Gastroparesis

Gastroparesis is a medical condition that affects the normal spontaneous movement of the muscles (motility) in your stomach. Normally, strong muscular contractions propel food through your digestive tract. In gastroparesis, the motility is slowed down or doesn't work at all, preventing your stomach from emptying properly.

Causes and Risk Factors

Gastroparesis can be caused by various factors, including:

• Diabetes: High blood sugar levels over a long period can damage the nerves that control digestion, leading to gastroparesis.
• Surgery: Certain surgeries, such as gastric bypass surgery or vagotomy, can damage the stomach muscles or the nerves that control them.
• Infections: Viral infections, such as gastroenteritis, can cause gastroparesis.
• Medications: Certain medications, such as anticholinergics and narcotics, can slow down or stop the stomach muscles from working properly.
• Neurological disorders: Conditions like Parkinson's disease, multiple sclerosis, and amyloidosis can affect the nerves that control digestion.
• (Idiopathic: In some cases, the cause of gastroparesis is unknown (idiopathic).

Symptoms

The symptoms of gastroparesis may include:

• Nausea and vomiting: Food stays in the stomach for too long, leading to nausea and vomiting.
• Bloating and discomfort: The stomach feels full and uncomfortable after eating.
• Abdominal pain: Pain or cramping in the abdomen, especially after eating.
• Weight loss: Malnutrition due to poor digestion and absorption of nutrients.
• Fatigue: Feeling tired or weak due to malnutrition and dehydration.

Diagnosis

Gastroparesis is diagnosed using the following tests:

• Upper endoscopy: A flexible tube with a camera is inserted through the mouth to visualize the stomach and small intestine.
• Barium swallow: A special liquid (barium) is swallowed, and X-rays are taken to show the movement of food through the digestive tract.
• Gastric emptying study: A small amount of radioactive material is eaten, and a special camera takes pictures of the stomach to measure how quickly food empties from it.
• Electrogastrography (EGG): A test that measures the electrical activity of the stomach muscles.

Treatment

Treatment for gastroparesis depends on the underlying cause and severity of symptoms. It may include:

• Dietary changes: Eating smaller, more frequent meals; avoiding fatty or high-fiber foods; and choosing foods that are easy to digest.
• Medications: Medications such as metoclopramide, domperidone, and erythromycin can help stimulate stomach motility and relieve symptoms.
• Gastrointestinal prokinetic agents: Medications that help move food through the digestive tract.
• Anti-nausea medications: Medications to control nausea and vomiting.
• Surgery: In severe cases, surgery may be necessary to implant a device that helps stimulate stomach motility or to perform a procedure called gastric electrical stimulation.

Complications

If left untreated, gastroparesis can lead to complications such as:

• Malnutrition: Poor digestion and absorption of nutrients can lead to malnutrition and weight loss.
• Dehydration: Vomiting can cause dehydration and electrolyte imbalances.
• Bacterial overgrowth: Food that stays in the stomach for too long can ferment, leading to bacterial overgrowth and further digestive problems.
• Bezoars: A mass of food that accumulates in the stomach and fails to pass into the small intestine.