Gastroparesis is a condition in which the walls of the stomach become partially paralyzed. Normally the stomach works to mix and propel food through the digestive tract without our ever having to think about it. The only time we really have to think about the functioning of our stomachs is when something has gone wrong and we don’t feel well. In patients with gastroparesis, the muscles that cause the stomach to empty don’t work properly, or they might be completely paralyzed, which prevents the stomach from emptying. When digestion is unable to take place, the patient may experience nausea, vomiting, and malnutrition.
The adult stomach can normally hold about a quart, but it can stretch to nearly gallon sized. It is lined with three muscle layers that create the movement of peristalsis. This action thoroughly mashes food and mixes it with powerful stomach enzymes and acids. After 3 to 4 hours the stomach should empty slowly through a valve that opens to the small intestine.
The vagus nerve goes from the brain stem through to the digestive tract and ends at the colon. The vagus nerve tells the muscles in the stomach to contract into peristaltic waves. When something goes wrong with the vagus nerve, the muscles of the stomach may become paralyzed. The vagus nerve can sustain damage through the course of certain disease processes and also as a result of surgeries to the GI tract from the esophagus to the stomach and small intestine.
Medications can cause temporary gastroparesis; if you have ever been constipated while taking pain medications such as Lortab, Darvocet-N, Dilaudid or Morphine, you have experienced this phenomenon. These drugs slow down the function of the stomach muscles, causing peristalsis to slow down or to become paralyzed temporarily. Often, patients taking chemotherapy and radiation have nausea, vomiting, constipation related to gastroparesis. However, diabetes is the most common cause of gastroparesis, because high sugar levels disrupt the nerve functions preventing the vagus nerve from sending impulses to the stomach. It is a vicious cycle: once the blood sugar levels are toxic enough to disrupt stomach function, the diabetes becomes worse and more out of control.
You might want to see your doctor if you have a history of diabetes or gastric surgery and you are experiencing bothersome heartburn, nausea, vomiting, and bloating when you are eating. It is normal for us to have some discomfort from time to time, but it isn’t normal to have these symptoms frequently. If your symptoms are interfering with your quality of life, then there is something that needs to be checked out. Don’t ignore your symptoms.
Your physician, if he/she suspects gastroparesis may order any number of tests to help confirm or rule out the diagnosis. One such test is called gastric emptying studies. This test consists of eating a small meal-eggs or oatmeal-that contains a prescribed amount of radioactive material. A scanner that acts similar to a Geiger counter scans the stomach at timed intervals to measure the amount of radioactive material left in the stomach. This is the preferred test to diagnose gastroparesis.
There are other tests the doctor may use to diagnose your condition. A gastroduodenal manometry is a test in which the doctor advances a tube down your throat into the stomach. The tube is pressure sensitive and is connected to a computer. The computer is able to monitor how your stomach behaves before and after you eat. Your doctor may also want to do a gastric endoscopy, in which he/she inserts a camera in a tube down into your stomach. This endoscopy examination is not to diagnose gastroparesis, but to rule out any other condition that may be causing your stomach to malfunction.
There is no cure for gastroparesis, however if you have an underlying condition, such as diabetes-keeping it under control could help relieve the gastroparesis. Making small changes to your lifestyle can help: eat smaller meals 5 or 6 times a day can relieve the discomfort. Fiber rich foods may need to be cooked-rather than eaten raw-to prevent bezoars, which are hard masses of indigestible fiber which can cause obstructions.
Patients with gastroparesis often do well on certain medications, such as anti-emetics that control nausea and vomiting. They also do well on meds that help to induce stomach contractions. These medications are usually ordered in liquid form because the pill forms do not absorb well. If you are having gastric problems, and nothing seems to be helping, be sure to talk with your physician. Your doctor may be able to give you advice on how to make changes to your lifestyle to help your stomach work better and feel better.
Source: Mayo Clinic information page
