December 10, 2020 Brian Dooley

Gastroparesis: 6 Symptoms and Treatments

Gastroparesis is a condition in which your stomach is unable to empty food normally. It’s common among people who have had diabetes for a long time, but those without diabetes can also have gastroparesis.

Doctors may not always be able to find the cause of gastroparesis. Most cases of gastroparesis are caused by damage to the vagus nerve. Among its functions, the vagus nerve controls the involuntary muscles of the stomach.

If the vagus nerve is damaged, the stomach muscles don’t get the message to contract during eating and digestion. This means that food sits in the stomach instead of passing through the gastrointestinal tract. When this doesn’t happen, it’s known as delayed gastric emptying. Normally, the stomach muscles contract and move food out of the stomach and into the small intestines.

Potential causes of gastroparesis and vagus nerve damage include diseases (like diabetes), infections, and abdominal surgery that damages the vagus nerve. Some medications can also cause impaired or delayed gastric emptying.

Gastroparesis Symptoms

You can have gastroparesis and be asymptomatic. If symptoms of gastroparesis occur, they may include:

1. Heartburn, acid reflux, or Gastrointestinal Reflux (GERD)
2. Nausea or vomiting
3. Feeling full quickly when eating
4. Abdominal pain or bloating
5. Loss of appetite, weight loss, or malnutrition
6. Changes in blood sugar

Gastroparesis Treatments

Like many conditions, treatment for gastroparesis begins by identification and treatment of its underlying causes. If your gastroparesis is caused by diabetes, your doctor will make recommendations for treatment.

Diet

The first step to managing gastroparesis is changing your diet and ensuring you get enough nutrition. A registered dietitian can help you create a balanced diet out of foods that are easy to digest. Many people with gastroparesis can live a normal life by changing their diet to include more soft foods and adding nutritional supplement drinks.

Other diet advice for those living with gastroparesis includes:

• Eat smaller meals. Instead of three meals a day, have six smaller meals throughout the day.
• Chew food completely before swallowing.
• Eat cooked fruits and vegetables instead of raw fruits and vegetables.
• Avoid fibrous fruits and vegetables, like oranges and broccoli.
• Avoid fatty foods that can slow digestion.
• Drink plenty of water each day (one to one and a half liters).
• Talk a walk after you eat to aid in digestion.
• Don’t lay down within two hours of eating.
• Avoid alcohol, smoking, and carbonated beverages.

Medication

Your doctor may prescribe medication to treat your gastroparesis. Some common medications include:

• Metoclopramide (Reglan) can stimulate stomach muscles by acting on the dopamine receptors in the stomach. This medication shouldn’t be used long-term because it can cause serious side effects.
• Domperidone also acts on the dopamine receptors in the stomach. It’s shown to have fewer side effects than Metoclopramide. However, its use is restricted in the United States.
• Erythromycin (Eryc, E.E.S.) is an antibiotic that works by stimulating the motilin receptors of the stomach. This causes the stomach to contract and move food through the system. Some patients can build up a tolerance to this medication, making it less effective with long-term use. Another potential side effect of erythromycin is diarrhea.

Surgery

Those who experience severe symptoms and don’t respond to other treatments may need surgical intervention. Surgical options include:

• Venting tubes may reduce symptoms like dehydration and vomiting.
• A percutaneous jejunostomy tube can provide additional nutrition.
• A lower stomach bypass can improve stomach emptying.

Electrical Stimulation

Researchers are studying electrical stimulation as a treatment for gastroparesis. Small electronics are attached to the stomach wall. Once activated, they cause the stomach to contract. This has been shown to reduce gastroparesis symptoms, like nausea and vomiting, but studies haven’t shown significant improvements in stomach emptying.

Do you have gastroparesis symptoms or other digestive issues? The team at Gastroenterology Consultants of San Antonio can help. Make an appointment today.