Although Stacy weighed just 117 pounds, she was a big eater. When she started feeling full after just a few bites of her favorite burger, she stuck the sandwich in a bag and finished it later. However, she eventually ended up in a physician’s office due to repeated bloating, nausea, vomiting, and a loss of appetite. The doctor diagnosed her as suffering from gastroparesis.
What is Gastroparesis?
It’s a condition that occurs when the stomach takes too long to empty its contents, according to the National Digestive Diseases Information Clearinghouse (NDDIC). In patients without this disorder, the stomach contracts regularly to push food into the small intestine as part of the digestive process.
The engineer for the movement of any food through a patient’s digestive tract is the vagus nerve. When this nerve undergoes damage, the muscles located in the stomach and intestines can’t work properly. Any food that’s been swallowed either stops moving or moves too slowly through the digestive tract.
Although diabetes is the most common cause of gastroparesis, the Mayo Clinic indicates that there are a number of other causes and risk factors. Among them are certain types of abdominal surgery, medications like narcotic pain killers and antidepressants, and specific cancer treatments. Patients with anorexia, bulimia, scleroderma, Parkinson’s disease, or hypothyroidism are at an elevated risk for developing this disorder.
Treatment for gastroparesis starts with isolating and then treating the medical condition that caused the problem. Often treatment involves significant dietary changes. Severe cases might require the use of a temporary feeding tube to make sure the patient receives adequate nutrition. A number of medications are available to regulate the speed with which food gets pushed through the digestive process.
How Do Doctors Diagnose Gastroparesis?
The NDDIC reports that diagnosis begins with a complete physical exam and medical history, usually followed by several blood tests to check electrolyte and other levels. Doctors might order any of six procedures – or a combination of them – before diagnosing gastroparesis.
The following procedures can help rule out an intestinal obstruction or other problems in the digestive tract:
Upper endoscopy. After light sedation, the physician passes an endoscope through the patient’s mouth, down the esophagus, and into the stomach. The purpose is to check for any abnormalities in the stomach.
Ultrasound. Sound waves define the shape of various internal organs. Doctors use ultrasound to rule out gallbladder disease and pancreatitis.
Barium studies. This fasting test requires a patient to swallow a thick drink containing barium. It allows a radiologist to visualize the stomach and note whether any food is still in it, a suggestion that gastroparesis is probable. In some cases, it’s necessary to repeat the procedure to check for problems with stomach emptying time.
Once a physician has ruled out causes other than gastroparesis, the following emptying tests can confirm the disorder:
Gastric emptying scintigraphy. Patients first eat a bland meal containing a small amount of a radioisotope, a substance that’s visible on scans. Scans capture the rate of gastric emptying at various points after eating. Doctors diagnose gastroparesis when more than 10 percent of the food consumed remains in the patient’s stomach 4 hours after eating.
Breath test. After eating a meal containing a small amount of an isotope, patients provide breath samples. Medical personnel measure the presence of the isotope in the carbon dioxide the patient exhales in order to calculate how fast his or her stomach is emptying.
SmartPill. Wearing a small receiver, the patient swallows a SmartPill, a small capsule that collects information as it moves through the digestive tract. Once the capsule exits the body, the patient returns the receiver to the physician. The information from the receiver goes into a computer, where it’s analyzed.
For many patients, the most difficult part of having this disorder is undergoing what can be a lengthy process to rule out other conditions and to get a clear diagnosis. In most cases, the specialist who diagnoses patients with gastroparesis is a gastroenterologist.
Sources:
http://digestive.niddk.nih.gov/ddiseases/pubs/gastroparesis/#complications
http://www.mayoclinic.com/health/gastroparesis/DS00612
