Gastroparesis: Symptoms, Causes, Treatment

What are the symptoms of gastroparesis?

Gastroparesis is a condition that affects the stomach muscles and prevents proper stomach emptying. The symptoms of gastroparesis can vary in severity and may include:

Nausea: A frequent and persistent feeling of needing to vomit.
Vomiting: Often of undigested food several hours after eating.
Feeling full quickly: Feeling full after eating only a small amount of food.
Bloating: Abdominal distension or bloating.
Abdominal pain: Discomfort or pain in the upper abdomen.
Lack of appetite: Reduced desire to eat.
Weight loss: Unintentional weight loss due to reduced food intake.
Heartburn or GERD: Acid reflux or heartburn due to delayed gastric emptying.
Blood sugar fluctuations: Difficulty managing blood sugar levels, especially in people with diabetes.

If you suspect you have gastroparesis, it’s important to consult a healthcare provider for proper diagnosis and management.

What are the causes of gastroparesis?

Gastroparesis can be caused by a variety of factors, but the most common cause is damage to or dysfunction of the vagus nerve, which controls the muscles of the stomach and intestines. Some of the common causes and risk factors include:

Diabetes: The most common cause of gastroparesis, as high blood sugar levels can damage the vagus nerve over time.
Surgery: Some types of surgery, especially involving the stomach or vagus nerve, can lead to gastroparesis.
Medications: Certain medications, such as opioids, anticholinergics, and some antidepressants, can delay gastric emptying and contribute to gastroparesis.
Nervous system diseases: Conditions such as Parkinson’s disease, multiple sclerosis, and amyloidosis can affect the nerves that control the stomach muscles.
Hypothyroidism: An underactive thyroid gland can slow down digestion and lead to gastroparesis.
Viral infections: Some viral infections, such as a stomach flu or a respiratory infection, can cause temporary gastroparesis.
Autoimmune diseases: Conditions like scleroderma and lupus can affect the digestive system, including the stomach muscles.
Eating disorders: Conditions like anorexia nervosa and bulimia can affect digestion and lead to gastroparesis.
Idiopathic: In some cases, the cause of gastroparesis is unknown, and it is termed idiopathic gastroparesis.

It’s important to work with a healthcare provider to determine the underlying cause of gastroparesis, as this can help guide treatment and management strategies.

How is the diagnosis of gastroparesis made?

The diagnosis of gastroparesis is typically made based on a combination of symptoms, medical history, physical examination, and diagnostic tests. Here are the common methods used to diagnose gastroparesis:

Medical history and physical examination: Your healthcare provider will ask about your symptoms, medical history, and any medications you’re taking. They will also perform a physical examination to check for signs of gastroparesis.
Gastric emptying study: This is the most common test used to diagnose gastroparesis. You will eat food containing a small amount of radioactive material, which can be tracked as it moves through your digestive system using a special camera. This test can determine how quickly your stomach empties.
Upper endoscopy: This procedure involves inserting a flexible tube with a camera on the end (endoscope) through your mouth and into your stomach to visually inspect the stomach lining. It can help rule out other conditions that may cause similar symptoms.
Ultrasound: An abdominal ultrasound may be used to look for any structural abnormalities in the stomach or other organs that could be causing symptoms.
Gastric manometry: This test measures the electrical and muscular activity in your stomach to assess how well it is working and how food moves through it.
Breath tests: These tests can detect the presence of bacterial overgrowth in the small intestine, which can contribute to gastroparesis.
Blood tests: Blood tests may be done to check for underlying conditions such as diabetes or thyroid disorders.

The specific tests used to diagnose gastroparesis may vary depending on the individual case and the healthcare provider’s recommendations. It’s important to discuss your symptoms and concerns with your healthcare provider to determine the most appropriate diagnostic approach.

What is the treatment for gastroparesis?

The treatment for gastroparesis aims to manage symptoms and improve stomach emptying. The approach may include a combination of lifestyle changes, dietary modifications, medications, and, in some cases, surgical interventions. Here are some common treatments:

Dietary changes: Eating smaller, more frequent meals that are low in fat and fiber can help reduce symptoms. Liquid meals or foods that are easier to digest, such as soups and pureed foods, may also be recommended.
Medications: Several medications can help improve stomach emptying and reduce symptoms. These may include prokinetic agents (such as metoclopramide or domperidone) to help move food through the stomach, antiemetics (such as ondansetron) to reduce nausea and vomiting, and medications to control acid reflux.
Botulinum toxin (Botox) injection: In some cases, injecting Botox into the pyloric sphincter (the muscle that controls the opening between the stomach and the small intestine) can help relax the muscle and improve stomach emptying.
Gastric electrical stimulation: This involves implanting a device similar to a pacemaker in the abdomen to help control stomach contractions and improve emptying.
Parenteral nutrition: In severe cases where oral feeding is not possible, nutrients may be delivered directly into the bloodstream through a vein (parenteral nutrition).
Surgical options: In some cases, surgery may be recommended to insert a feeding tube into the small intestine (jejunostomy tube) or to remove part of the stomach (partial gastrectomy) to improve stomach emptying.
Acupuncture: Some people find relief from symptoms through acupuncture, although more research is needed to determine its effectiveness.

It’s important for individuals with gastroparesis to work closely with their healthcare team to develop a treatment plan that addresses their specific symptoms and needs.

What is the life expectancy of someone with gastroparesis?

Gastroparesis, also known as delayed gastric emptying, is a condition where the stomach takes too long to empty its contents into the small intestine. The life expectancy of someone with gastroparesis depends on various factors, including:

Severity of symptoms: Mild cases may not significantly impact daily life, while severe cases can lead to malnutrition, dehydration, and electrolyte imbalances, which can compromise overall health and life expectancy.
Underlying cause: Gastroparesis can be caused by a variety of conditions, such as diabetes, Parkinson’s disease, surgery, or medications. The underlying cause can influence the progression of the condition and the individual’s overall health.
Nutritional status: Gastroparesis can lead to malnutrition if the body is unable to absorb adequate nutrients. Malnutrition can increase the risk of complications and affect overall health.
Presence of other health conditions: Individuals with gastroparesis may have other underlying health conditions that can impact their life expectancy, such as chronic diseases like heart disease, kidney disease, or liver disease.

According to a study published in the Journal of Clinical Gastroenterology, the median survival rate for patients with gastroparesis is around 10-15 years after diagnosis. However, this range can vary significantly depending on individual factors.

In general, individuals with gastroparesis may face a higher risk of:

Malnutrition: Prolonged periods of malnutrition can lead to weight loss, fatigue, and impaired immune function.
Dehydration: Inadequate nutrient absorption can lead to dehydration and electrolyte imbalances.
Gut bacterial overgrowth: Gastroparesis can create an environment conducive to bacterial overgrowth in the small intestine, leading to malabsorption and potentially serious complications.
Increased risk of infections: Gastroparesis can increase the risk of infections, particularly in the upper gastrointestinal tract.

It’s essential for individuals with gastroparesis to work closely with their healthcare provider to manage their symptoms and underlying conditions. Lifestyle modifications, such as dietary changes and medication adjustments, can help alleviate symptoms and improve quality of life. In some cases, surgical intervention or placement of a gastric pacemaker may be necessary to restore normal gastric motility.

If you or someone you know has been diagnosed with gastroparesis, it’s crucial to consult with a healthcare provider to discuss personalized treatment options and monitor overall health.