What is Gastroparesis?
What is Gastroparesis?
Updated June 10, 2015.
Gastroparesis, also called delayed gastric emptying, is a disorder in which the stomach takes too long to empty its contents. It often occurs in people with type 1 diabetes or type 2 diabetes.
Gastroparesis happens when nerves to the stomach are damaged or stop working. The vagus nerve controls the movement of food through the digestive tract. If the vagus nerve is damaged, the muscles of the stomach and intestines do not work normally, and the movement of food is slowed or stopped.
Diabetes can damage the vagus nerve if blood glucose levels remain high over a long period of time. High blood glucose causes chemical changes in nerves and damages the blood vessels that carry oxygen and nutrients to the nerves.
Causes of Gastroparesis
Updated June 10, 2015.
Gastroparesis is most often caused by
Symptoms of Gastroparesis
Updated June 10, 2015.
These symptoms may be mild or severe, depending on the person.
Diagnosing Gastroparesis
Updated June 10, 2015.
Treatment of Gastroparesis with Medications
Updated June 10, 2015.
The primary treatment goal for gastroparesis related to diabetes is to regain control of blood glucose levels. Treatments include insulin, oral medications, changes in what and when you eat, and, in severe cases, feeding tubes and intravenous feeding.
It is important to note that in most cases treatment does not cure gastroparesis--it is usually a chronic condition. Treatment helps you manage the condition so that you can be as healthy and comfortable as possible.
Insulin for blood glucose control
If you have gastroparesis, your food is being absorbed more slowly and at unpredictable times. To control blood glucose, you may need to
Your doctor will give you specific instructions based on your particular needs.
******
There are other types of gastroparesis treatment. These include medication and diet.
Medications for Gastroparesis
Several drugs are used to treat gastroparesis. Your doctor may try different drugs or combinations of drugs to find the most effective treatment.
Updated June 10, 2015.
Changing your eating habits can help control gastroparesis. Your doctor or dietitian will give you specific instructions, which may include meal size and frequency.
The doctor may also recommend that you avoid high-fat and high-fiber foods. Fat naturally slows digestion--a problem you do not need if you have gastroparesis--and fiber is difficult to digest.
Some high-fiber foods like oranges and broccoli contain material that cannot be digested.
Avoid these foods because the indigestible part will remain in the stomach too long and possibly form bezoars.
Feeding Tube for Gastroparesis Sufferers If other approaches do not work, you may need surgery to insert a feeding tube.
Parenteral Nutrition for Gastroparesis Parenteral nutrition refers to delivering nutrients directly into the bloodstream, bypassing the digestive system. The doctor places a thin tube called a catheter in a chest vein, leaving an opening to it outside the skin. For feeding, you attach a bag containing liquid nutrients or medication to the catheter. The fluid enters your bloodstream through the vein. Your doctor will tell you what type of liquid nutrition to use.
For more information on treatment with diet, please read this article.
Updated June 10, 2015.
If food lingers too long in the stomach, it can cause problems like bacterial overgrowth from the fermentation of food. Also, the food can harden into solid masses called bezoars that may cause nausea, vomiting, and obstruction in the stomach. Bezoars can be dangerous if they block the passage of food into the small intestine.
Gastroparesis can make diabetes worse by adding to the difficulty of controlling blood glucose.
When food that has been delayed in the stomach finally enters the small intestine and is absorbed, blood glucose levels rise. Since gastroparesis makes stomach emptying unpredictable, a person's blood glucose levels can be erratic and difficult to control.
Updated June 10, 2015.
Follow your doctor's treatment plan
It is important to follow your doctor's recommendations for diet, and take any medications that may be prescribed.
Eat 6 small meals instead of 3 big meals.
This keeps your stomach from getting too full, and reduce gastric pressure.
Avoid fatty foods and foods that are difficult to digest These include vegetable shortenings, crackers, candies, cookies, snack foods, fried foods, processed foods made with partially hydrogenated vegetable oils, chicken skin, butter, whole milk, legumes, lentils, and citrus fruits.
******
Sources:
National Digestive Diseases Information Clearinghouse
Updated June 10, 2015.
Gastroparesis, also called delayed gastric emptying, is a disorder in which the stomach takes too long to empty its contents. It often occurs in people with type 1 diabetes or type 2 diabetes.
Gastroparesis happens when nerves to the stomach are damaged or stop working. The vagus nerve controls the movement of food through the digestive tract. If the vagus nerve is damaged, the muscles of the stomach and intestines do not work normally, and the movement of food is slowed or stopped.
Diabetes can damage the vagus nerve if blood glucose levels remain high over a long period of time. High blood glucose causes chemical changes in nerves and damages the blood vessels that carry oxygen and nutrients to the nerves.
Causes of Gastroparesis
Updated June 10, 2015.
Gastroparesis is most often caused by
- diabetes
- postviral syndromes
- anorexia nervosa
- surgery on the stomach or vagus nerve
- medications, particularly anticholinergics and narcotics (drugs that slow contractions in the intestine)
- gastroesophageal reflux disease (rarely)
- smooth muscle disorders such as amyloidosis and scleroderma
- nervous system diseases, including abdominal migraine and Parkinson's disease
- metabolic disorders, including hypothyroidism
Symptoms of Gastroparesis
Updated June 10, 2015.
