Gastroparesis
Gastroparesis is the paralysis of the stomach, affecting muscle and nerve activity. This can cause issues with processing and emptying food into the small intestine – holding up the whole digestive process. This leads to food sitting in the stomach for too long, causing adverse symptoms.
Read on to learn more about this condition and its symptoms, causes, diagnosis, and treatment options.
Symptoms
Most people who experience the condition don’t notice any symptoms. However, some may experience the following:
- Bloating
- Excessive belching
- Heartburn or acid reflux
- Poor appetite
- Feeling full too soon after starting a meal
- Feeling full long after a meal
- Weight loss
- Constipation
- Nausea
- Regurgitating undigested food
- Vomiting
- Abdominal pain
- Anorexia
Generally, symptoms can range from feeling mild to severe. If you experience any of the following symptoms for more than 2-3 months, we advise you to seek the advice of a gastroenterologist.
Complications
Gastroparesis can cause complications due to its effect on the digestive system.
Dehydration and malnutrition can occur due to repeated vomiting and not consuming enough nutrients. Changes in the amount and rate of food passing through the small bowel can also affect blood sugar levels. If you have diabetes, this change in blood sugar can make your diabetes worse.
If food sits in the stomach for too long, a solid mass called a bezoar can form. This can cause symptoms such as nausea or vomiting. It can even cause stomach obstruction to occur, which can lead to symptoms such as abdominal pain, bloating, and an overall feeling of illness. It can be life-threatening, as it prevents food from passing through the digestive system.
If you have any signs or symptoms of the listed complications, you should seek immediate medical help, as they can cause further issues.
Causes
There are various causes of gastroparesis. However, in most cases, a direct cause cannot be found.
The leading known cause in adults is diabetes. Over time, blood sugar levels can increase if you are having difficulty managing the condition, which can cause damage to the stomach’s nerves. High blood sugar levels can also damage blood vessels that carry oxygen to the tissues in the stomach, affecting the muscles as well.
Diabetic gastroparesis affects 13 out of every 1000 (1.3%) people who have diabetes. It is more common in those with type 1 diabetes, but it can affect all types.
Other known causes include:
- Gastrointestinal infections
- Certain medicines, particularly opioid pain medication
- Multiple sclerosis
- Parkinson’s disease
- Connective tissue conditions, such as diffuse systemic sclerosis
Medications used to help control diabetes, like Ozempic, may worsen your gastroparesis or raise your risk of the condition. Although rare, it is important to be aware before taking these medications.
Surgical procedures can damage the vagus nerve, which can lead to post-surgical gastroparesis. The vagus nerve sends signals to major organs to regulate essential bodily functions like digestion.
Procedures that could cause post-surgical gastroparesis include:
- Acid reflux surgery (known as fundoplication)
- Oesophagus (gullet) surgery
- Gastric bypass surgery
- Partial gastric resection (removal of part of the stomach)
- Surgery to cut the vagus nerve – a treatment for stomach ulcers (vagotomy)
- Lung surgery or pancreatic surgery
Evidence has suggested that those with eating disorders may experience delayed gastric emptying. If you suspect you may have an eating disorder, please speak to your doctor.
Diagnosis
In your initial appointment, we will evaluate your symptoms, medical history (including any previous surgical procedures or conditions you may experience), and family history.
If we suspect you may have gastroparesis, we will conduct further investigations to determine your condition. Tests may include an upper endoscopy (gastroscopy), breath test, CT scan, MRI, or abdominal ultrasound.
We may also perform gastric emptying scintigraphy (GES), which observes your stomach’s movements and how it empties. During the procedure, we ask you to eat a solid meal containing a small amount of isotope. External gamma cameras scan and detect the presence of the isotope to track the progress of the meal.
The isotope will disappear from your body rapidly after the procedure. Before this procedure, please discuss any allergies or medication you are taking with your practitioner.
Treatment
Treatment will depend on the cause of your symptoms.
Unfortunately, the damage that can cause gastroparesis can’t be fully fixed, but we can offer treatment to help stimulate muscle movement and encourage emptying. This could involve a treatment plan of medications such as anti-sickness medication or prucalopride, diet modification, and, if necessary, surgical treatment.
We will work with you to help control your stomach’s movements and maintain an effective treatment plan so that we can work to help you achieve your new ‘normal’ digestive health.
Book an appointment
If you experience digestive issues and are worried about gastroparesis, speak to one of our specialists for an expert consultation and diagnostic tests.
Book an appointment to look after your stomach’s health.