Everything You Need To Know About Managing Gastroparesis

Gastroparesis refers to stomach paralysis and is also known as delayed emptying of the gastric. It is a functional medical disorder that affects the stomach muscles and nerves, causing the contraction of the stomach muscles to weaken, resulting in the increased inability to digest and empty food normally. This causes the food to remain in the stomach for prolonged periods.

The result of the inability to process and empty food properly is the holding up of the entire digestive process. Individuals suffering from gastroparesis usually experience discomfort during digestion and may experience long-lasting side effects. The discomfort might result in them having a reduced appetite, causing them to have trouble meeting their nutritional needs. Even if they do eat, the food may not pass completely to the intestines, causing the development of bezoar, which is a solid, hardened mass.

Who is at risk of developing gastroparesis?

Gastroparesis affects anybody, regardless of gender and age. However, it is usually observed more frequently among women between the ages of 30 and 60 as compared to men. Diabetic individuals, especially those with type 1 diabetes, are also at a higher risk of developing the disorder due to nerve damage as a result of high blood sugar levels.

In addition, individuals with certain neurological conditions, such as chronic pain, multiple sclerosis, or Parkinson’s disease, may develop an increased risk towards gastroparesis. Lastly, individuals who have undergone certain surgeries on their stomach or oesophagus may have a higher risk of developing gastroparesis, too.

Types of gastroparesis

Gastroparesis can be classified according to its cause. In most cases, the cause of gastroparesis is not clear and is categorised as idiopathic gastroparesis. If it is caused by diabetes, it is known as diabetes-related gastroparesis. If it develops after surgery, it is known as post-surgical gastroparesis.

Gastroparesis symptoms

The most common gastroparesis symptoms are:

• Constipation

• Heartburn and acid reflux

• Regurgitating large chunks of undigested food

• Upper abdominal pain

• Bloating

• Fluctuation of blood sugar levels

• Appetite loss

• Vomiting and nausea

• Feeling full for extended periods and/or very quickly

• Indigestion

What causes gastroparesis?

As mentioned earlier, individuals with diabetes or who have had surgery are at a higher risk of developing gastroparesis. However, there are some other known causes of gastroparesis, too. For example:

• Gastrointestinal infections and viral infections, such as rotavirus and norovirus.

• Autoimmune diseases

• Medications such as tricyclic antidepressants, anticholinergics, calcium channel blockers, and cyclosporine

There are also less common causes of gastroparesis, such as collagen-vascular diseases, endocrine disorders, and cystic fibrosis.

Gastroparesis complications

Individuals with gastroparesis may suffer a series of complications, such as:

• Dehydration, malnutrition, and weight loss: Chronic vomiting and nausea are common symptoms of gastroparesis and can lead to malnutrition and weight loss. Frequent vomiting can also cause a deficiency of electrolytes and water, which leads to dehydration.

• Acid reflux complications: Gastroparesis leads to abdominal distension, making it easier for stomach acid to flow back into your oesophagus. Chronic acid reflux causes complications, such as oesophagitis and heartburn.

• Blood sugar complications: Gastroparesis interrupts the digestive system, causing the interruption of controlled, regular production of glucose into the bloodstream. This causes the blood sugar level to fluctuate suddenly when food is finally digested, which can result in dire consequences for diabetic individuals, causing gastroparesis to worsen, too.

• Gastric outlet obstruction and bezoar: Bezoar refers to the hardened, compacted mass that develops in the stomach as a result of food remaining in the stomach for prolonged periods. Bezoar may become too big to enter the intestines, resulting in it blocking the stomach exit.

Testing for and diagnosing gastroparesis

A combination of medical history and tests can help doctors to determine gastroparesis. Tests, such as abdominal ultrasound, CT scan, upper endoscopy, and MRI, are usually conducted to rule out any mechanical obstructions. Physical examinations and blood tests are also conducted to help determine the underlying cause of gastroparesis.

Additionally, the doctor may also conduct a gastric emptying study to determine gastric motility. Such tests include:

• Gastric motility breath test: This study helps to track the progress of your digestion by measuring the gases in your breath. For this study, you will consume a special meal containing carbon-13 that will produce a specific, measurable form of carbon dioxide known as CO2-13.

• Gastric emptying scintigraphy: This test is a form of nuclear medicine imagining test that tracks the digestion progress of a beverage or meal, recording how long the process takes. During this test, you will consume a beverage or meal containing a tiny dosage of a radioactive substance that will then be monitored periodically using a special camera.

Managing and treating gastroparesis

While doctors are not able to treat the damage caused by gastroparesis directly, they can employ treatments that will help to stimulate stomach muscle contractions. Medications, such as metoclopramide, motilin agonists, serotonin agonists, and dopamine antagonists, are usually the first-line treatment.

Concurrently, doctors may advise the patient to modify their diet, consuming less fat and fibre to improve digestion. In the case where either does not work well, surgery would be recommended. However, it is usually the last resort. The affected individual may either be recommended a gastric bypass or pyloroplasty.

Conclusion

For some individuals, gastroparesis may come and go quickly. For others, it can be a chronic condition that can be managed with adequate treatment. All in all, gastroparesis is not life-threatening if managed timely and properly. And that can easily be avoided early with regular gastroenterology visits.

GUTCARE is a digestive care specialist that offers a broad range of gastro-related treatments, such as pancreas cancer symptoms and fatty liver symptoms. We will work with you to minimise the risk of gastroparesis-related complications. With the right care, your risk is insignificant.

Click here to make an appointment with us today!

Reference(s):

https://www.needhamgastro.com/articles/diagnosing-gastroparesis

https://my.clevelandclinic.org/health/diseases/15522-gastroparesis