Overview

Gastroparesis literally translated means “stomach paralysis”. Gastroparesis is a digestive disorder in which the motility of the stomach is either abnormal or absent. In healthy people, when the stomach is functioning normally, contractions of the stomach help to crush ingested food and then propel the pulverized food into the small intestine where further digestion and absorption of nutrients occurs. When the condition of gastroparesis is present the stomach is unable to contract normally, and therefore cannot crush food nor propel food into the small intestine properly. Normal digestion may not occur.

Symptoms

Symptoms of gastroparesis include bloating, nausea/vomiting, early fullness while eating meals, heartburn, and upper abdominal pain. A person with gastroparesis may regurgitate or vomit undigested food many hours after their last meal. Weight loss can occur due to poor absorption of nutrients or taking in too few calories.

Causes

There are many causes of gastroparesis. Diabetes is one of the most common causes for gastroparesis. Other causes include infections, endocrine disorders like hypothyroidism, connective tissue disorders like scleroderma, autoimmune conditions, neuromuscular diseases, idiopathic (unknown) causes, psychological conditions, eating disorders, certain cancers, radiation treatment applied over the chest or abdomen, some chemotherapy agents, and surgery of the upper intestinal tract.  Gastroparesis can also be caused by certain drugs which slow down gastric emptying including opiods (pain medications).

Diagnosis

Medications that cause slow emptying should typically be stopped, and reversible conditions (example: hypothyroid) treated prior to testing. Radiographic tests, endoscopic procedures, and motility tests are used to exclude obstruction, to view the stomach lining and obtain biopsies, and to examine muscle contraction patterns. After upper endoscopy, the most widely used test is a gastric emptying study which determines the rate of emptying of solid and liquid material from the stomach.

Treatment

Diet is one of the mainstays of treatment for those who suffer from gastroparesis as some foods are more difficult than others to digest. Fatty foods take a longer time to digest, as do foods that are fibrous, like raw vegetables. People with gastroparesis should reduce their intake of fiber or avoid completely. Fortunately, thick and thin liquids (e.g. pudding and nutrient drinks) are usually tolerated and can pass through the stomach. Many people with gastroparesis can live a relatively normal life with the aid of supplemental nutritional drinks, soft foods the consistency of pudding and by pureeing solid food in a blender. Occasionally, feeding tubes must be placed in severe cases.  There are also medications available that stimulate contraction of the stomach which leads to improvement in gastric emptying.  Additionally, refractory patients are sometimes candidates for gastric electrical stimulation which uses surgically implants electrodes to trigger stomach contractions.