What Is Gastroparesis?

August is Gastroparesis Awareness Month. At Indianapolis Gastroenterology and Hepatology, we specialize in treating gastroparesis and offer personalized care to minimize the effects of this condition. Our board-certified gastroenterologists wish to educate patients throughout Indianapolis, IN about gastroparesis and how we might go about addressing this gastrointestinal (GI) disease.

About gastroparesis

The term gastroparesis refers to paralyzed stomach. It is one of the most severe and complicated GI motility problems as it affects the natural spontaneous movement of the stomach muscles. Generally, muscular contractions in the stomach move food through the gastrointestinal tract. If gastroparesis occurs, however, the stomach's ability to move food is significantly impaired or may come to a halt altogether. This can block the stomach contents from emptying normally and cause a number of medical conditions.

What are the signs and symptoms of gastroparesis?

Nearly one in 25 individuals across the United States, even young children, has gastroparesis. It is more prevalent in females compared to males, and it is also more widespread among people who have had diabetes for some time. A number of signs and symptoms of gastroparesis are:

• Feeling full even after eating very little
• Acid reflux or heartburn
• Inconsistent blood sugar levels
• Vomiting of undigested food
• Abdominal bloating
• Lasting pain in the abdomen
• Decreased appetite and unintended loss of weight
• Persistent nausea

Oftentimes, individuals who have gastroparesis don't show any obvious indications. In some instances, the condition appears for a brief time and goes away on its own or gets better with medical care. Advanced or refractory cases of the disease may be less responsive to care.

What factors cause gastroparesis?

In many instances, the primary reason for the GI condition is not always obvious. However, medical professionals have identified a number of contributing causes associated with gastroparesis, such as:

• Scleroderma: This connective tissue condition impacts the organs, muscles, blood vessels, and skin.
• Medications: Opioids, blood pressure medications, some antidepressants, and allergy medications may result in slow stomach clearing and produce gastroparesis-like effects. Among individuals previously impacted by the disorder, these medications make their condition worse.
• Vagus nerve damage. High blood glucose levels, viral infections, and stomach or small intestine surgery can cause harm to the vagus nerve. Critical for controlling the digestive tract, the vagus nerve stimulates the stomach muscles to contract to push food into the small intestine. When the vagus nerve is impaired, it can't send proper signals to the stomach muscles. As a result, food might remain in the stomach longer rather than move into the small intestine for normal digestion.
• Amyloidosis: Amyloidosis is a condition that develops when deposits of protein fibers build up in bodily tissues and organs.

Additional health complications that may occur from gastroparesis include:

1. Severe dehydration. Frequent vomiting could cause the extreme loss of bodily fluids.
2. Dietary deficiencies. Appetite loss and frequent vomiting might induce poor dietary consumption and thwart the ability to adequately absorb proteins, vitamins, and minerals.
3. Undigested food. Food that fails to digest in the stomach can harden into a solid mass known as a bezoar. Gastric bezoars may induce nausea and vomiting and could be fatal if they prevent food from passing into the small bowel.
4. Unpredictable blood sugar changes. While gastroparesis isn't a cause of diabetes, continual shifts in the rate and volume of food emptying into the bowels might lead to erratic blood glucose levels. Such fluctuations in blood glucose can negatively affect a diabetic condition, which in turn could worsen gastroparesis.
5. Diminished state of well-being. The negative impacts of gastroparesis might make it hard to perform daily tasks and complete other normal duties.

Diagnosing gastroparesis

GI physicians specialize in intestinal disorders, like gastroparesis. Along with reviewing a person's medical history and symptoms, a GI specialist will carry out a physical evaluation and most likely order blood tests, such as those designed to evaluate glucose levels. Further processes conducted to diagnose gastroparesis might include:

• Four-hour solid gastric emptying study: This test examines the length of time it requires for food to empty out of the stomach. Individuals eat a meal that contains a radioactive isotope. An image of the stomach is captured one minute following the consumption of the meal. Follow-up images are then taken at specific times to view how the food propels through the stomach and bowels.
• SmartPill™ motility testing system: The SmartPill is a miniature, digestible capsule that holds an electronic device. After the capsule is ingested and migrates down the GI tract, it forwards gastric information to a receiver attached to the patient. SmartPill records and monitors how fast food travels through the intestinal system.

How do GI specialists treat gastroparesis?

Gastroparesis is often a persistent intestinal disorder. Treatment typically doesn't cure gastroparesis but with proper care, it can often be controlled and managed. People with diabetes need to make a conscious effort to assess and maintain their blood sugar levels to reduce the issues with gastroparesis. Some people could benefit from medications, like:

• Erythromycin: This antibiotic medication elicits stomach movement and helps in propelling food through the gastric tract. Adverse effects are diarrhea and the chance of developing resistant bacteria if taking the antibiotic for a period of time.
• Antiemetics: These medications help manage stomach upset.
• Reglan: This type of medication triggers stomach muscle contractions to help propel food into the small intestine. It can also relieve nausea and vomiting. Additional side effects might be loose bowels and, rarely, a concerning nerve condition.

Certain patients may be good candidates for a surgical approach to address gastroparesis, like:

• Gastric electrical stimulation: A small apparatus referred to as a gastric stimulator is introduced into the abdomen. It contains two leads connected to the stomach muscles that deliver small electric shocks in an effort to help relieve the urge to vomit.
• Gastric bypass: During this procedure, a small pouch is developed from the top portion of the stomach. The small bowel is divided in half and bound directly to the small stomach pouch. A gastric bypass significantly curtails the quantity of food the patient can take in, and can be more effective for a person who is obese and diabetic than either medication or a gastric electrical stimulator.

Other types of gastroparesis treatments include:

• Jejunostomy/feeding tube: In a severe case of gastroparesis, a jejunostomy tube or feeding tube could be suitable. A plastic tube is surgically inserted through the abdomen into the small intestine. Typically, liquid nutrients are introduced into the tube, which directly enter the small bowel and ultimately the blood with greater speed. This approach to treating gastroparesis is often a short-term measure.
• IV Nutrition: This intravenous (parenteral) nutrition process enables nutrients to enter the bloodstream via a catheter placed in a blood vessel in the chest wall. Much like a jejunostomy tube, IV nutrition is a temporary option for treating severe gastroparesis conditions.
• POP: Peroral pyloromyotomy (POP) is a nonsurgical procedure during which a doctor places a thin, flexible instrument in the upper GI tract and into the stomach. The specialist then augments the pylorus, or the structure that aids in emptying the stomach, allowing gastric contents to move into the small intestine more readily.

Is there a special diet for gastroparesis?

According to the American College of Gastroenterology, a healthy diet is a pillar of treating gastroparesis and provides a natural approach to care. In addition, doctors may prescribe medication and carry out medical services to control symptoms of gastroparesis. However, these gastroparesis treatments work best if a specific diet is followed. This includes reducing the consumption of foods that can be difficult to digest, like fibrous and fatty foods. Following this type of diet will assist in easing digestion and decrease the risk of health issues resulting from gastroparesis.

In the event you are noticing signs of gastroparesis or complications related to a diagnosis of gastroparesis, we encourage you to set up a visit with an Indianapolis, IN gastrointestinal specialist near you immediately. Please call Indianapolis Gastroenterology and Hepatology today to arrange for an appointment.