Gastroparesis is a disease in which the stomach cannot empty itself of food in a normal fashion. This is a common condition in people who have had diabetes for a long time, but it may also occur in other situations.
Gastroparesis is caused by nerve injury, including damage to the vagus nerve. In its normal state, the vagus nerve contracts (tightens) the stomach muscles to help move food through the digestive tract. In cases of gastroparesis, the vagus nerve is damaged by diabetes. This prevents the muscles of the stomach and intestine from working properly, which keeps food from moving from the stomach to the intestines.
Anatomy of the stomach
Other causes of gastroparesis include:
The symptoms of gastroparesis include:
Gastroparesis can cause several problems:
Your doctor will go over your symptoms and medical history with you. He or she will also give you a physical examination and may order certain blood tests, including blood sugar levels.
Other tests that are used to diagnose gastroparesis include:
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:
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.
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.
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).
The Gastroparesis Clinic is part of the Digestive Disease & Surgery Institute at Cleveland Clinic, and offers a multidisciplinary approach to gastroparesis to increase treatment success and improve patient experience.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 07/02/2018