What is gastroparesis?
Gastroparesis, which literally means slow or paralyzed stomach, is a disease in which the stomach cannot move food into the duodenum at the normal rate/pattern of speed or motility. The “rule of thumb” for stomach emptying is that half of a meal should be out of the stomach by one hour, and almost all food by two hours. In gastroparesis, a meal will literally stay in the stomach for hours, even overnight after an evening meal. This condition is seen in diabetics, but can also occur in patients with a history of stomach surgery, patients with a prior injury to the Vagus nerve and even patients with no major medical conditions at all. Sometimes, it is believed to be a post-infectious (or post-viral) phenomenon. The most common category of gastroparesis is “idiopathic,” meaning that there is no obvious cause for that patient’s delayed stomach emptying.
What are the symptoms of gastroparesis?
Symptoms of gastroparesis include epigastric/abdominal pain, nausea and vomiting. Patients often describe early satiety, which is feeling full very quickly after only eating a small amount. They also have a loss of appetite and may lose weight as a result. For patients with diabetes, they will have unpredictable and highly variable blood sugar control. Gastroparesis can mimic symptoms caused by GERD or ulcers.
How is gastroparesis diagnosed?
A careful history and physical exam are important parts to the diagnosis of gastroparesis. Evaluation of the motility patterns of the stomach are essential for an accurate diagnosis. This is done either via a nuclear medicine imaging test known as a gastric emptying study (typically this involves eating an egg with a special tracer in it), or via a newer modality called a SmartPill exam.
The SmartPill exam measures the pH, pressure and temperature as it travels through the GI tract, and in doing so can determine the speed of gastric transit. Endoscopy is also essential to exclude an anatomical cause of delayed stomach emptying, which could include a pyloric stenosis, gastric outlet obstruction, ulcer disease, or malignancy.
How is gastroparesis treated?
Treatment for gastroparesis is tailored to each patient, with the goal of choosing therapy that best matches each individual’s disease pattern and severity. Treatment often involves dietary and behavior modification to start with – eating smaller, more frequent meals as opposed to three traditional meals throughout the day.
Eating a lower fat diet also helps quite a bit. Medications can play an important role in getting the stomach to empty better, and endoscopic and surgical therapies are continually improving. There is also an implantable “gastric pacemaker” device available, known as an Enterra device.
Our experienced team of physicians and advanced practice providers at Associates in Gastroenterology can help you with your concerns,questions and management of all aspects of gastrointestinal and liver disease. We would love to be your gastroenterology practice. Please schedule an appointment either by calling us (719-635-7321) or by clicking here.
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