Gastroparesis

When our stomachs perform normally, the muscles within them contract strongly to push food into the digestive tract. However, in nearly 50 out of 100,000 people, the muscles do not work properly, causing food to move slowly into the small intestine or to remain in the stomach for too long. This condition is called gastroparesis or delayed gastric emptying.

Gastroparesis tends to occur more in women than men – at a ratio of four to one – and its symptoms replicate those of other conditions. In fact, one in four adults experience symptoms similar to those of gastroparesis.

These may include:

  • Nausea and vomiting (especially undigested food)
  • Abdominal bloating
  • Belly pain
  • Feeling full even after eating just a few bites
  • Acid reflux or heartburn (GERD)
  • Changes in blood sugar levels
  • Lack of appetite and weight loss.

After a physical exam and review of medical history, your doctor may want to perform any of the following tests to rule out other conditions:

  • Blood tests– These tests detect dehydration, malnutrition, infection, or blood sugar issues.
  • Imaging tests (upper GI series) –The patient ingests a barium mixture to coat and silhouette the esophagus, stomach, and upper intestine for X-rays. The doctor may also perform an ultrasound, MRI or CT scan (more specialized X-rays).
  • Gastric-emptying scan (scintigraphy)– The patient is given a meal with a tiny amount of radioactive material and is then scanned by a radiologist to time how long food remains in the stomach.
  • Gastric-emptying breath test –The patient eats a meal containing a substance that is absorbed by the intestine and released in the breath. The patient’s breath is tested a few hours later to reveal how fast the contents emptied the stomach.
  • Wireless capsule (the SmartPill) – The patient swallows a tiny electronic device that sends information to a computer as it travels through the digestive system.
  • Upper endoscopy – A thin, flexible tube (endoscope) equipped with a camera is passed through the patient’s esophagus to examine the stomach lining.
  • Gastric manometry –A thin tube is fed into the patient’s stomach to check electrical and muscular activity as well as digestion speed.

Often, treating gastroparesis requires treating an underlying condition. A change in diet can ease symptoms, and your doctor may prescribe medications to stimulate the stomach muscles.

Other treatments include:

  • Electrical stimulation– Electrodes attached to the stomach send impulses to trigger muscle contractions.
  • Internal feeding tube (jejunostomy) – A tube, called a jejunum, is inserted into the small intestine through the skin of the abdomen. The patient takes nutrients through the tube, bypassing the stomach. Temporary feeding tubes, through the mouth or stomach, may also be prescribed.
  • Intravenous (parenteral) nutrition – In severe cases, nutrition is fed directly into the bloodstream through a catheter.

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