Gastroparesis

In most cases the cause of gastroparesis cannot be found. Gastroparesis can affect anyone, but it’s more common in people with diabetes and is related to poor blood glucose control. Other underlying causes include hypothyroidism, viral infections, Parkinson’s disease, multiple sclerosis, and scleroderma.  Sometimes, it can be caused by damage to the nerve that controls stomach muscles.

Certain medications that can delay gastric emptying include narcotics, some antidepressants, some blood pressure medications and allergy medicines, drugs that treat intestinal muscle spasms, medicines to treat an overactive bladder, and some types of insulin. If you have been diagnosed with gastroparesis, these medicines can make your symptoms worse.

Gastroparesis symptoms vary widely and may include nausea, vomiting, abdominal bloating, belching, heartburn, and pain in the upper abdomen, feeling full quickly after eating small amounts of food, feeling full long after eating, poor appetite, changes in blood sugar levels, malnutrition due to poor absorption of nutrients from food, and more.

Gastroparesis is diagnosed through a combination of medical history and review of medications, current and past health problems and surgeries, physical exam, laboratory tests, imaging studies and endoscopic tests. Your Gastroenterology Associates of Brooklyn GI clinician may recommend one or more of these tests to diagnose gastroparesis:

• Gastric emptying scintigraphy – This is the most common test used to diagnose gastroparesis. It involves swallowing a small amount of a radioactive substance, followed by imaging scans to see how long it takes for the material to pass through your stomach and intestine.
• Upper Endoscopy – This is an examination of the inside of your stomach and intestine. It involves inserting a flexible tube with a camera into your digestive tract in order to look for any abnormalities.
• Ultrasound or CT scans – These imaging tests are used to look for abnormalities in the structure of your digestive system, such as blockages or narrowed portions.
• Blood tests – Doctors may order blood tests to check for nutrient deficiencies, such as iron or B12 deficiency, that could indicate gastroparesis. They will also be used if you show signs of dehydration or malnutrition, and to check your blood sugar levels.
• Breath, urine, and stool tests.

Treatment for gastroparesis varies depending on the cause and severity of your symptoms. For example, if you have poorly controlled diabetes, treatment is aimed at improving blood sugar control.

Gastroparesis is a chronic digestive disorder, which means that there is no cure. However, various treatments are available to help manage the symptoms of gastroparesis. The aim of these treatments is to reduce nausea and vomiting and improve digestion.

Medication: Prokinetic agents (metoclopramide), anti-emetic agents (ondansetron, domperidone), and antidepressants (amitriptyline) may be prescribed to reduce nausea and vomiting. Antispasmodic medications (hyoscyamine) may also be used to help reduce abdominal pain by calming stomach muscles.

Dietary adjustments: Eating frequent, small meals and avoiding high-fat and high fiber foods can help improve digestion. Chewing food thoroughly and drinking plenty of fluids are also important.

Surgery: Surgery is usually a last resort for people with severe gastroparesis who have not responded to other treatments. The most common type of surgery involves inserting an electrical stimulator around the stomach nerve to help relax the muscles.

Lifestyle changes: As part of treatment, it is important to minimize stress and practice good sleep hygiene. Regular exercise may also be beneficial in helping manage symptoms.

Counseling: Talking with a mental health professional can help with managing anxiety and depression associated with gastroparesis.