Delayed Gastric Emptying

Delayed gastric emptying, also known as gastroparesis, is a medical condition where the stomach takes too long to empty its contents into the small intestine. This can lead to various symptoms and complications.

Causes

The exact cause of delayed gastric emptying is often unknown, but it can be associated with several factors, including:

• Diabetes: High blood sugar levels can damage the nerves that control stomach muscles, leading to delayed gastric emptying.
• Surgery: Certain surgeries, such as gastrectomy or fundoplication, can disrupt the normal functioning of the stomach and lead to delayed gastric emptying.
• Medications: Some medications, such as anticholinergics and narcotics, can slow down stomach contractions and contribute to delayed gastric emptying.
• Infections: Viral or bacterial infections, such as gastroenteritis, can cause inflammation and damage to the stomach lining, leading to delayed gastric emptying.
• Neurological disorders: Conditions like Parkinson's disease, multiple sclerosis, and amyotrophic lateral sclerosis (ALS) can affect the nerves that control stomach muscles and lead to delayed gastric emptying.

Symptoms

The symptoms of delayed gastric emptying can vary in severity and may include:

• Nausea and vomiting: Undigested food can be regurgitated, leading to nausea and vomiting.
• Bloating and discomfort: The stomach may feel full or bloated, leading to discomfort and pain.
• Abdominal pain: Pain in the upper abdomen can occur due to delayed gastric emptying.
• Weight loss: Malnutrition and weight loss can occur if the body is not able to absorb nutrients properly.
• Fatigue: Delayed gastric emptying can lead to fatigue, as the body may not be getting the necessary nutrients.

Diagnosis

The diagnosis of delayed gastric emptying typically involves a combination of medical history, physical examination, and diagnostic tests, including:

• Upper endoscopy: A flexible tube with a camera is inserted through the mouth to visualize the upper digestive tract.
• Barium swallow: A liquid containing barium is swallowed, and X-rays are taken to visualize the stomach and small intestine.
• Gastric emptying study: A radioactive substance is ingested, and a special camera takes images of the stomach to measure the rate of gastric emptying.

Treatment

The treatment of delayed gastric emptying depends on the underlying cause and may include:

• Dietary changes: Eating smaller, more frequent meals can help manage symptoms.
• Medications: Medications such as metoclopramide and domperidone can help stimulate stomach contractions and improve gastric emptying.
• Gastrointestinal prokinetics: These medications can help regulate stomach motility and improve gastric emptying.
• Surgery: In some cases, surgery may be necessary to relieve symptoms or treat underlying conditions.

Complications

If left untreated, delayed gastric emptying can lead to several complications, including:

• Malnutrition: Delayed gastric emptying can lead to malabsorption of nutrients, resulting in malnutrition and weight loss.
• Electrolyte imbalance: Vomiting and diarrhea can lead to electrolyte imbalances, which can be life-threatening if not treated promptly.
• Gastroesophageal reflux disease (GERD): Delayed gastric emptying can increase the risk of developing GERD, a condition characterized by stomach acid flowing back into the esophagus.