Topic Overview
What is gastroparesis?
Gastroparesis is a disorder in which the stomach requires
significantly more than its normal 1½ to 2 hours to empty. The delay results in
bothersome and possibly serious symptoms because digestion is altered.
What causes gastroparesis?
Gastroparesis occurs when the nerves to the stomach are damaged
or don't work.
Diabetes is the most common cause. Other causes
include some disorders of the nervous system, such as
Parkinson's disease and
stroke, and some medicines, such as tricyclic
antidepressants,
calcium channel blockers, and
narcotics.
What are the symptoms?
Symptoms are intermittent and most often occur during and after a
meal. They include:
- A feeling of fullness after only a few bites
of food.
- Frequent bloated feeling.
- Belching and
hiccups.
- Heartburn or vague stomach pain.
- Nausea or
vomiting.
- Loss of appetite and weight loss.
Symptoms range from mild to severe. Severe symptoms of
gastroparesis may improve with treatment using medicines that help the
stomach empty more quickly (motility agents). In very severe cases, a feeding
tube placed in the small intestine may be needed.
A person with gastroparesis also may have episodes of high and
low blood sugar levels. Gastroparesis may be suspected in a person with
diabetes who has upper digestive tract symptoms or has blood sugar levels that
are difficult to control. Controlling blood sugar levels may decrease symptoms
of gastroparesis.
How is gastroparesis diagnosed?
A diagnosis is confirmed with one or more tests that indicate how
quickly food leaves your stomach, including a radioisotope gastric emptying
scan. For these tests, you will drink a fluid or eat some food containing a
slightly radioactive substance. This substance shows up on a special image,
allowing a doctor to see food in your stomach and watch how quickly it leaves
your stomach.
How is it treated?
Treatment for
gastroparesis depends on the severity of the condition
and may include:
- Eating several small meals each day rather
than three larger meals.
- Eating meals that are low in fibre and
fat.
- Medicine to help the stomach empty more quickly (motility
agents), such as metoclopramide , domperidone (available in Canada and Europe), or erythromycin. Erythromycin is an antibiotic, but it can also help
the stomach empty more quickly.
- Surgery to place a feeding tube in
the small intestine, if gastroparesis is severe.