Gastroparesis

Gastroparesis is a condition accompanied by the abnormal contraction of the muscles of the stomach.

Because of weak contracrions, the stomach fails to propel food through the gastrointestinal tract.

Gastroparesis can interfere with normal digestion, can cause nausea and vomiting and problems with blood sugar levels. The exact cause of gastroparesis remains uknown.

Several types of gastroparesis exist. Idiopathic gastroparesis (IG) occurs when the cause is not known. This form of gastroparesis is more likely to develop in young and middle-aged women.

People with diabetes can develop gastroparesis, which is known as diabetic gastroparesis (DG). Gastroparesis can also occur after surgery.

There is no cure for gastroparesis. Dietary changes and certain medications can relieve some of the symptoms of gastroparesis. 

The signs and symptoms of gastroparesis include the following:

• Vomiting
• Nausea
• Bloating
• Abdominal pain
• Lack of appetite
• Weight loss and malnutrition

Although the exact cause of gastroparesis is unknown, many doctors believe it is as aresult of  dysfunction of the nerve (vagus nerve) that controls the contraction of the muscles of the stomach.

The vagus nerve is the chief nerve that controls the activity of the gastrointestinal tract. This includes signaling the muscles of the stomach to contract and push food into the small intestines for further digestion.

Damage to the vagus nerve will cause food to remain in the stomach for longer periods than usual.

Diabetes and surgery of the stomach or intestines can cause damage of the vagus nerve.

There are several tests that can be used to diagnose gastroparesis. They include:

Upper gastrointestinal (GI) endoscopy

An endoscope 9tube with a camera at one end is used to examine the digestive tract from the esophagus to the first part of the small intestines (duodenum). The images are displaced on a screen.

Computerized tomography (CT) and magnetic resonance (MR) enterography

These tests are noninvassive and preferred since they can be used to find inflammation and blockages in the intestines.

Upper gastrointestinal (GI) series

A barium contrast X-ray imaging test.

Gastric emptying test

In this test the patient is asked to take a light meal containing small amounts of radioactive material. A scanner is then used to monitor the amount of radioactive material in the stomach and to monitor the rate at which the stomach empties.

This is the most important test used to diagnose gastroparesis  since it can show the rate of gastric emptying.

A breath test

Involves drinking a small amount of sugar water and measuring the amount of gas produced by the body in the breath.

There are several treatments available for gastroparesis. They include dietary changes, medications and surgical procedures.

Dietary changes include:

• Eating smaller meal frequently
• Chewing food thoroughly
• Eating well-cooked food vegetables instead of raw foods
• Avoiding foods high in fiber such as orages and broccoli
• Drinking water throughoutbeach meal and avoiding carbonated drinks

Medications used for the treatment of gastroparesis include:

• Medications that stimulate the stomach muscles like
• Metoclopramide (Reglan) and erythromycin (Eryc,E.E.S). Others include domperidone and Cisapride.
• Medications to control nausea and vomiting like prochlorperazine (Compro), thiethylperazine  and diphenhydramine (Benadryl, Unisom). Other drugs include ondaserton (Zofran).

People with gastroparesis who are unable to tolerate any food or liquids require surgery in which a feeding tube is placed in the intestines.

Another procedure involves using a  gastric venting tube to help relive pressure from gastric contents.

A few alternative and homeopathic remedies exist for managing the symptoms of gastroparesis.

Acupancture has been shown to relieve some symptoms of gastroparesis.

Taking ginger and transdermal patches of anti-emetics can be effective against nausea.

Factors which may increase the risk of gastroparesis include:

• Having diabetes
• Abdominal or esophageal surgery
• Infections
• Medications that slow the rate of stomach emptying like narcotic pain medications
• Radiation therapy
• Scleroderma ( a connective tissue disease)
• Diseases affecting the nervous system like Parkinson's disease or multiple sclerosis
• Hypothyroidisms ( low levels of thyroid hormone)

Gastroparesis can cause the following complications:

• Severe dehydration due to continuious vomiting.

• Malnutrition. This is caused by  poor appetite or reduced absorption of nutrients.

• Formation of benzoars which cause nausea and vomiting. Benzoars are formed by undigested food that hardens and remains in the stomach. This condition can be life-threatening especially if they prevent food from passing into the intestines.

• Changes in the blood sugar. This can worsen diabetes which can further worsen gastroparesis.

• Decreased quality of life. This is mostlty due to the acute flare-up of symptoms which can make working difficult.