certain antidepressants, opioids, high blood pressure, and allergy medications may produce delayed gastric emptying and induce symptoms similar to gastroparesis. In people already impacted by the disease, these types of medications tend to worsen their conditions.
  • Vagus nerve damage. Elevated blood glucose levels, viral infection, and stomach or small intestine surgery can harm the vagus nerve. Essential for managing the GI system, the vagus nerve causes stomach muscles to contract and push food toward the small intestine. When the vagus nerve is impaired, it is unable to properly signal the stomach muscles. If this happens, food may remain in the stomach for a longer period of time instead of moving into the small intestine for normal digestion.
  • Scleroderma: This connective tissue disorder impacts the skin, blood vessels, muscles, and organs.

Health complications that can be caused by gastroparesis include:

  1. Extreme dehydration. Frequent vomiting can cause a person to lose bodily fluids and experience severe dehydration.
  2. Dietary deficiencies. Appetite loss and ongoing regurgitation of stomach contents could result in poor nutritional consumption and prevent the ability to digest enough vitamins, minerals, and proteins.
  3. Undigested food. Food that fails to digest in the stomach can solidify, forming a mass known as a bezoar. A bezoar might cause nausea and vomiting and could be life-threatening if it prevents food from emptying into the small bowel.
  4. Unpredictable blood sugar changes. Though gastroparesis is not a cause of diabetes, repeated fluctuations in the volume and speed at which food migrates into the small intestine can spike abnormal blood sugar levels. Such variations in blood glucose typically make a diabetic condition worse, which can exacerbate gastroparesis.
  5. Reduced quality of life. The negative impact of gastroparesis can interfere with a person's ability to perform work duties and keep up with other daily tasks.

Diagnostic tests for gastroparesis

Gastrointestinal doctors specialize in the diagnosis and treatment of gastric issues, such as gastroparesis. In addition to assessing a person's symptoms and health history, a GI specialist will perform a physical assessment and likely recommend certain types of blood screenings to evaluate blood sugar levels and other health factors. Additional services used to detect gastroparesis may include:

  • Four-hour solid gastric emptying study: This test determines the timeframe it requires for food to empty out of the stomach. Individuals consume a meal that includes a radioactive isotope. A scan of the stomach is captured one minute after the meal is consumed. More images are then completed at various times after consumption to study how the food migrates through the stomach and the rest of the digestive system.
  • SmartPill™ motility testing system: The SmartPill is a digestible, miniature capsule that houses an electronic device. After the capsule is swallowed and migrates down the digestive tract, it relays diagnostic readings to a receiver attached to the individual. This test tracks and records how fast food migrates through the gastrointestinal system.

How do GI specialists treat gastroparesis?

Gastroparesis is a chronic problem. While treatment will not likely cure gastroparesis, the condition can often be managed and controlled. Patients who have diabetes should consciously monitor and control their blood sugar levels to minimize the effects of gastroparesis. Certain medications might also prove effective in treating gastroparesis among patients. These include:

  • Erythromycin: An antibiotic, erythromycin causes gastric movement and aids in pushing food through the GI tract. Additional effects include loose bowels and developing antibiotic-resistant bacteria over time.
  • Reglan: This medication stimulates the stomach muscles to contract to push food into the small intestine. It can also help relieve vomiting and queasiness. Secondary effects may include diarrhea and, rarely, a concerning neurological disorder.
  • Antiemetics: These medications help minimize queasiness.

A number of individuals may benefit from surgery to address gastroparesis. Surgical options can include:

  • Gastric bypass: With this surgical procedure, a little pouch is formed from the uppermost area of the stomach. Half of the small intestine is bound directly to this small pouch. This procedure greatly restricts the amount of food an individual can take in, and could be more successful for a person who is both diabetic and obese than either medication or a gastric stimulator.
  • Gastric electrical stimulation: A tiny device referred to as a gastric stimulator is placed into the abdominal area. It has two leads connected to the stomach that administer small electric shocks to help reduce the need to vomit.

Additional forms of treatments for gastroparesis are:

  • POP: Peroral pyloromyotomy (POP) is a newer, non-surgical procedure during which a physician positions a long, flexible instrument in the patient's mouth and down into the stomach. The specialist then severs the pylorus or the valve that aids in emptying the stomach, allowing stomach contents to migrate to the small bowel more smoothly.
  • IV Nutrition: With this intravenous, or parenteral, nutrition method, nutrients directly enter the bloodstream through a catheter placed within a blood vessel in the chest. Parenteral nutrition is a temporary measure for treating advanced cases of gastroparesis.
  • Feeding/jejunostomy tube: When gastroparesis is advanced, a feeding tube or jejunostomy tube might be appropriate. A special tube is surgically threaded through the abdomen into the small intestine. Typically, liquid nutrients are administered through the feeding tube, which passes straight into the small bowel and then into the bloodstream very quickly. A jejunostomy-tube approach to addressing gastroparesis is typically a short-term treatment.

Dietary guidelines for gastroparesis

As reported by the American College of Gastroenterology, a proper diet is a pillar of gastroparesis treatment. It also provides a natural approach to controlling the condition. To treat gastroparesis, doctors may prescribe medication and carry out other medical services to reduce its symptoms. However, such medical therapies function most effectively when the patient follows a specific type of diet. A gastroparesis diet focuses on minimizing the consumption of foods that can be challenging to digest, such as fatty and fibrous foods. This can help facilitate digestion and decrease the risk of complications resulting from gastroparesis.

If you are developing gastroparesis signs or symptoms or have troubles related to a gastroparesis diagnosis, we urge you to book a visit with a Jackson, MS gastroenterologist near you immediately. Please contact GI Associates & Endoscopy Center today to learn more about gastroparesis or to schedule a consultation with one of our board-certified gastroenterologists.

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