Gastroparesis

Upon the weakening of the stomach’s muscle contractions, food is not meticulously crushed and does not empty into the intestine ordinarily.

From the muscular actions, both liquid and solid foods are emptied from the stomach differently. The most frequent is the slow emptying of solid food, followed by liquid and solid food, and then the liquid food itself.

What are the Signs and Symptoms of Gastroparesis?

The main causes of gastroparesis are vomiting and nausea. Other symptoms include; pain in the abdomen, malnutrition, the altering in blood sugar levels, heartburn or GERD, abdominal bloating, loss of weight, losing of appetite right away, and a certain feeling of fullness after taking up a couple of bites.

The vomiting occurs mostly after meals but in worst cases, the person with gastroparesis still might vomit even with an empty stomach because of the stomach secretions being accumulated.

Upon vomiting due to gastroparesis, the grinding action of the stomach is out, which makes the vomited food contain perceptible large segments of the consumed food right before the vomiting occurred.

What are the Causes of Gastroparesis?

The causes of gastroparesis is still not well identified but in most cases, gastroparesis is believed to be caused by any diseases in the stomach or nerves controlling the damaged muscles of the stomach which are the vague nerves; these are the nerves that handle the compound procedures in the digestive tract like stimulating the stomach’s muscles to push and constrict food into the small intestine.

When the vagus nerve is defective, it can no longer send signals to the muscles in the stomach which may later on cause food to stay in the stomach much longer, than be moved and digested in the small intestine.  Diabetes mellitus is the most common cause of gastroparesis and it affects the vagus nerves.

Surgical procedures done in the stomach and esophagus can be another reason that can endanger the stomach’s muscles. Another example of a disease that can cause gastroparesis is Scleroderma that also impairs the stomach’s muscle.

Every so often, reflexes inside the nervous system can be a cause as well like for example; the inflammation of the pancreas. Given that none of the muscles or nerves is disrupted, but messages are sent to the stomach coming from the pancreas to prevent the normal functioning of the muscles.

Some other causes of gastroparesis may include; idiopathic gastroparesis, mineral imbalance in the blood, and medications.

How is Gastroparesis Diagnosed?

Physicians have many ways to diagnose a patient with gastroparesis. Below are the tests that can be done:

• Gastric emptying study – This is a nuclear medicine test that measures the amount of food emptied from the stomach. Eating light meals necessitate in this test whether it be solid or liquid that contains a small amount of radioactive material so that the movement of the material will be detected later on by a scanner in order to monitor which food leaves the stomach.
• Upper gastrointestinal endoscopy – This is for visual examination in the upper digestive system namely the stomach, esophagus, and the duodenum. This involves a small camera on the end of a long tube that’s flexible enough.
• Upper GI series – A series of X-rays wherein the patient drinks a white, chalky liquid medium to help the stomach’s abnormalities be seen if there’s any.
• Breath test – The test simply involves the person to drink little amount of sugar water to measure the amount of gas processed by the body in the breath.

How to Treat Gastroparesis?

To start with gastroparesis treatment, the underlying condition should be well identified. Treatments may include:

• Medications that can stimulate the muscles of the stomach. These could be; Reglan and Eryc, E.E.S., domperidone, and cisapride. Medications that can control vomiting and nausea may also be used like; Compro, Unisom, Benadryl, and Zofran.
• Surgery – This treatment is for patients that can’t tolerate any food or liquids. Physicians will then propose to place a jejunostomy tube in the small intestine. Physicians can also suggest a gastric venting tube to help alleviate pressure from the gastric contents.
• These tubes are only temporary when blood sugar levels are uncontrollable or gastroparesis worsens. Some patients need an IV feeding tube in order for it to be directed into a vein in the chest.

Diet for Gastroparesis

The Physician can also refer the patient to a dietician who can help the person find foods that are much easier to digest in order to get equal amount of nutrients and calories. The dietician might advocate the patient to:

• Chew food comprehensively
• Drink a good amount of water for every meal
• Avoid smoking, alcohol and drinks that are carbonated
• Eat well-cooked vegetables and fruits
• Eat smaller meals more regularly
• After eating, do some gentle exercises like going for a walk
• If it is much easier for liquids to swallow, try pureed foods and soups
• Avoid eating fibrous vegetables and fruits
• Pick low-fat foods but if tolerable, small amount of fatty foods may be added to the diet

Prognosis

Gastroparesis is more difficult to treat if there are motility disorders of the muscles in the small intestine that accompanies with it. If gastroparesis is caused by a problem that’s reversible, the condition subsides when the problem resolves.

For diabetes patients, blood sugar control will refine the emptying of the stomach. If no reversible causes are there, it is very rare for gastroparesis to be resolved. As a matter of fact, it becomes worse as time flies.

References

1. gastroparesis – symptoms, causes, complications, treatment at http://www.mayoclinic.org/diseases-conditions/gastroparesis/basics/definition/con-20023971
2. What is gastroparesis? What causes gastroparesis? What are gastroparesis symptoms and signs? How is gastroparesis diagnosed? How is gastroparesis treated? at http://www.medicinenet.com/gastroparesis/article.htm
3. What Are the Symptoms of Gastroparesis?, What Are the Complications of Gastroparesis?, How Is Gastroparesis Diagnosed?, What Is the Treatment for Gastroparesis?, Dietary Modifications for Gastroparesis, Other Treatment Options for Gastroparesis at http://www.webmd.com/digestive-disorders/digestive-disorders-gastroparesis?page=3#1
4. Camilleri M, Parkman HP, Shafi MA, Abell TL, Clinical guideline: management of gastroparesis.Am J Gastroenterolwww.ncbi.nlm.nih.gov/pubmed/23147521
5. Koch KL. Gastric neuromuscular function and neuromuscular disorders. In: Feldman M, Friedman LS, Brandt LJ, eds.Sleisenger and Fordtran’s Gastrointestinal and Liver Disease
6. Spotlight on gastroparesis,” unauthored article, Balance (magazine of Diabetes UK, no. 246, May-June 2012, p. 43.