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Menorah Medical Center
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Gastroparesis

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
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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 and the muscles of the stomach do not work properly.

Risk Factors

The main risk factor is diabetes. Diabetes can damage the vagus nerve, which may lead to gastroparesis. High blood glucose 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 medications, such as anticholinergics or opioids
  • Infection from a virus
  • Diseases affecting the nerves, muscles, or hormones
  • Diseases affecting metabolism (body’s ability to make and use energy)
  • Chronic disease
  • Anorexia or bulimia
  • Radiation therapy or chemotherapy
  • Smoking
  • Alcohol use

Symptoms

Gastroparesis may cause:

  • 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 can assess the stomach and surrounding structures:
  • Other procedures
    • Upper GI 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 dietitian 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, nutrients can be delivered to the body by going directly into the intestines or bloodstream. These methods bypass the stomach. Access to the intestines can be done with a tube that goes down the throat or through an opening in the abdominal wall. A tube in the vein can access the bloodstream.

Medications

You may be given medications to treat the symptoms and help the stomach with emptying. These medications work by stimulating the stomach muscles to contract. Examples include:

  • Metoclopramide
  • Erythromycin

Other medications 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 chance of gastroparesis:

  • If you have diabetes, follow your treatment plan.
  • Avoid medications that delay gastric emptying. These include opioids, calcium channel blockers, and some antidepressants. Keep a list of all the medications you are taking and share this list with your doctor. Make sure you talk to your doctor before stopping any medications.

Revision Information

  • Reviewer: Daus Mahnke, MD
  • Review Date: 03/2016 -
  • Update Date: 06/03/2013 -
  • American College of Gastroenterology

    http://patients.gi.org

  • American Gastroenterological Association

    http://www.gastro.org

  • Canadian Association of Gastroenterology

    https://www.cag-acg.org

  • Health Canada

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

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

  • Gastroparesis. American College of Gastroenterology website. Available at: http://patients.gi.org/topics/gastroparesis. Accessed April 4, 2011.

  • Gastroparesis. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/gastroparesis/Pages/facts.aspx. 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.