What Is Gastroparesis?
Gastroparesis is a condition in which food stays in your stomach for a longer period than it should. You might hear your doctor call it delayed gastric emptying.
With gastroparesis, you may have:
- Heartburn or gastroesophageal reflux disease (GERD)
- Acid reflux
- Upset stomach
- Throwing up undigested food
- A feeling of fullness quickly when you eat
- Not getting enough nutrition
- Lack of appetite and weight loss
- Trouble controlling blood sugar
- Belly pain
Some people who have gastroparesis don't have any symptoms they can notice.
What is gastroparesis pain like?
If you have pain with gastroparesis, it's often in the upper belly area, around the stomach or intestines. It can be dull or sharp pain.
For most people, doctors can't figure out what brings on gastroparesis. They do know that it often affects women more than men.
Gastroparesis from diabetes
Diabetes is the most common known cause of gastroparesis. It can damage nerves—including the vagus nerve, which regulates your digestive system—and certain cells in your stomach.
Gastroparesis risk factors
Some things can make you more prone to getting gastroparesis, including:
- Injury to your vagus nerve from surgery
- A lack of thyroid hormone (hypothyroidism)
- Viral stomach infections (gastroenteritis)
- Medications such as narcotics and some antidepressants
- Parkinson's disease
- Multiple sclerosis
- Rare conditions such as amyloidosis (deposits of protein fibers in tissues and organs) and scleroderma (a connective tissue disorder that affects your skin, blood vessels, skeletal muscles, and internal organs)
Gastroparesis can result in some problems, including:
- Bacteria growth, if food stays in your stomach for too long and ferments
- Serious dehydration, if you can't keep fluids down
- A blockage of your small intestine, when food hardens into a solid lump called a bezoar and stops food from passing from your stomach
- Malnutrition, if your body can't get the nutrients it needs
- Rising blood sugar levels , when food finally leaves your stomach and enters your small intestine. Gastroparesis makes it harder to control your blood sugar
Gastroparesis can also affect your overall quality of life. The symptoms you have can make everyday life harder, and it can take longer for you to do things.
Your doctor will ask about your symptoms and medical history. They'll also do a physical exam. They may order tests including:
- Radioisotope gastric-emptying scan (gastric scintigraphy). Your doctor will give you food that contains a very small amount of something radioactive. Then, you lie under a scanning machine. If more than 10% of food is still in your stomach 4 hours after eating, you have gastroparesis.
- Blood tests. These can spot dehydration, malnutrition, infection, or blood sugar problems.
- Barium X-ray. You'll drink a liquid (barium), which coats your esophagus, stomach, and small intestine and shows up on an X-ray. This is also known as an upper gastrointestinal series or a barium swallow.
- Gastric emptying breath tests (13C-GEBTs). This is a nonradioactive test that measures how fast your stomach empties after you eat a meal that has a chemical element called the 13C isotope added to it.
- Gastric manometry. Your doctor passes a thin tube through your mouth and into your stomach to check electrical and muscular activity and to figure out how fast you're digesting.
- Electrogastrography. This measures electrical activity in your stomach using electrodes on your skin.
- The smart pill. You swallow a tiny electronic device that sends information about how fast it's traveling as it moves through your digestive system.
- Ultrasound. This imaging test uses sound waves to create pictures of your organs. Your doctor may use it to rule out other diseases.
- Upper endoscopy. Your doctor passes a thin tube called an endoscope down your esophagus to look at the lining of your stomach.
Depending on the cause, gastroparesis can be chronic, which means it lasts a long time. You can take steps to manage and control it.
Changes in diet for gastroparesis
Changing your eating habits is one of the best ways to control gastroparesis symptoms. You might try eating six small meals each day rather than three larger ones. This way, you have less food in your stomach and don't feel as full.
Have more liquids and low-residue foods, such as applesauce instead of whole apples. Drink plenty of water and fluids like low-fat broths, soups, juices, and sports drinks. Avoid high-fat foods, which can slow digestion, and high-fiber foods, which are harder to digest.
Make sure you're getting enough of the right nutrition. Your doctor might send you to a dietitian who can help you find foods you like that are easy to digest.
Don't lie down for 2 hours after you eat. Gravity can help your digestion and keep food or acid from traveling into your throat. Gentle exercise like walking can help you feel better.
Your doctor might give you medicines including:
- Drugs to stimulate your stomach muscles. You take metoclopramide (Reglan) before eating. It causes your stomach muscles to contract and move food along. It also helps with upset stomach and vomiting. Side effects include diarrhea, drowsiness, anxiety, and, rarely, a serious neurological disorder. Erythromycin is an antibiotic that also causes stomach contractions and helps move food out. Side effects include diarrhea and the growth of resistant bacteria if you take it for a long time.
- Antiemetics. These drugs—including diphenhydramine (Benadryl and others) and ondansetron (Zofran)—help control nausea. If the nausea and vomiting won't go away, prochlorperazine (Compro) may work.
Other treatments for gastroparesis
If you have diabetes, controlling your blood sugar levels will keep you from having serious problems.
Your doctor might need to give you a feeding tube or jejunostomy tube. They put it in through your belly and into your small intestine. To feed yourself, you'll put nutrients into the tube, and they'll go directly into your small intestine. This way, they skip your stomach and get into your bloodstream faster.
Your doctor can also inject botulinum toxin (such as Botox) into your pylorus, the valve from your stomach to your small intestine. This relaxes the valve, keeping it open for longer so your stomach can empty.
Electrical stimulation uses electrodes attached to your stomach wall to trigger stomach contractions.
In a procedure called per-oral pyloromyotomy, your doctor uses an endoscope to cut your pylorus valve so it's easier for your stomach to empty.
Although surgery can sometimes cause gastroparesis, patients who have obesity and diabetes might have gastric bypass surgery. Your doctor creates a small pouch from the top part of your stomach and attaches it to the lower end of your small intestine. This limits how much food you can eat.
If your case is severe, you might also need intravenous nutrition or parenteral nutrition, in which nutrients go straight into your bloodstream through a catheter in a vein in your chest. Doctors tend to use this for only a short time.
Doctors don't always know what causes gastroparesis, but diabetes is one common cause.
- If you have symptoms including nausea, throwing up undigested food, heartburn, and belly pain, let your doctor know so they can do tests to see whether you have gastroparesis.
- This condition is treated with drugs that stimulate your stomach muscles so food can more easily go through to your intestines. Your doctor may also suggest you take a medicine to calm your nausea and stop you from vomiting.
- Making some changes to the way you eat might help your gastroparesis. Drink plenty of fluids and have several smaller meals instead of two or three bigger ones. Make sure your food is nutritious.
How common is gastroparesis?
It's not a common disorder. Of 100,000 people, about 10 men and 40 women have gastroparesis. But the symptoms are very much like other kinds of gastrointestinal conditions (ones that affect your stomach and intestines). About one out of every four people in the U.S. have symptoms similar to gastroparesis.