Gastroparesis

Gastroparesis, or delayed emptying of the stomach, literally means paralysis of the stomach. Although the stomach isn’t paralyzed in gastroparesis, its function is slowed down to varying degrees, and bloating is one of the most common symptoms. It’s an under-diagnosed condition associated with nausea and abdominal pain that can lead to vomiting and weight loss in severe cases.

SYMPTOMS

In most people, gastroparesis symptoms include:

• Bloating
• Abdominal pain
• Feeling abnormally full after eating, particularly meals containing an abundance of fat and/or fiber

Symptoms usually fluctuate, with flare-ups precipitated by a large, fatty meal or by eating too much fiber in one sitting. Gastroparesis can be severe in some people, especially in diabetics, whose stomach emptying can completely shut down when their blood sugar is poorly controlled, leading to abdominal pain, bloating, and recurrent episodes of vomiting after eating.

CAUSES

We don’t know the reason behind gastroparesis in most people. In some instances, the vagus nerve, which controls stomach emptying, can be damaged or affected by illness, causing the muscles to not work properly. Diabetes, intestinal surgery, and neurological conditions like Parkinson’s disease and multiple sclerosis (MS) can cause gastroparesis, as well as certain viral illnesses. Some lifestyle habits may contribute to or cause gastroparesis, including eating a lot of fatty foods and eating too late and/or large meals at night. Medical complications that can slow digestion and bring it to a complete standstill, which are sometimes mistaken for gastroparesis, include:

• Adhesions
• Volvulus
• Radiation
• Hernia
• Diastasis recti
• Tumors or other masses

Slow transit, or constipation, is also sometimes mistaken for gastroparesis.

DIAGNOSIS

Gastroparesis is diagnosed with a test called a gastric emptying study, in which radioactive material is eaten with a meal, and the speed at which it takes to empty from the stomach is monitored and measured using a radioactive scanning device. The results from this test are used to assess if an individual suffers from delayed emptying of the stomach.

TREATMENT

Medications

Medications to help improve the contractility of the stomach are sometimes prescribed to those suffering from gastroparesis, but most of these medications are poorly tolerated with side effects that include neurological symptoms. These medications that are most often used for gastroparesis include:

• Metoclopramide (Reglan)
• Domperidone (no longer available in the U.S.)

Lifestyle Modifications

Lifestyle modifications that help resolve gastroparesis and gastroparesis-related symptoms include:

• Shift most of your calorie intake to the first half of your day; breakfast like a queen, lunch like a princess, dinner like a pauper – and nothing after the sun sets.
• Split your fat and fiber intake up into small servings.
• Avoid carbonated beverages.
• Eat small, frequent meals.
• Travel with low-fat, healthy snacks.
• Choose lunch for dining out instead of dinner.
• Move around as much as you can especially after eating and try eating your last meal 4 hours before going to bed.
• Drink your water in between meals instead of during meals, and be sure to sip your beverages, not gulp them.
• Chew your food well.
• Wait a few hours after eating to exercise to give your stomach time to empty.
• Wear clothes that are not tight around your waist and abdomen.

Stagnating stool in the colon may result in toxins being absorbed through the intestinal lining into the bloodstream. Hardened feces that accumulate along the lining of the colon can also lead to overgrowth of harmful bacteria and interfere with absorption of water and nutrients.