Gastroparesis is a dysmotility disorder of stomach. It is a disorder in which the stomach takes too much time for emptying of food further downwards into the intestine. Thus it is also called delayed gastric emptying disorder. Normally the food that we swallow enters into the stomach. Here the food is churned and crushed into small pieces and pushed forwards into intestine due to frequent contraction of stomach muscles.
In gastroparesis the stomach muscles do not contract as they should which causes delay in gastric emptying. Gastroparesis is not curable but with medicines, food alteration and other techniques the symptoms can be well managed.
What Are The Causes Of Gastroparesis?
The exact cause of gastroparesis is not well understood. However, diabetes is considered to be one of the most triggering causes for this condition. People with uncontrolled blood sugar are most vulnerable to suffer from this condition. Actually uncontrolled sugar for a long time can cause damage to several nerves in the body.
Gastroparesis occurs when the vagus nerve is damaged. Vagus nerve controls the muscle movement of stomach. When this nerve is damaged, the muscles become weak.
Eating disorders such as anorexia nervosa and bulimia, radiation of chest and stomach region for treating cancer in this area, esophagus surgery, hypothyroidism, Parkinson’s disease, surgery which can damage the vagus nerve all can cause lead to gastroparesis.
Sign And Symptoms Of Gastroparesis
Gastroparesis can present with various symptoms. The severity of these symptoms may differ from one person to another depending on how intense the condition is.
Following are the most common symptoms:
- Vomiting of undigested food and in large volume many hours after eating is strongly suggestive of gastroparesis.
- Nausea
- Heartburn
- Reduced appetite
- Weight loss
- Gasses in stomach
- Bloating of stomach
- Pain in upper abdomen.
- Uncontrolled blood sugar level in people suffering from diabetes.
- Malnourishment leading to various deficiencies of vitamins and minerals.
All the above symptoms are present in many other gastrointestinal disorders, thus it becomes difficult to diagnose gastroparesis.
Diagnosis Of Gastroparesis
After taking complete medical history and performing physical examination, the physician will recommend the patient to do certain tests which may further help in diagnosing the gastroparesis. These tests include:
- Ultrasonography of upper abdomen: This will help to rule out pancreatic disease or disease related to gallbladder.
- Barium X-ray test: In this thick fluid called barium is ingested by the patient. After some time X-rays are taken. It helps to ascertain the gastric motility and emptying period.
- Endoscopic examination helps to visualize the inner lining and anomaly if present inside the stomach.
- Gastric emptying scintigraphy is confirmatory test which doctors rely on for final diagnosis of gastroparesis.
Complications Of Gastroparesis
- Weight loss: Patient suffering from gastroparesis looses weight as he often vomits after eating.
- Malnutrition and dehydration: Due to reduce intake of food and vomiting, the body remains devoid of nutrition as well as fluid. Both this prevailing for long time can lead to dehydration and nutritional deficiency in the body.
- Bacterial infection: Since there is delay in food emptying, bacteria start growing in the stomach which can make the person vulnerable for bacterial infection.
- Cannot control blood sugar: People suffering from diabetes have serious problem in controlling their blood sugar if they have gastroparesis. This is because the ingested food does not get digested at normal time as it should.
- Bezoar: Long time stasis of food results in formation of a mass of food. This is called bezoar. A large bezoar can block the passage through which food normally passes from stomach to the intestine.
Treatment Options For Gastroparesis
Treatment of gastroparesis is a challenging task for the doctor as well as for the patient. One thing is sure, the disorder is not curable. Thus the main management aim is to alleviate the symptoms and prevent complications.
Since majority of cases are the result of uncontrolled diabetes, the first thing that needs to be done is rigorous attempts to control blood sugar level and optimize the glycemic control.
Alteration in diet is also advisable along with medication. Certain types of medicines are prescribed by the physician that will help to prevent vomiting and nausea. Doctors also prescribe medicines that stimulate the muscles of stomach which will help to digest the food.
Change in diet: Patients suffering from this disease are advised by the dietician to eat foods that can be easily digested so that there is no compromise in absorption of nutrition.
These patients are advised following steps:
- Instead of 3 large meals, patient should eat few smaller meals frequently.
- Eat well cooked vegetables and fruits.
- Since fat and fiber are slow to digest, patient is advised to limit its intake.
- Drink water during meals.
In rare cases surgery may be necessary if all the above measures are ineffective in controlling vomiting and malnutrition.