What is Gastroparesis?

When you have Gastroparesis (literally “stomach paralysis”), sometimes referred to as delayed gastric emptying (in the absence of mechanical obstruction), your stomach's muscles don't work properly, which prevents your stomach from emptying properly. This may affect blood sugar levels, nutrition, and digestion in addition to producing nausea and vomiting.

The most common symptoms of gastroparesis include:  

• Nausea
• Abdominal bloating 
• Vomiting (particularly of undigested food) 
• Heartburn or gastroesophageal reflux
• Feeling full quickly when eating 
• Changes in blood sugar levels 
• Weight loss and malnutrition
• Lack of appetite 
  

Although the precise reason for gastroparesis is frequently unknown, it is thought to be brought on by a breakdown of the nerve signals going to the stomach. Below are the possible causes: 

• Idiopathic (unknown/unexplained) - most common cause present in about half of patients  
• Diabetes mellitus (DM) - most common and severe in type 1 diabetics 
• Rheumatological diseases - amyloidosis, scleroderma 
• Autoimmune - autoimmune gastrointestinal dysmotility causing delayed emptying 
• Neurological conditions - stress, Parkinson disease, multiple sclerosis, brainstem CVA and tumors, autonomic neuropathy 
• Postsurgical -  vagal nerve injury during fundoplication and partial gastric resection 
• Trauma - spinal cord injury 
• Viral infections including Norwalk virus and rotavirus  
• Medications - narcotics, cyclosporine, phenothiazines, dopamine agonists, octreotide, alpha-2-adrenergic agonists (e.g. clonidine), tricyclic antidepressants, calcium channel blockers, GLP-1 agonists exenatide or analogs liraglutide, lithium, progesterone

A physical examination, medical history, and other tests, including a stomach emptying study, upper GI endoscopy, ultrasound, and blood tests, are frequently used to diagnose Gastroparesis.  

Gastroparesis is typically treated with dietary modifications, drugs, and in more severe situations, procedures or surgery. Although there is no known treatment for gastroparesis, dietary adjustments and medications to make your stomach muscles operate more normally can provide some relief. It's crucial to keep in mind that each individual's symptoms and severity may differ greatly, and that treatment is frequently individualised to the patient's particular needs and circumstances.  

References

1. “Gastroparesis.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 2021, www.mayoclinic.org/diseases-conditions/gastroparesis/symptoms-causes/syc20355787. Accessed 15 Aug 2023  

2. “Gastroparesis.” National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services, 2021, www.niddk.nih.gov/healthinformation/digestive-diseases/gastroparesis. Accessed 15 Aug 2023  

3. “Gastroparesis.” Johns Hopkins Medicine, The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System, 2021, www.hopkinsmedicine.org/health/conditions-and-diseases/gastroparesis. Accessed 15 Aug 2023  

4. “Gastroparesis.” American College of Gastroenterology, American College of Gastroenterology, 2021, gi.org/topics/gastroparesis/. Accessed 15 Aug 2023  

5. “Gastroparesis.” MedlinePlus, U.S. National Library of Medicine, 2021, medlineplus.gov/gastroparesis.html. Accessed 15 Aug 202 

6. “Gastroparesis.”National Institute of Health, National Library of Medicine, 30 Sep. 2022. Accessed 12 Jan. 2024. https://www.ncbi.nlm.nih.gov/books/NBK551528/