Gastroparesis Symptoms and Treatment Options

Gastroparesis is a term that describes an immotile stomach. The condition is among the gravest and most concerning stomach motility problems as it prevents the natural involuntary activity of the stomach muscles. Normally, forceful muscular contractions in the stomach move food throughout the gastrointestinal (GI) system. If gastroparesis is present, however, the stomach's ability to push food slows considerably or may even come to a halt. This decrease in motility can interfere with the proper emptying of the stomach and may cause additional medical conditions.

August is Gastroparesis Awareness Month. The experienced gastroenterologists at Texas Digestive Disease Consultants in DFW are pleased to offer care for gastroparesis and are dedicated to educating patients on its symptoms and treatment. Read on to learn more about this chronic digestive disorder.

What are the signs and symptoms of gastroparesis?

Nearly one in 25 individuals across the United States, including kids, has gastroparesis. This digestive concern is more widespread in females than males, and it's more common in patients who have been living with diabetes for a long time. Signs and symptoms of gastroparesis often include:

• Bloating
• Acid reflux or heartburn
• Lingering abdominal pain
• Inconsistent blood sugar levels
• Vomiting of undigested food
• Poor appetite and unintended weight loss
• Feeling full very quickly when eating
• Frequent nausea

Oftentimes, people with gastroparesis don't exhibit any recognizable signs. For some, the condition appears for a brief time and goes away on its own or is diminished with medical care. Select cases may be less responsive to treatment.

What factors cause gastroparesis?

In many cases, the leading source of this GI condition isn't always obvious. However, the medical community has pinpointed several factors that may contribute to gastroparesis, such as:

• Medications: Allergy medications, opioid pain relievers, high blood pressure medications, and some antidepressants can cause delayed gastric emptying and induce gastroparesis-like symptoms. In those diagnosed with the condition, these forms of medications can make the condition worse.
• Amyloidosis: This disease arises when deposits of protein fibers build up in organs or tissues throughout the body.
• Vagus nerve damage. Elevated blood glucose levels, surgery to the stomach or small intestine, and viruses can injure the vagus nerve. Vital for controlling the intestinal system, the vagus nerve stimulates stomach muscle contraction to move food toward the small intestine. An impaired vagus nerve cannot properly communicate with the stomach muscles. In these cases, food could be held in the stomach for a longer period of time instead of moving into the small intestine to digest.
• Scleroderma: This disorder of the connective tissue is known to affect the skin, blood vessels, muscles, and organs.

Additional health problems that may occur from gastroparesis include:

1. Extreme dehydration. Ongoing vomiting can cause dehydration.
2. Malnutrition. A depressed appetite and the frequent purging of stomach contents may lead to inadequate nutritional consumption and the inability to absorb adequate nutrients.
3. Undigested food. Food that remains in the stomach may solidify, forming a mass referred to as a bezoar. Such a mass may trigger nausea and vomiting and could be life-threatening if it prevents food from migrating into the small intestine.
4. Unpredictable blood sugar changes. Even though gastroparesis isn't a cause of diabetes, repeated variations in the speed and volume of food traveling into the small bowel may result in abnormal blood sugar levels. These fluctuations in blood sugar have a negative effect on a diabetic condition. In turn, this might worsen gastroparesis.
5. Reduced quality of life. Symptoms associated with gastroparesis can make it tough to perform daily tasks and keep up with other responsibilities.

How is gastroparesis diagnosed?

GI doctors specialize in digestive conditions, like gastroparesis. Along with discussing a patient's medical history and symptoms, a gastroenterologist will conduct a physical assessment and might order certain types of blood analyses, such as those to measure glucose levels. Other procedures conducted to diagnose gastroparesis could include:

• Four-hour solid gastric emptying study: This test determines the amount of time it takes food to empty out of the stomach. Patients receive a meal that has a special radioactive isotope. An image of the stomach is performed one minute after the meal is eaten. Additional scans are then taken at various times after consumption to examine how the food propels through the stomach and intestines.
• SmartPill™ motility testing system: The SmartPill is a digestible, miniature capsule that houses an electronic device. When the capsule is ingested and migrates through the GI tract, it conveys information to a recorder attached to the individual. This test monitors and records how quickly food moves through the intestinal tract.

Treating gastroparesis

Gastroparesis is often a long-lasting medical issue. Even though treatment won't likely reverse the condition, it can be controlled and managed with professional care. Those with diabetes are advised to actively track and manage their blood glucose amounts to diminish the concerns with gastroparesis. In some instances, patients might experience relief with medications, like:

• Reglan: Reglan stimulates stomach muscle contractions to propel food into the small intestine and reduce nausea and vomiting. Secondary effects that may occur are loose bowels and, in rare instances, a concerning neurological condition.
• Erythromycin: An antibiotic, erythromycin also encourages gastric movement and helps in pushing food through the GI tract. Additional effects are loose bowels and developing antibiotic-resistant bacteria if taking it for a period of time.
• Antiemetics: These medications help control queasiness.

A number of people may benefit from a surgical approach to address gastroparesis, including:

• Gastric electrical stimulation: A tiny device referred to as a gastric stimulator is introduced into the abdominal area. It contains two leads attached to the stomach that administer minor electric shocks to help reduce the urge to regurgitate.
• Gastric bypass: With this surgical procedure, a small pouch is created from the uppermost part of the stomach. Half of the small bowel is attached to this new stomach pouch. This surgery substantially curtails the quantity of food a person can take in, and can be more helpful for a person who is both diabetic and obese when compared with medication or a gastric stimulator.

Other gastroparesis treatments are:

• Feeding/jejunostomy tube: If gastroparesis is severe, a feeding tube or jejunostomy tube may be ideal. A special tube is surgically inserted through the abdomen into the small bowel. Liquid nutrients are administered through the tube, which goes straight into the small intestine, and are able to enter into the blood more quickly. The jejunostomy tube is typically a temporary treatment.
• IV Nutrition: During this parenteral (or intravenous) feeding method, nutrients directly enter the blood through a catheter inserted into a vein in the chest. Similar to a jejunostomy feeding tube, parenteral nutrition is a temporary measure for treating severe gastroparesis conditions.
• POP: Peroral pyloromyotomy (POP) is a newer option during which a doctor places a thin, flexible instrument through the mouth and esophagus and into the stomach. The doctor then severs the pylorus, or the valve that aids in emptying the stomach, allowing food to move to the small bowel more easily.

Dietary considerations for gastroparesis

As specified by the American College of Gastroenterology, a healthy diet is a cornerstone of gastroparesis management and can serve as a natural course of care. However, physicians might also recommend medication and conduct medical treatments to reduce symptoms of this intestinal condition. Gastroparesis therapies function most effectively when the patient also adheres to a certain diet. Such as diet includes decreasing the consumption of foods that are more challenging to digest, such as fibrous and fatty items. This can aid in easing digestion while also decreasing the risk of gastroparesis-related health complications.

If you are having indications of gastroparesis or issues related to a diagnosis of gastroparesis, we encourage you to book an appointment with a DFW gastrointestinal doctor near you promptly. Please contact Texas Digestive Disease Consultants today to schedule a consultation or to learn more about gastroparesis symptoms and treatment.