Gastroparesis: Symptoms, Causes and Treatment

Gastroparesis is a health hazard that arises on account of food remaining within the gastrointestinal tract for longer than the normal period of time. Under normal circumstances, the stomach muscles contract incessantly, to move the ingested food forward, along the small intestine. This movement is controlled by the vagus nerve, which when damaged results in the onslaught of Gastroparesis. When the normal function of the vagus nerve is hampered, the stomach muscles and intestines are not able digest ingested food as quickly as required. The food moves slowly down the gastrointestinal tract, or at times, even stops moving, preventing effective absorption of nutrients and defecation of undigested food. This stagnation also triggers erratic blood sugar levels and hampers nutrition.

Causes

Gastroparesis is either chronic or transient, depending on the trigger factor. This medical condition is the result of the body's reaction to certain cancer treatments, drugs, anorexia nervosa, abnormal eating patterns and bulimia. The condition is also observed in diabetics and victims of autoimmune syndromes such as Parkinson's disease and fibromyalgia. Chronic gastroparesis is also on record as the aftermath of abdominal surgery and acute viral infection.

Symptoms

Gastroparesis signs and symptoms include:

• Nausea and vomiting.
• Heartburn.
• Early satiety leading to weight loss.
• Bloating and puffiness of the abdominal muscles.
• Increased blood glucose levels.
• Gastroesophageal reflux.
• Stomach cramps and spasms.

Diagnosis and Treatment

The diagnostic measures include upper endoscopy, under the influence of a sedative. The endoscope is inserted through the mouth and guided down the esophagus, into the abdomen. In an ultrasound, sound waves help to rule out gallbladder disease and pancreatitis, before defining the shape of the abdominal organs and the extent of damage. In the Barium X-ray method, the oral consumption of barium coats the stomach, highlighting the infected area on the subsequent X-ray. Gastric emptying scintigraphy involves the oral consumption of a radioisotope, while the SmartPill method involves the swallowing of a small device in a capsule. Both these diagnostic measures help the doctor to identify the abdominal region of concern and extent of vagus nerve damage. This condition is also diagnosed with any one, or a combination of X-rays and manometry.

The treatment options usually include:

• Dietary changes to include low-fiber meal components and restrictions on fatty foods.
• Oral medication such as Erythromycin, Metoclopramide, Cisapride and Domperidone.
• Insulin dosage for diabetics.
• Gastric neurostimulator implants.

The stagnation or fermentation of undigested food in the stomach creates the right environ for bacterial overgrowth. This causes the ingested food to harden into bezoars or solid masses. The resultant obstruction in the stomach blocks the passage of food components into the small intestine. Since gastroparesis results in unpredictable defecation and nutrient absorption, blood glucose levels become difficult to control. Gastroparesis, if neglected, could trigger life-threatening fluctuations in blood glucose levels and malnutrition. The onslaught of fatigue and weight loss take a toll on the quality of life. This delayed gastric emptying disorder needs to be addressed in time, and most importantly, treated with the right diet. Diabetes has been observed as a potent trigger. It is very important for diabetics to monitor the blood glucose count regularly and address any abnormality immediately. There are cases of idiopathic gastroparesis, where the cause of the condition remains unknown even after diagnostic tests.