The word ‘gastro’ means stomach, and ‘paresis’ refers to partial paralysis of muscles, so gastroparesis is a disease in which the normal functioning of your stomach muscles gets affected. The stomach structure contains smooth muscle tissues that play a role in emptying the stomach during digestion. If these muscles do not function normally, the digestive contents stay inside the stomach for a longer duration which can cause pain, nausea, vomiting, and other associated symptoms. Gastroparesis cannot be cured, but it can be managed with medications and lifestyle modifications.
One of the major reasons for gastroparesis is an injury to your vagus nerve. The vagus nerve transmits signals from your brain to the digestive tract. These signals are responsible for the normal contraction of your gastrointestinal muscles for proper digestion. Damage to the vagus nerve can result in impaired or delayed signals which causes gastroparesis. Diabetes is considered an important causative factor of gastroparesis as it can damage the vagus nerve.
Gastroparesis can also occur as a post-surgical complication if your vagus nerve gets damaged during the procedure. Many cases of this disease are also idiopathic, which means that no apparent cause can be identified. Other factors that may lead to gastroparesis include medications such as pain killers and antidepressants, viral infections, pregnancy, hypothyroidism, amyloidosis, and connective tissue diseases. Brainstem stroke and hypokalemia (low potassium level) are considered life-threatening causes of gastroparesis.
Risk factors of gastroparesis are linked with its underlying causes. People with uncontrolled diabetes are at the highest risk. History of an esophageal or abdominal surgery such as gastrectomy is another risk factor. The use of medications that affect the emptying rate of the stomach can also cause this condition. These medications include narcotics and antidepressants. Neurological diseases such as Parkinson’s disease or connective tissue diseases such as scleroderma can also put you at risk.
Although gastroparesis can occur at any age, its incidence has been higher among old age people over the age of 60. This can be attributed to the higher prevalence of diabetes and the usage of medications. Gastroparesis is more predominant among females than males.
The signs and symptoms of gastroparesis can vary depending on your age and the severity of disease. Many people with mild gastroparesis do not develop any noticeable symptoms. If the disease has progressed to a moderate or severe stage, you may notice different symptoms related to your digestive tract. The most common symptoms are abdominal pain, discomfort after eating, nausea, vomiting, and bloating. Nausea or vomiting can occur even after eating a small portion of the meal. You will have a feeling of fullness even after eating less than usual. Acid reflux is another common issue that can present as heartburn. These symptoms can also lead to loss of appetite and malnutrition, resulting in gradual weight loss.
History and a brief physical examination are made at the beginning of the diagnostic process. If you have known diabetes, mention it to your doctor along with your current medications. Gastroparesis is diagnosed on the basis of multiple tests. A standard diagnostic approach is known as scintigraphy. You are given a light meal tagged with a small amount of radioactive material in this test. A device is used to visualize the movement of that radioactive material through your digestive tract to monitor its rate of emptying. A similar test can also involve ingestion of a SmartPill that contains a small electronic device. Other diagnostic techniques include breath tests, abdominal ultrasound, and upper GI endoscopy.
The symptoms of gastroparesis resemble many other diseases, so it needs to be differentiated based on history and diagnostic tests. Differentials include gastric infections, gastroesophageal reflux disease, anorexia nervosa, bulimia nervosa, functional dyspepsia, rumination syndrome, cyclic vomiting syndrome, pancreatitis, gastric obstruction, and a few other neurological illnesses.
Treatment of gastroparesis begins with a diagnosis of the underlying cause. If diabetes is the main reason, your doctor will advise medications and lifestyle changes to maintain a controlled blood sugar level. Majority of the cases of gastroparesis are managed by dietary modifications. You can be referred to a dietician in this case who can prepare a dietary plan for you according to your condition. The dietician will also advise a few lifestyle modifications to ease digestion. These include eating in smaller bites, eating cooked fruits and vegetables instead of raw ones, intake of low-fat foods, increasing intake of liquid or semi-liquid foods, avoiding greasy food and carbonated drinks, etc. Following a proper diet plan and relative guidance can help in the long-term management of this condition.
Medications are only required in moderate to severe cases. These may include prokinetics (such as metoclopramide), anti-emetics (such as diphenhydramine), and antibiotics (such as erythromycin). A newer medication known as domperidone has been noticed to be effective in some cases.
The prognosis of this disease depends on its underlying cause. Viral gastroparesis can be managed well over time. Among all other causes, diabetic gastroparesis has the worst prognosis. The risk of complications is higher in cases of uncontrolled diabetes.
Gastroparesis can be prevented by avoidance and management of its possible causes. If you have a family history of diabetes, lower the intake of processed sugars and monitor your blood sugar levels. Known diabetic patients should follow management guidelines as advised by their doctors. Maintain a balanced diet, drink plenty of water, and exercise regularly to achieve optimum health.
Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on April 28th, 2023.