What Is Gastroparesis?

Overview

Gastroparesis is a long-term condition that causes food to take much longer to pass through the stomach than it normally should. This occurs because of damage to the nerves and muscles within the stomach. Management of gastroparesis may include dietary changes, medicines and other treatments. However, if left untreated, further complications may arise. Here is everything you need to know about gastroparesis. 

Types of gastroparesis

Diabetic gastroparesis

Those with diabetes are more likely to develop gastroparesis because fluctuating blood glucose levels can cause damage to the vagus nerve that runs through the digestive tract. Diabetic gastroparesis is relatively common in adults, with 13 people per every 1000 diagnosed with diabetes also having a diagnosis of gastroparesis. 

Idiopathic gastroparesis

This type of gastroparesis has no known cause. This means it is not related to diabetes, surgery, or any medication that may slow gastric emptying.¹

Post-surgical gastroparesis

Post-surgical gastroparesis may occur as a result of having surgery. Surgeries that increase the risk for gastroparesis include gastric bypass surgery, heart/lung transplants, and surgery for acid reflux (fundoplication).²

Causes of gastroparesis

Gastroparesis is present when there is a problem with the nerves and muscles within the stomach. There are various types of gastroparesis, all caused and exacerbated by other issues, for example, diabetes and surgery, which can result in damaged nerves and muscles.^5.6 Gastroparesis may also be caused by bacterial or viral infections. However, in many cases, gastroparesis has no known cause and is idiopathic in nature. 

Signs and symptoms of gastroparesis

Symptoms of gastroparesis may include:

• Feeling full quickly after eating 
• Nausea and vomiting
• Bloating
• Heartburn
• Abdominal discomfort or tummy pain
• Weight loss

Management and treatment for gastroparesis

Many management techniques for gastroparesis include changing the diet, such as: 

• Eating smaller, more frequent meals a day (rather than 3 large meals)
• Reducing the amount of insoluble fibre within your diet (insoluble fibre is found in foods like wheat bran, vegetables and whole grains) 
• Drinking liquid foods (for example, soups and smoothies) rather than eating solid foods. 
• In more severe cases, it may be necessary to provide the body with all the required nutrients via intravenous feeding (often a temporary solution to help individuals who are severely malnourished)

Additionally, medication may be prescribed to help to treat the symptoms like nausea and vomiting. Medicines, like metoclopramide and domperidone, may also be used to help decrease stomach emptying time. For those who have type 1 diabetes, insulin pumps may be given to help regulate blood glucose levels.

When nutritional therapy and medication do not work effectively, surgery alternatives may be required. Although surgery alternatives may help reduce symptoms and increase quality of life, there is still little research on the effectiveness of surgeries to help gastroparesis.³

Diagnosis of gastroparesis

If your doctor suspects gastroparesis, they may perform tests such as:

• Gastric scintigraphy –   when you are given a special meal (chicken or egg whites) which has been radiolabelled with a scannable marker to measure the time it takes for your body to digest food by tracking its movement through the digestive system
• Upper endoscopy –  when a thin, flexible tube attached with a camera at the end is passed through your mouth and into your intestines to determine whether there are any mechanical obstructions of the stomach and rule out any other problems
• Barium contrast radiography –  involves swallowing a white solution known as barium, which will cover your digestive tract and make it easier for your doctor to see any emptying delays within your stomach

Although there is no definitive way of diagnosing gastroparesis, a gastroparesis diagnosis is usually given after many different tests have been performed. The most commonly used test for gastroparesis is the gastric scintigraphy test.⁷ 

Risk factors

Gastroparesis is linked with many other medical conditions, including:^4,8

• Chronic pancreatitis – A long-standing condition affecting and damaging  the pancreas
• Irritable bowel syndrome –A disorder affecting our gastrointestinal tract, mainly the stomach and intestines 
• End-stage renal disease –Last stage of long-standing kidney disease
• Diabetes  

Although certain types of gastroparesis may not be prevented, it is important to seek help from your healthcare provider if you are experiencing signs of the condition. 

Complications

If gastroparesis is left untreated for an extended period, there can be a variety of further issues, such as:

• Dehydration and malnutrition
• Overgrowth of bacteria within the stomach
• Decreased quality of life 
• Blockages within the small intestines known as bezoars

FAQs

How common is gastroparesis?

In 2016, the prevalence of gastroparesis was 13.8 per 100,000 people.⁹ The most common type of gastroparesis is idiopathic gastroparesis, followed by diabetic gastroparesis, and lastly, post-surgery gastroparesis. 

How can I prevent gastroparesis?

Some types of gastroparesis (e.g., diabetic gastroparesis) may be prevented by long-term control of blood glucose levels. However, often, gastroparesis does not have a specific cause, and there is no effective prevention technique.

When should I see a doctor?

You should see your doctor when you are experiencing symptoms such as: 

• Feeling full quickly when eating
• Feeling nauseous and vomiting after eating 
• Bloating or heartburn for 3 weeks or longer 

Summary

Gastroparesis delays the emptying of food contents from the stomach. There are many types of gastroparesis, including idiopathic, diabetic, and post-surgery gastroparesis. Bloating, vomiting, feeling full quickly when eating, and abdominal pain are common symptoms experienced in all types of the condition. A thorough examination by your healthcare provider will help to diagnose gastroparesis and can rule out other causes, such as mechanical obstructions. It is important to treat the symptoms with one or a combination of methods, such as changing the diet, taking medication, and/or undergoing surgery. These will help to reduce the risk of further complications and ultimately improve your quality of life.