• Gastroparesis

    (Delayed Gastric Emptying)

    Definition

    Gastroparesis is a disorder that affects the digestive system. During normal digestion, the stomach breaks down food and then contracts to push food down to the small intestine. With gastroparesis, there is delayed emptying of the stomach. Food either moves slowly through the digestive tract or does not move at all. This can pose problems since the food can harden causing blockage, nausea, and vomiting. Bacteria can also start to grow. Gastroparesis is a potentially serious condition. It requires care from your doctor.
    The Stomach and Intestines
    IMAGE
    Copyright © Nucleus Medical Media, Inc.

    Causes

    Movement of food in the digestive system is controlled by the vagus nerve. Gastroparesis occurs when this nerve is damaged.

    Risk Factors

    The main risk factor is diabetes . Diabetes can damage the vagus nerve, which may lead to gastroparesis. High blood sugar can also damage blood vessels that carry nutrients and oxygen to the vagus nerve, preventing it from working properly. Other risk factors include:
    • Gastroesophageal reflux disease (GERD)
    • Surgery that involves the stomach or vagus nerve
    • Taking certain medicines (eg, anticholinergics or narcotics)
    • Infection from a virus
    • Diseases affecting the nerves, muscles, or hormones
    • Diseases affecting metabolism (body’s ability to make and use energy)
    • Anorexia or bulimia
    • Radiation or chemotherapy

    Symptoms

    If you have any of these symptoms, do not assume it is due to gastroparesis. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:
    • Feeling full early during a meal
    • No appetite
    • Nausea and vomiting
    • Bloating
    • Pain in your abdomen or esophagus (the muscular tube that carries food from your mouth to your stomach)
    • Heartburn
    • Weight loss
    The following may worsen symptoms:
    • High-fiber foods, like raw vegetables and fruits
    • Fatty foods
    • Carbonated drinks

    Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will also be done. The doctor may do:
    • Blood tests
    • Tests to measure:
      • Stomach volume before and after a meal
      • The rate at which the stomach empties
      • The ability of the muscles in the stomach and small intestine to contract and relax
      Imaging tests:
      • Ultrasound —uses sound waves to create an image of organs inside the body
      • Barium x-ray —uses a milky fluid to coat the lining of the intestines to create an x-ray image
      • Gastric emptying study—uses radioactive meal to measure stomach emptying directly with an x-ray
      Other procedures
      • Upper endoscopy —a thin, lighted tube inserted down the throat to examine the esophagus, stomach, and small intestine
      • SmartPill—a pill-sized device that is swallowed to capture information on the digestive system

    Treatment

    Talk with your doctor about the best treatment plan for you. Treatment options include:

    Diet

    Managing what you eat can help control gastroparesis. You may work with your doctor or a registered dietician to create a meal plan that is right for you. This may include:
    • Eating small meals several times throughout the day
    • Following a liquid diet
    • Limiting high-fat and high-fiber foods

    Alternative Nutrition

    In severe cases, you may need to have nutrients delivered directly to your intestines (skipping the stomach) or directly to your bloodstream. Feeding tubes may be inserted down your throat or through your abdomen and into your intestines to help deliver food. Nutrients may also be given through a thin tube that is placed in one of your veins.

    Medications

    You may be given medicines that treat your symptoms and help your stomach empty. These medicines work by stimulating the stomach muscles to contract. Examples include:
    • Metoclopramide (Reglan)
    • Erythromycin
    Other medicines may be prescribed to reduce nausea.

    Surgery

    In severe cases, your doctor may consider surgery. This may include removing part of the stomach .

    Prevention

    To help reduce your chances of getting gastroparesis, take the following steps:
    • Control diabetes. Since diabetes is a common risk factor for gastroparesis, it is important that you follow treatment plans from your doctor if you have diabetes.
    • Avoid medicines that delay gastric emptying. Some medicines may keep your stomach from emptying properly. These include narcotic pain medicines, calcium channel blockers, and some antidepressants. Keep a list of all the medicines you are taking and share this list with your doctor. Make sure you talk to your doctor before stopping any medicines.

    RESOURCES

    American College of Gastroenterology http://www.acg.gi.org/

    American Gastroenterological Association http://www.gastro.org/

    CANADIAN RESOURCES

    Canadian Institute for Health Information http://www.cihi.ca/

    Health Canada http://www.hc-sc.gc.ca/

    References

    DynaMed Editors. Gastroparesis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated November 29, 2010. Accessed April 4, 2011.

    Fox J, Foxx-Orenstein A. Gastroparesis. The American College of Gastroenterology website. Available at: http://www.acg.gi.org/patients/gihealth/gastroparesis.asp . Accessed April 4, 2011.

    Gastroparesis. The National Digestive Diseases Information Clearinghouse, National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/gastroparesis/ . Updated July 2007. Accessed April 4, 2011.

    Shakil A, Church RJ, Rao SS. Gastrointestinal complications of diabetes. Am Fam Physician . 2008;77(12):1697-1702.

    Soykan I, Sivri B, Sarosiek I, Kiernan B, McCallum RW. Demography, clinical characteristics, psychological and abuse profiles, treatment, and long-term follow-up of patients with gastroparesis. Dig Dis Sci . 1998;43(11):2398-2404.

    Revision Information

  • Join WellZones today.

    Make a Change For LifeLearn more

    Wellmont LiveWell is creating a new tradition of wellness in the mountains by providing individuals with tools and encouragement to live healthier lifestyles.

  • HeartSHAPE Spotlight

    HeartSHAPE® Test Learn more

    Fight heart disease early and prevent heart attacks with HeartSHAPE® - a painless, non-invasive test that takes pictures of your heart to scan for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.


  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.