- heartburn
- nausea
- vomiting of undigested food
- an early feeling of fullness when eating
- weight loss
- abdominal bloating
- erratic blood glucose levels
- lack of appetite
- gastroesophageal reflux
- spasms of the stomach wall
These symptoms may be mild or severe, depending on the person.
Diagnosing Gastroparesis
Updated June 10, 2015.
- Barium x ray
After fasting for 12 hours, you will drink a thick liquid called barium, which coats the inside of the stomach, making it show up on the x ray. Normally, the stomach will be empty of all food after 12 hours of fasting. If the x ray shows food in the stomach, gastroparesis is likely. If the x ray shows an empty stomach but the doctor still suspects that you have delayed emptying, you may need to repeat the test another day. On any one day, a person with gastroparesis may digest a meal normally, giving a falsely normal test result. - Radioisotope gastric-emptying scan
You will eat food that contains a radioisotope, a slightly radioactive substance that will show up on the scan. The dose of radiation from the radioisotope is small and not dangerous. After eating, you will lie under a machine that detects the radioisotope and shows an image of the food in the stomach and how quickly it leaves the stomach. Gastroparesis is diagnosed if more than half of the food remains in the stomach after 2 hours. - Gastric manometry
This test measures electrical and muscular activity in the stomach. The doctor passes a thin tube down the throat into the stomach. The tube contains a wire that takes measurements of the stomach's electrical and muscular activity as it digests liquids and solid food. The measurements show how the stomach is working and whether there is any delay in digestion.
- Barium x ray
Treatment of Gastroparesis with Medications
Updated June 10, 2015.
The primary treatment goal for gastroparesis related to diabetes is to regain control of blood glucose levels. Treatments include insulin, oral medications, changes in what and when you eat, and, in severe cases, feeding tubes and intravenous feeding.
It is important to note that in most cases treatment does not cure gastroparesis--it is usually a chronic condition. Treatment helps you manage the condition so that you can be as healthy and comfortable as possible.
Insulin for blood glucose control
If you have gastroparesis, your food is being absorbed more slowly and at unpredictable times. To control blood glucose, you may need to
- take insulin more often
- take your insulin after you eat instead of before
- check your blood glucose levels frequently after you eat and administer insulin whenever necessary
Your doctor will give you specific instructions based on your particular needs.
******
There are other types of gastroparesis treatment. These include medication and diet.
Medications for Gastroparesis
Several drugs are used to treat gastroparesis. Your doctor may try different drugs or combinations of drugs to find the most effective treatment.
- Metoclopramide (Reglan). This drug stimulates stomach muscle contractions to help empty food.
- Erythromycin. This antibiotic also improves stomach emptying.It works by increasing the contractions that move food through the stomach.
Updated June 10, 2015.
Changing your eating habits can help control gastroparesis. Your doctor or dietitian will give you specific instructions, which may include meal size and frequency.
The doctor may also recommend that you avoid high-fat and high-fiber foods. Fat naturally slows digestion--a problem you do not need if you have gastroparesis--and fiber is difficult to digest.
Some high-fiber foods like oranges and broccoli contain material that cannot be digested.
Avoid these foods because the indigestible part will remain in the stomach too long and possibly form bezoars.
Feeding Tube for Gastroparesis Sufferers If other approaches do not work, you may need surgery to insert a feeding tube.
Parenteral Nutrition for Gastroparesis Parenteral nutrition refers to delivering nutrients directly into the bloodstream, bypassing the digestive system. The doctor places a thin tube called a catheter in a chest vein, leaving an opening to it outside the skin. For feeding, you attach a bag containing liquid nutrients or medication to the catheter. The fluid enters your bloodstream through the vein. Your doctor will tell you what type of liquid nutrition to use.
For more information on treatment with diet, please read this article.
Updated June 10, 2015.
If food lingers too long in the stomach, it can cause problems like bacterial overgrowth from the fermentation of food. Also, the food can harden into solid masses called bezoars that may cause nausea, vomiting, and obstruction in the stomach. Bezoars can be dangerous if they block the passage of food into the small intestine.
Gastroparesis can make diabetes worse by adding to the difficulty of controlling blood glucose.
When food that has been delayed in the stomach finally enters the small intestine and is absorbed, blood glucose levels rise. Since gastroparesis makes stomach emptying unpredictable, a person's blood glucose levels can be erratic and difficult to control.
Updated June 10, 2015.
Follow your doctor's treatment plan
It is important to follow your doctor's recommendations for diet, and take any medications that may be prescribed.
Eat 6 small meals instead of 3 big meals.
This keeps your stomach from getting too full, and reduce gastric pressure.
Avoid fatty foods and foods that are difficult to digest These include vegetable shortenings, crackers, candies, cookies, snack foods, fried foods, processed foods made with partially hydrogenated vegetable oils, chicken skin, butter, whole milk, legumes, lentils, and citrus fruits.
******
Sources:
National Digestive Diseases Information Clearinghouse
