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Gastroparesis

(Delayed Gastric Emptying)

Definition

Gastroparesis is a disorder that affects the digestive system. During normal digestion, the stomach breaks down food and then contracts to push food down to the small intestine. With gastroparesis, there is delayed emptying of the stomach. Food either moves slowly through the digestive tract or does not move at all. This can pose problems since the food can harden causing blockage, nausea, and vomiting. Bacteria can also start to grow. Gastroparesis is a potentially serious condition. It requires care from your doctor.
The Stomach and Intestines
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Causes

Movement of food in the digestive system is controlled by the vagus nerve. Gastroparesis occurs when this nerve is damaged and the muscles of the stomach do not work properly.

Risk Factors

The main risk factor is diabetes. Diabetes can damage the vagus nerve, which may lead to gastroparesis. High blood glucose can also damage blood vessels that carry nutrients and oxygen to the vagus nerve, preventing it from working properly. Other risk factors include:

Symptoms

Gastroparesis may cause:
The following may worsen symptoms:

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will also be done. The doctor may do:

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Diet

Managing what you eat can help control gastroparesis. You may work with your doctor or a registered dietitian to create a meal plan that is right for you. This may include:
  • Eating small meals several times throughout the day
  • Following a liquid diet
  • Limiting high-fat and high-fiber foods

Alternative Nutrition

In severe cases, nutrients can be delivered to the body by going directly into the intestines or bloodstream. These methods bypass the stomach. Access to the intestines can be done with a tube that goes down the throat or through an opening in the abdominal wall. A tube in the vein can access the bloodstream.

Medications

You may be given medications to treat the symptoms and help the stomach with emptying. These medications work by stimulating the stomach muscles to contract. Examples include:
  • Metoclopramide
  • Erythromycin
Other medications may be prescribed to reduce nausea.

Surgery

In severe cases, your doctor may consider surgery. This may include removing part of the stomach.

Prevention

To help reduce your chance of gastroparesis:

RESOURCES

American College of Gastroenterology http://patients.gi.org

American Gastroenterological Association http://www.gastro.org

CANADIAN RESOURCES

Canadian Association of Gastroenterology https://www.cag-acg.org

Health Canada http://www.hc-sc.gc.ca

References

Gastroparesis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 29, 2010. Accessed April 4, 2011.

Gastroparesis. American College of Gastroenterology website. Available at: http://patients.gi.org/topics/gastroparesis. Accessed April 4, 2011.

Gastroparesis. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/gastroparesis/Pages/facts.aspx. Updated July 2007. Accessed April 4, 2011.

Shakil A, Church RJ, Rao SS. Gastrointestinal complications of diabetes. Am Fam Physician. 2008;77(12):1697-1702.

Soykan I, Sivri B, Sarosiek I, Kiernan B, McCallum RW. Demography, clinical characteristics, psychological and abuse profiles, treatment, and long-term follow-up of patients with gastroparesis. Dig Dis Sci. 1998;43(11):2398-2404.

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