Gastroparesis definition

Gastroparesis, also called delayed gastric emptying, is a digestive disorder that slows or stops the movement of food from stomach to small intestine, even though there is no blockage in the stomach or intestines. In this condition, normal digestion may not occur. It affects the normal spontaneous movement of the muscles in stomach. It tends to affect women more than men.

Etiology of gastroparesis

Etiologies of gastroparesis include:

•     Diabetes (the most common known cause)

•     Connective tissue disorders

•     Prior infection

•     Mesenteric ischemia

•     Post-surgical complication

•     Idiopathic causes

Idiopathic gastroparesis refers to gastroparesis of unknown cause which is the most common category for this illness.

Other conditions that are associated with gastroparesis include

•     Certain cancers

•     Parkinson’s disease

•     Cystic fibrosis

•     Autoimmune conditions

•     Thyroid disorders

•     Amyloidosis

Gastroparesis symptoms

•     Feeling full shortly after starting a meal

•     Feeling full long after eating a meal

•     Nausea

•     Vomiting

•     Bloating

•     Epigastric pain

•     Heartburn

•     Regurgitation

Gastroparesis Diagnosis

Doctors diagnose it based on physical exams, symptoms, asking questions and medical history. Eating patterns can also be helpful.
After that, doctor probably wants to run some test such as:

•     Blood test (check for diabetes)

•     An ultrasound

•     Endoscopy

Some tests to see how well stomach empties

•     Gastric emptying scintigraphy test

•     Smart Pill (a capsule that contains a device to track how fast food moves through your digestive tract)

•     Carbon breath test

Gastroparesis Treatment

Treating gastroparesis depends on the intensity of symptoms, cause, complications and how people respond to treatment. If diabetes is causing gastroparesis, patients should control their diabetes and blood glucose level.
After controlling the underlying condition, doctor may recommend:

1.     diet changing

2.     medications

3.     botulinum toxin injections

4.     surgery

A newer treatment for gastroparesis is called per oral pyloromyotomy. This is a nonsurgical procedure in which the doctor inserts an endoscope into the patient’s mouth and advances it to the stomach.

Diet changing

One of the best ways to help control the symptoms is to change eating habits. Dietitians can help patients and choose foods that are easier to digest. patients should also get enough calories and nutrients.

Some recommendation about eating

•     Eat smaller meals more frequently

•     Chew food thoroughly

•     Eat well-cooked fruits and vegetables rather than raw fruits and vegetables

•     Avoid fibrous fruits and vegetables, such as oranges and broccoli, which may cause bezoars

•     Choose mostly low-fat foods, but if you can tolerate them, add small servings of fatty foods to your diet

•     Try soups and pureed foods if liquids are easier for you to swallow

•     Drink about 1 to 1.5 liters of water a day

•     Exercise gently after you eat, such as going for a walk

•     Avoid carbonated drinks, alcohol and smoking

•     Try to avoid lying down for 2 hours after a meal

•     Take a multivitamin daily

list of foods recommended for people with gastroparesis

Starches: White bread, Plain or egg bagels, English muffins, Flour or corn tortillas, Pancakes, Puffed wheat and rice cereals, Cream of wheat or rice, White crackers, Potatoes white or sweet (no skin), Rice, Pasta
Protein: Lean beef, veal and pork (not fried), Chicken or turkey (no skin and not fried), Crab, lobster, shrimp, clams, scallops, oysters, Tuna (packed in water), Cottage cheese, Eggs
Fruits and vegetables: Tomato sauce, paste, puree, juice, Carrots (cooked), Beets (cooked), Mushrooms (cooked), Vegetable juice, Fruit juices and drinks, Apple sauce, Bananas, Peaches and pears (canned)
Dairy: Milk, Yogurt (without fruit pieces), Custard and pudding, Frozen yogurt

Medicine

Some medicine may improve symptoms. The drug categories commonly used are prokinetic agents and anti-emetic agents.

•     Prokinetic agents help the stomach empty more quickly.

Some of them are:
Metoclopramide, Domperidone, Erythromycin

•     Anti-emetic agents such as antihistamines, phenothiazine, are used to treat nausea and vomiting.

Surgery

One type of surgery for gastroparesis is gastric electrical stimulation, which is a treatment that sends mild electric shocks to the stomach muscles.
Complications:

Gastroparesis can lead to some complications such as:

•     Dehydration

•     Malnutrition

•     Decreased blood pressure

•     Muscle weakness

•     Rapid breathing

•     Decreased urine output