If you have this condition, damaged nerves and muscles don’t work with their usual strength and coordination – slowing the movement of materials through your digestive system. This is a common condition in people who have had diabetes for a long time, but it can occur in other conditions as well. Gastroparesis can be misdiagnosed and is sometimes mistaken for ulcers, heartburn, or allergic reactions. In people without diabetes, the condition may be related to acid reflux. Gastroparesis can interfere with normal digestion and can cause nausea, vomiting, and abdominal pain. It can also become problematic for people with blood sugar levels and nutrition. Although there is no cure for gastroparesis, changes in your diet, along with medication, may provide some relief.
Causes of Gastroparesis
Gastroparesis causes due to nerve injury, including damage to your vagus nerve. In its normal state, the vagus nerve contracts (tightens) the muscles in your stomach to help move food through your digestive tract. In cases of gastroparesis, diabetes causes damage to your vagus nerve. This prevents the muscles in your stomach and intestines from working properly, which prevents food from moving from your stomach to your intestines.
Abdominal anatomy
Other causes of gastroparesis include:
- Viral infections.
- Gastric (stomach) surgery with injury to your vagus nerve.
- Medicines such as narcotics and some antidepressants.
- Amyloidosis deposits protein fibers in tissues and organs and scleroderma is a connective tissue disorder that affects your skin, blood vessels, skeletal muscles, and internal organs.
Symptoms of Gastroparesis
Signs and symptoms of gastroparesis include:
- vomit
- Nausea
- Flatulence
- Stomach pain
- Feeling fullness after eating a few bites
- Undigested food is eaten a few hours before.
- Acid reflux
- Changes in blood sugar levels
- Loss of appetite
- Weight loss and malnutrition
Many people with gastroparesis have no noticeable signs and symptoms.
Gastroparesis Complications
Problems can be:
- When you can’t keep fluids down, you can become dehydrated.
- If your body can’t get the nutrients it needs, you can become malnourished.
- If food stays in your stomach too long and ferments, that can lead to bacterial overgrowth.
- When food hardens into a solid lump, it is called a bezoar. This can prevent food from moving into your small intestine.
- If you have diabetes. Your blood sugar level can rise as food leaves your stomach and enters your small intestine. Gastroparesis makes it difficult for you to control your blood sugar.
Diagnosis of Gastroparesis
Doctors diagnose gastroparesis based on your medical history, physical exam, symptoms, and medical tests. Your doctor may also perform medical tests to look for signs of gastrointestinal complications and to rule out other health problems that may be causing your symptoms.
Medical history
Your doctor will ask about your medical history. He or she will ask for details about your current symptoms and medications, and current and past health problems such as diabetes, scleroderma NIH external link, nervous system NIH external link disorders, and hypothyroidism.
Your doctor may also ask about this.
- Types of medications you are taking. Be sure to tell your doctor about all prescription drugs, over-the-counter medications, and dietary supplements NIH external link you are taking.
- Whether you have had the esophageal, stomach, or small bowel surgery.
- Whether you’ve had radiation therapy to your chest or abdomen NIH external link.
Physical examination
During a physical exam, your doctor will
- Check your blood pressure, temperature, and heart rate
- Check for signs of dehydration and malnutrition.
- Check your belly for unusual sounds, tenderness, or pain.
Treatment of Gastroparesis
Treatment for gastroparesis begins with identifying and treating the underlying condition. If diabetes is causing your indigestion, your doctor can help you manage it.
Changes in your diet
Maintaining proper nutrition is the most important goal in treating gastroparesis. Many people can manage gastroparesis through dietary changes. Your doctor can refer you to a dietitian who can work with you to find foods that are easy for you to digest. This can help you get enough calories and nutrients from your food.
A dietitian may recommend that you try:
- Eat smaller meals more often.
- Chew food thoroughly.
- Eat well-cooked fruits and vegetables instead of raw fruits and vegetables.
- Avoid fibrous fruits and vegetables, such as oranges and broccoli, which can cause hemorrhoids
- Choose mostly low-fat foods, but if you can tolerate fat, include small servings of fatty foods in your diet.
- If swallowing liquids is easier for you, try soups and pureed foods.
- Drink approximately 34 to 51 ounces (1 to 1.5 liters) of water a day.
- Do gentle exercise after eating, such as going for a walk
- Avoid carbonated drinks, alcohol, and smoking.
- Avoid lying down for two or more hours after a meal.
- Take a daily multivitamin.
Ask your dietitian for a comprehensive list of recommended foods for people with gastritis. Here is a short list:
Starch
- White bread, rolls, and whole wheat bread without nuts or seeds
- Plain or egg bagels
- English muffins
- Flour or corn tortillas
- Pancakes
- Puffed wheat and rice cereal
- Cream of wheat or rice
- White crackers.
- Potatoes, white or sweet (not skinned)
- Baked French Fries
- Rice
- Pasta
Protein
- Lean beef, veal, and pork (not fried)
- Chicken or turkey (not skinned and not fried)
- Shrimp, lobster, shrimp, clams, scallops, oysters
- Tuna (packed in water)
- Cheese
- Eggs
- Tofu
- Dried meat baby food
Fruits and vegetables
- Pureed vegetables and fruits like baby food
- Tomato sauce, paste, puree, juice
- Carrots (cooked)
- Beetroot (cooked)
- Mushrooms (cooked)
- Vegetable juice
- Vegetable broth
- Fruit juices and drinks
- Apple sauce
- Bananas
- Peaches and pears (canned)
Dairy
- Milk, if tolerated
- Yogurt (without fruit pieces)
- Custard and pudding
- Frozen yogurt
Medicines
Medications to treat gastroparesis may include:
- Medicines to stimulate the abdominal muscles. These medications include metoclopramide (Reglan) and erythromycin. Erythromycin may lose its effectiveness over time and cause side effects such as diarrhea. A newer drug, domperidone, with fewer side effects, is also available with limited access.
- Medicines to control nausea and vomiting. Medications to help reduce nausea and vomiting include diphenhydramine (Benadryl, others) and ondansetron (Zofran). Prochlorperazine (Campro) is used if nausea and vomiting persist.
Surgical treatment
Some people with gastroparesis may not be able to tolerate any food or liquid. In these situations, doctors may recommend that a feeding tube (jejunostomy tube) be placed in the small intestine. Or the doctor may recommend a gastric venting tube to help relieve pressure from the gastric contents. Feeding tubes can go through your nose or mouth or directly into your small intestine through your skin. The tube is usually temporary and only used when gastroparesis is severe or when blood sugar levels cannot be controlled by other means. Some people may need an IV (parenteral) feeding tube that goes directly into a chest vein.