What Are the Symptoms of Gastroparesis?

August is Gastroparesis Awareness Month. What is gastroparesis?

Gastroparesis refers to having a nonmotile stomach. It is among the most severe and complicated intestinal motility disorders as it affects the regular automatic movement of the muscles in the stomach. Generally, forceful muscular contractions in the stomach help move food along the gastrointestinal (GI) tract. But when gastroparesis develops, the stomach's ability to push food slows considerably or may completely stop. Such a condition can keep stomach contents from emptying normally and might cause a number of medical conditions. The skilled GI specialists at Adult Gastroenterology Associates in Tulsa, OK are pleased to offer personalized medical services for gastroparesis.

What are the signs and symptoms of gastroparesis?

Approximately one in 25 individuals across the United States, even kids, has gastroparesis. This digestive concern is more common in females compared to males, and it is also more common among individuals who are long-term diabetics. Common signs and symptoms of gastroparesis include:

• Decreased appetite and unintended loss of weight
• Feeling fullness very quickly when eating
• Abdominal bloating
• Persistent nausea
• Lingering pain in the abdominal area
• Inconsistent blood sugar levels
• Heartburn or gastroesophageal reflux (the backup of stomach contents into the esophagus)
• Vomiting of undigested food

Many patients with gastroparesis may not have obvious signs or symptoms. In some instances, the condition is very brief and abates by itself or improves with medical attention. Select cases of the condition may be unresponsive to treatment.

What can cause gastroparesis?

In many instances, the exact cause of gastroparesis isn't always obvious. However, medical professionals have detected several factors that can contribute to this GI motility condition, including:

• Scleroderma: A connective tissue disorder, scleroderma affects the organs, muscles, blood vessels, and skin.
• Vagus nerve damage. Small intestine or stomach surgery, elevated blood glucose levels, and viral infections can cause harm to the vagus nerve. Vital for controlling the GI system, the vagus nerve causes the muscles in the gut to contract to propel food toward the small intestine. A damaged vagus nerve is unable to properly control the muscles in the stomach. In this instance, food might become trapped in the stomach for a longer period of time as opposed to migrating into the small intestine to digest.
• Amyloidosis: Amyloidosis is a condition that develops when deposits of protein fibers build up in bodily tissues and organs.
• Medications: Opioid pain relievers, certain antidepressants, high blood pressure prescriptions, and allergy medications may lead to delayed gastric clearing and result in symptoms similar to gastroparesis. For individuals already impacted by the disease, these types of medications could worsen its effects.

Complications that may occur from gastroparesis are:

1. Severe dehydration. Frequent vomiting can result in the loss of bodily fluids.
2. Malnutrition. Decreased and repeated vomiting might induce poor caloric consumption and the inability to take up enough nutrients.
3. Undigested food. Food that remains in the stomach could solidify, forming a mass known as a bezoar. Bezoars could induce nausea and vomiting and may be fatal if they block food from emptying out of the stomach.
4. Unpredictable blood sugar changes. Even though gastroparesis does not cause diabetes, recurring changes in the amount and speed of food passing out of the stomach may cause unstable blood glucose amounts. These fluctuations in blood sugar can make diabetes worse, which may intensify gastroparesis.
5. Reduced quality of life. Gastroparesis symptoms can make it challenging to perform everyday tasks and carry out additional responsibilities.

How is gastroparesis identified?

Gastroenterologists provide specialty care in gastric disorders, including gastroparesis. Along with reviewing a person's medical history and symptoms, a GI specialist will provide a physical evaluation and likely recommend specific blood analyses, including those that evaluate glucose levels. Other procedures performed to diagnose gastroparesis include:

• SmartPill™ motility testing system: The SmartPill is a tiny, digestible capsule that contains an electronic apparatus. Once the capsule is consumed and makes its way down the GI system, it delivers gastric readings to a device positioned on the patient. SmartPill mobility testing records and monitors the rate at which food migrates through the intestinal system.
• Four-hour solid gastric emptying study: This test determines the time it requires for a meal to make its way through the stomach. Individuals consume a meal that includes a radioactive isotope. An image of the stomach is taken 60 seconds after the meal is eaten. Further images are then captured at various times over the next few hours to assess how the food moves through the stomach and the remainder of the GI system.

Treating gastroparesis

Gastroparesis is a chronic gastrointestinal condition. Though the disorder might not be cured through treatment, it can be managed and controlled. People who have diabetes need to consciously track and control their blood sugar amounts to diminish the issues with gastroparesis. In some instances, gastroparesis patients might benefit from medications, including:

• Reglan: This type of medication stimulates contractions in the stomach muscles to help propel food into the small bowel. It can also help minimize vomiting and queasiness. Side effects can include diarrhea and, on rare occasions, a concerning nerve condition.
• Erythromycin: An antibiotic, erythromycin also stimulates gastric motility and aids in moving food through the GI tract. Potential side effects are loose bowels and the risk of developing antibiotic-resistant bacteria from taking the medication over a long period of time.
• Antiemetics: These medications help control stomach upset.

A number of patients may be good candidates for surgical procedures to treat gastroparesis, such as:

• Gastric electrical stimulation: A small device referred to as a gastric stimulator is introduced into the abdomen. It contains two leads connected to the stomach that provide tiny electric shocks, which help control vomiting.
• Gastric bypass: With this surgical procedure, a small pocket is developed from the upper portion of the stomach. Half of the small bowel is connected directly to this newly created pouch in the stomach. A gastric bypass substantially restricts the volume of food the patient can take in, and can be more helpful than medication or a gastric stimulator in obese diabetic patients.

Additional types of treatment approaches for gastroparesis are:

• POP: Nonsurgical peroral pyloromyotomy (POP) is a procedure in which a doctor places an endoscope through the upper GI tract and into the stomach. The physician then augments the pylorus, or the structure that aids in emptying the stomach, letting stomach contents migrate to the small intestine more readily.
• IV Nutrition: With this intravenous, or parenteral, nutrition technique, nutrients directly enter the blood through a catheter inserted into a vessel in the chest area. Similar to a jejunostomy tube, parenteral nutrition is a temporary solution for treating significant gastroparesis cases.
• Feeding/jejunostomy tube: When gastroparesis is advanced, a jejunostomy tube or feeding tube could be ideal. A plastic tube is surgically placed through the abdomen into the small intestine. Liquid nutrients are administered into the feeding tube, entering the small intestine and passing into the blood more quickly. A jejunostomy tube is generally a temporary option.

Is there a special diet for gastroparesis?

According to the American College of Gastroenterology, diet is a pillar of managing gastroparesis and additionally provides a natural form of care. GI doctors may also recommend medication and conduct other medical services to alleviate symptoms of the intestinal condition. However, such therapies work more effectively when the patient adheres to a specific diet. A gastroparesis diet limits foods that are hard to digest, like those high in fiber or fat content. This can help ease digestion and decrease the risk of ramifications resulting from gastroparesis.

If you are experiencing gastroparesis symptoms or issues related to a diagnosis of gastroparesis, we urge you to visit a Tulsa, OK gastrointestinal specialist near you immediately. To schedule a consultation with our experienced team, please contact Adult Gastroenterology Associates today.