Learn a Few Things About Gastroparesis

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Have you ever heard of gastroparesis?

First of all, it’s pronounced gas-tro-pah-REE-sus, and it’s a digestive disorder fairly well-known to diabetics, who seem to be the majority of sufferers.

In simple terms, gastroparesis means that the ability of the stomach to crush and pulverize food and propel it into the small intestine has been compromised somehow. Literally translated, gastroparesis means “stomach paralysis,” and without stomach contractions, normal digestion can’t take place.

The American College of Gastroenterology listed several possible causes: infections, endocrine disorders, autoimmune conditions, neuromuscular disease, certain cancer treatments; certain medications, including narcotics and some antidepressants; eating disorders like anorexia nervosa and bulimia, and injury to the vagus nerve during surgery on the esophagus, stomach or duodenum.

When should you be concerned? One common symptom is feeling full shortly after you start a meal. Along with that, you might feel bloating, stomach pain, heartburn or nausea, and you might regurgitate undigested food several hours after a meal. There might also be lack of appetite and unintended weight loss. But such symptoms could have a variety of causes, not necessarily gastroparesis.

Diabetics get gastroparesis when high blood sugar levels damage the vagus nerve, the mechanism that tells your stomach muscles when to contract.

As the ACG pointed out, a number of diagnostic tools are available these days, including upper endoscopy, in which a thin tube with a camera attached is fed into the stomach via the throat. Another method is to have patients swallow a tiny amount of radioactive material, then watch how it empties from the stomach. New to doctors’ toolboxes is a wireless capsule called a SmartPill that transmits information about the intestine to a receiver worn around the patient’s waist. The test takes up to six hours, and the pill leaves the body within 72 hours.

If gastroparesis is diagnosed, the first thing to evaluate is the medications you are taking and whether they are contributing to the problem. Also, doctors will emphasize diet changes, such as fewer raw vegetables, less fiber and limits on fatty foods -- in general, patients have to watch out for foods that are hard to digest or they risk having undigested food form a mass in the stomach and cause a blockage.

Doctors are able to prescribe a few medications for gastroparesis, but use of the drugs is limited because of undesirable side effects and limited effectiveness, the ACG said. Patients suffering malnutrition or severe symptoms might be candidates for surgery, which calls for the placement of various tubes in the stomach. Meanwhile, researchers are looking into electrical gastric stimulation for problems with stomach contractions; it involves surgically or endoscopically attaching electrodes to the stomach wall to stimulate gastric emptying.

For more information on gastroparesis, see:

http://www.acg.gi.org/patients/gihealth/gastroparesis.asp

http://familydoctor.org/online/famdocen/home/common/digestive/disorders/965.html

Reviewed June 7, 2011
Edited by Alison Stanton

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Jennifer Jaff

The last sentence of this article is entirely inaccurate. Gastric electrical stimulation was approved by the FDA under a humanitarian device exemption in 2000. It has been in use for 11 years and there are a load of medical journal articles that support its use. Before patients go this route, there are several medications they should try including Reglan and erythromycin. In addition, although not FDA approved, some patients have had good luck with domperidone, which is available from Canada and elsewhere. Medication for nausea including Zofran and Phenergan may help, as well. There even are botox injections to the pylorus.

The key to gastroparesis is that it's not about fixing the stomach itself; it's about stimulating the vagus nerve. That's why a neurostimulator works so well for so many patients. We have done over 150 insurance appeals for the gastric electrical stimulator, which is covered by Medicare, United Healthcare, and many other plans.

June 24, 2011 - 4:46am

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Deborah Ross View Profile Send Message

We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.