10 Facts About Gastroparesis You Should Know

Gastroparesis is a medical condition characterized by delayed gastric emptying, where the movement of food from the stomach to the small intestine is slowed or impaired. This can result in various gastrointestinal symptoms and potential complications. While the exact etiology may be unclear, it is often associated with other underlying diseases, disorders, or the use of certain medications. There are a variety of treatment options available that focus on managing symptoms and mitigating complications, enabling patients with gastroparesis to maintain a healthy quality of life.

1. Function of a Healthy Digestive System

In an optimally functioning gastrointestinal system, sustenance progresses through the digestive tract driven by involuntary muscular contractions known as peristalsis, which are regulated by the vagus nerve within the stomach. These rhythmic contractions facilitate the breakdown of food and its subsequent propulsion into the small intestine. Once there, the body efficiently absorbs nutrients, water, and electrolytes from the digested material into the bloodstream, ensuring proper nourishment and hydration.

2. Disrupted Digestion

Gastroparesis is a condition that impairs the normal digestive process due to inadequate gastric muscle contractions, leading to delayed gastric emptying into the small intestine. This can negatively affect nutrient absorption and cause various discomforting symptoms and potentially serious complications. Three primary forms of gastroparesis exist: idiopathic, diabetic, and postsurgical, with the idiopathic type being the most common yet having an unidentified cause.

3. Symptoms of Gastroparesis

Gastroparesis is often characterized by a spectrum of symptoms affecting the gastrointestinal system, including but not limited to nausea, vomiting, heartburn, abdominal pain, and difficulties with digestion. Patients with this condition may report feelings of bloating, early satiety, and discomfort after consuming small portions of food. These symptoms can lead to a reduced appetite, subsequent weight loss, dehydration, and nutritional deficiencies.

4. Potential Complications

Untreated gastroparesis can have severe consequences that require immediate medical intervention prior to addressing the underlying condition. Complications such as dehydration and malnutrition are prevalent due to the delayed gastric emptying. Additionally, food that remains too long in the stomach can ferment, leading to bacterial overgrowth. In rare cases, a bezoar may form from food that fails to digest, posing a risk of intestinal blockage. It is crucial to monitor and treat these complications early to prevent further health issues.

5. Comorbidities

Gastroparesis is often associated with a variety of comorbid conditions, particularly those related to the endocrine, nervous, and muscular systems, as well as connective tissue disorders. Notable comorbidities include hypothyroidism, scleroderma, and Parkinson's disease. The most common related condition is diabetes, which can lead to nerve damage. Specifically, gastroparesis symptoms emerge due to damage to the vagus nerve, which plays a crucial role in regulating the digestive system.

6. Diagnosing Gastroparesis

The initial step in diagnosing a suspected case of gastroparesis involves a comprehensive review of the patient's symptom history, including any previously identified ailments or disorders, recent surgeries, and current medications, coupled with a detailed physical examination. Should gastroparesis be considered likely by the examining physician, they will proceed to order a series of diagnostic tests. These tests are designed to assess the functionality and overall condition of the patient's digestive system, as well as to dismiss the possibility of other health issues or blockages that could be causing the symptoms.

7. Diagnostic Testing for Gastroparesis

Gastroparesis is typically diagnosed through definitive tests including a gastric emptying study and an upper endoscopy. The gastric emptying study involves the patient eating a meal that contains a trace amount of radioactive material, allowing a scanner to monitor the rate at which food moves from the stomach to the small intestine. Alternatively, an upper endoscopy entails the insertion of a slender tube equipped with a camera down the throat to visually inspect the esophagus, stomach, and upper portion of the small intestines for any irregularities or blockages. Additional diagnostic methods may encompass ultrasound and x-rays, as well as the use of motility capsules—electronic pills that capture and relay digestive information to a monitor after ingestion.

8. Treatment

Managing gastroparesis typically involves initially treating any underlying conditions. Healthcare professionals may advise discontinuing medications that exacerbate gastroparesis symptoms. If clinical symptoms continue, pharmacological or surgical interventions may become necessary. Surgery is generally considered only for patients who do not respond to medical management or those suffering from severe complications. Prokinetic agents such as antibiotics and dopamine-receptor antagonists are used to enhance gastric motility. Antiemetics can be prescribed to alleviate nausea and vomiting. Among the surgical options are the implantation of a gastric electrical stimulator, the placement of a jejunal feeding tube, or performing a gastrostomy to address more severe cases.

9. Diet and Eating Habits

Proper dietary management is crucial in mitigating the symptoms and averting complications associated with gastroparesis. Patients are advised to eliminate raw and fibrous fruits and vegetables, alongside foods that are rich in fat and fiber, to facilitate smoother digestion. Adequate hydration is beneficial for digestive health, so drinking ample water is recommended. Consuming smaller, well-chewed meals throughout the day can help alleviate the sensation of fullness and minimize digestive strain. Additionally, incorporating moderate post-meal exercise can promote gastric motility and support stomach emptying.

10. Living with Gastroparesis

Gastroparesis, when associated with an identifiable medical condition or medication, may improve significantly with targeted treatment of that underlying cause. Conversely, idiopathic gastroparesis is generally a persistent condition, with varying levels of treatment efficacy among patients. This condition can substantially disrupt everyday activities and contribute to significant social and emotional challenges. Nonetheless, with a tailored dietary plan, appropriate medications, and diligent medical care, the management of gastroparesis is achievable, enabling individuals to maintain a satisfactory quality of life.