How is gastroparesis treated?
Gastroparesis is a chronic (long-lasting) condition. This means that treatment usually doesn’t cure the disease, but you can manage it and keep it under control. People who have diabetes should try to control their blood glucose levels to reduce the problems of gastroparesis.
Some patients may benefit from medications, including:
- Reglan: You take this drug before you eat, and it causes your stomach muscles to contract to help move food out of your stomach. Reglan also helps cut down on vomiting and nausea. Side effects include diarrhea and, rarely, a serious neurological (nerve) disorder.
- Erythromycin: This is an antibiotic that also causes stomach contractions and helps move food out. Side effects include diarrhea and development of resistant bacteria from taking the antibiotic for a long time.
- Antiemetics: These are drugs that help control nausea.
Surgery for gastroparesis
Gastroparesis patients who still have nausea and vomiting even after taking medications may benefit from surgery. One type of surgery for gastroparesis is gastric electrical stimulation, which is a treatment that sends mild electric shocks to the stomach muscles. In this procedure, the doctor inserts a small device called a gastric stimulator into the abdomen. The stimulator has two leads that are attached to the stomach and provide the mild electric shocks, which help control vomiting. The strength of the electric shocks can be adjusted by the doctor. The device runs on a battery that lasts up to 10 years.
Another surgery to relieve gastroparesis symptoms is gastric bypass, in which a small pouch is created from the top part of the stomach. The small intestine is divided in half and the lower end is attached directly to the small stomach pouch. This limits the amount of food the patient can eat. This surgery is more effective for an obese diabetic patient than either medication or a gastric stimulator.
Are there any other treatments for gastroparesis?
A newer treatment for gastroparesis is called per oral pyloromyotomy (POP). This is a nonsurgical procedure in which the doctor inserts an endoscope (a long, thin, flexible instrument) into the patient’s mouth and advances it to the stomach. The doctor then cuts the pylorus, the valve that empties the stomach, which allows food to move from the stomach to the small intestine more easily.
In a severe case of gastroparesis, your doctor may decide you would benefit from a feeding tube, or jejunostomy tube. The tube is inserted in a surgical procedure through your abdomen into your small intestine. To feed yourself, you put nutrients into the tube, which go directly into your small intestine; this way, they go around the stomach and get into your bloodstream more quickly. The jejunostomy tube is usually a temporary measure.
Another treatment option is intravenous, or parenteral, nutrition. This is a feeding method in which nutrients go directly into your bloodstream through a catheter placed into a vein in your chest. Like a jejunostomy tube, parenteral nutrition is meant to be a temporary measure for a severe case of gastroparesis.
Should I change my diet if I have gastroparesis?
One of the best ways to help control the symptoms of gastroparesis is to change your daily eating habits. For instance, instead of three meals a day, you can eat six small meals. In this way, there is less food in your stomach — you won’t feel as full, and it will be easier for the food to leave your stomach.
Another important factor is the texture of food; liquids and low residue are encouraged (for example, you should eat applesauce instead of whole apples with intact skins).
You should also avoid foods that are high in fat (which can slow down digestion) and fiber (which is difficult to digest).