Learning About Gastroparesis
What is it?
Gastroparesis is a disorder that slows or stops the flow of food
from your stomach into the small intestine. It's also called delayed
gastric emptying. It's caused by a problem with motility. This is
the movement of the muscles in the digestive tract.
For many people, gastroparesis is a lifelong health problem. But
treatment can help ease symptoms and prevent complications.
With treatment, most people can manage their symptoms and keep up
their normal routines. If your symptoms are moderate to severe, you
may need to see your doctor more often for checkups. If you have a
long-term (chronic) health problem that may be linked to
gastroparesis, such as diabetes, regular follow-ups are vital. These
can help keep track of your blood sugar control. This is key to
successfully managing both conditions. Also, other treatments will
likely be needed.
What causes it?
Gastroparesis can be caused by:
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Diabetes.
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Surgery of any of the digestive organs, such as the stomach and
intestines.
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Certain medicines, such as strong pain medicines (opioids) and
some antidepressants.
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An underactive thyroid (hypothyroidism).
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Central nervous system disorders, such as Parkinson disease and
multiple sclerosis.
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Some autoimmune diseases, such as systemic scleroderma.
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A viral stomach infection.
In many cases, the cause of gastroparesis may not be known.
What happens when you have gastroparesis?
With normal motility, signals from nerves tell the stomach muscles
when to contract. These muscles move food from the stomach into the
first part of the small intestine (the duodenum). With
gastroparesis, the nerves or muscles are damaged. This causes
motility to slow down or stop.
As a result, food can't move from the stomach as it should into the
small intestine. This delayed emptying can cause nausea, vomiting,
and other symptoms. Malnutrition can result. Hardened lumps of food
(bezoars) can form in the stomach and cause other problems as well.
Your doctor will ask about your symptoms and health history. You’ll
also be examined. In addition, blood tests and X-rays are often done
to check your health and rule out other problems. To confirm the
problem, you may need other tests as well, such as:
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Upper endoscopy. This is done to see inside the stomach and
duodenum. For the test, an endoscope is used. This is a thin,
flexible tube with a tiny camera on the end. It’s inserted through
the mouth and down into the stomach and duodenum.
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Upper gastrointestinal (GI) series. This is done to take
X-rays of the upper GI tract from the mouth to the small
intestine. For the test, a substance called barium is swallowed.
The barium coats the upper GI tract so that it will show up
clearly on X-rays.
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Radioisotope gastric-emptying scan. This is done to measure
how quickly food leaves the stomach. For the test, a meal
containing a harmless radioactive substance (tracer) is eaten.
Then scans of the stomach are done. The tracer shows up clearly on
the scans. It shows the movement of the food through the stomach.
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Gastric (antroduodenal) manometry. This test gives pressure
measurements of the stomach and small intestine. It checks how the
contractions are working.
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Wireless capsule study. For this test, you swallow a
wireless capsule. The capsule measures how well your stomach
empties and how fast food and fluids move through your intestines.
You'll pass the capsule out of your body with a bowel movement.
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Gastric emptying breath test. This test checks stomach
emptying. It measures how much carbon dioxide you breathe out over
several hours after eating food.
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Scintigraphic gastric accommodation. This test measures
your stomach contents before and after a meal. It also checks how
well your stomach relaxes after you eat food.
What are the symptoms?
These can include:
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Upset stomach (nausea) and vomiting.
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Feeling full quickly when eating.
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Belly pain.
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Heartburn.
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Belly bloating.
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Weight loss.
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Loss of appetite.
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High and low blood sugar levels (in people with diabetes).
How is it treated?
The goal of treatment is to help you manage your condition.
Treatment may include:
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Diet changes. You may need to make changes to your eating
habits and daily diet. For instance, your doctor may tell you to
eat small meals during the day. Doing this can keep you from
feeling full too quickly. You may be placed on a liquid or soft
diet. This means you’ll eat liquid foods or foods that are mashed
or put through a blender. Plus, you may need to stay away from
foods high in fats and fiber. These can slow digestion. For more
help with your diet, your doctor can refer you to a dietitian. In
severe cases, you may need a feeding tube. This sends liquid food
or medicine directly to your small intestine, bypassing the
stomach.
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Treating diabetes. If you have diabetes, it's important to
control your blood sugar. High sugar levels may make gastroparesis
worse.
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Medicines. These can help manage symptoms, such as nausea
and vomiting. They can also improve motility. Each medicine has
certain risks and side effects. Your doctor can tell you more
about any medicine that's prescribed for you. Also, if you're on
opioid pain relievers and certain other medicines, your doctor may
also advise stopping these if they're adding to your
gastroparesis.
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Surgery. You may need to have a tube surgically put into
your stomach. The tube removes excess air and fluid. This can ease
severe symptoms of nausea and vomiting. In rare cases, other
surgery may be needed on the stomach or small intestine. This is
to make a new passageway for food to be emptied from the stomach.
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Gastric electrical stimulation. This treatment is done less
often and may not be available. Your doctor can tell you more
about this treatment if it's a choice for you.
Current as of: October 19, 2024
Content Version: 14.6
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