Gastroparesis, or delayed gastric emptying, occurs when the stomach takes too long to empty its contents. Gastric refers to the stomach, and paresis is a condition where muscle weakness or paralysis occurs due to nerve damage. The effects of gastroparesis are that muscles in the stomach do not move well or have impaired mobility, causing digestion time to slow down.
Food stays in the stomach too long, leading to gastrointestinal symptoms such as abnormal fullness, nausea, and vomiting. The symptoms of gastroparesis progress over time, gradually getting worse. It can also affect how your body absorbs vitamins, nutrients, and medications such as insulin. Gastroparesis can also lead to dramatic weight loss, malnutrition, and, in severe cases, death. It is a common disorder affecting around 2% of the population and occurs more frequently in women and people of color. It is most prevalent in the southeastern portion of the United States.
Causes
Approximately one-third of all gastroparesis cases have been linked to type 1 and type 2 diabetes. Other causes include damage to the nerves of the stomach during surgery, certain medications, neurological disorders, and viral infections. In some cases, doctors cannot determine the cause and classify the condition as idiopathic gastroparesis, which means unknown cause.
Symptoms
The most common symptoms of gastroparesis include premature fullness, not wanting to eat, severe heartburn, nausea, and vomiting. Other symptoms can include bloating, weight loss, and low blood sugar. Some individuals describe having sulfur-tasting or smelly belches.
Diagnosis
A diagnosis of gastroparesis is typically made by a gastroenterologist, a medical professional who specializes in studying the gastrointestinal system. Your doctor will review your medical history and symptoms to determine what tests may be needed. To rule out other diseases, your doctor may have you do a few diagnostic tests, such as the upper endoscopy and the barium contrast radiography. The most common test to diagnose gastroparesis is a gastric emptying study.During this test, you will eat a small meal, typically of scrambled eggs with a small amount of safe, radioactive material.This test aims to see how fast the food moves through your digestive system. A scan of your digestive system will be takenimmediately and every hour until the food is digested. The scan can take up to four hours.
Treatment
Doctors start treatment by attempting to figure out what caused your gastroparesis. In some cases, better management of diabetes can lessen the symptoms of gastroparesis. If it is a side effect of a medication, your doctor may discontinue it or change to another drug. Always ask your doctor before making any changes to your medications.
In many cases, gastroparesis can be managed by careful interventions such as dietary changes, medications, and surgery. Your doctor may ask you to change your diet and avoid foods that trigger your symptoms. Instead of having large meals, smaller, more frequent meals are recommended. Also, try to avoid foods that are spicy, fatty, and have high amounts of fiber, as they may make symptoms worse. They may also refer you to a dietitian who can individualize your diet plan. Your doctor may ask you to increase your water intake and your daily exercise to improve your symptoms.
Your doctor may also prescribe medications to help manage your symptoms and aid in digestion. Surgery may also be recommended if other treatments are not effective, and your gastroparesis is severe. Depending on your personal care plan, your doctor may also recommend feeding tubes and IV nutrition to ensure your body gets all the nutrients it needs. If left untreated, gastroparesis can lead to dehydration, malnutrition, and in advanced stages, death.
Tips to decrease symptoms of gastroparesis
- Stay hydrated
- Eat small, routine meals
- Maintain an upright posture
- Increase lean protein
- Manage your blood sugar
Individuals with a diabetes diagnosis are at a higher risk of complications related to gastroparesis. Anyone interested in joining a diabetes education and support group can contact Rural Health (clemson.edu). Clemson Extension Rural Health and Nutrition Team offers an ongoing diabetes self-management program, Health Extension For Diabetes (clemson.edu). In-person and virtual options are available program offerings in most South Carolina counties. Any additional information can be found at Home & Garden Information Center | Clemson Cooperative Extension | Clemson University, South Carolina. Fact sheets Diabetes | Home & Garden Information Center (clemson.edu) and Health Extension for Diabetes | Home & Garden Information Center (clemson.edu) can provide a synopsis of the program opportunity and its relation to diabetes.
References:
- CDC. (2020, December 30). Diabetes and Digestion. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/library/features/diabetes-digestion.html
- Cleveland Clinic. (2024). How to follow a gastroparesis diet: What to eat and avoid. Retrieved from:
- Gastroparesis Diet: What To Eat and Avoid (clevelandclinic.org)
- Gastroparesis. (n.d.). Yale Medicine. https://www.yalemedicine.org/conditions/gastroparesis
- Johns Hopkins University. 2023. Gastroparesis. Retrieved from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/gastroparesis#:~:text=Gastroparesis%2C%20also%20called%20gastric%20stasis,solid%20mass%20called%20a%20bezoar.
- Johnson, G. Ashley, UT Physicians (2023, September 1). Gastroparesis: Understanding the condition and its treatment. UT Physicians. https://www.utphysicians.com/gastroparesis-understanding-the-condition-and-its-treatment/
- Madhusudan Grover, Henry P. Parkman, Pankaj J. Pasricha, Epidemiology of Gastroparesis in the United States, Gastroenterology, Volume 162, Issue 7, 2022, Pages 2136-2137, https://doi.org/10.1053/j.gastro.2021.10.030. (https://www.sciencedirect.com/science/article/pii/S0016508521037021)
- Mayo Clinic. 2022. Gastroparesis. Retrieved from: https://www.mayoclinic.org/diseases-conditions/gastroparesis/symptoms-causes/syc-20355787
- Young, C. F., Moussa, M., & Shubrook, J. H. (2020). Diabetic Gastroparesis: A Review. Diabetes Spectrum, 33(3), 290–297. https://doi.org/10.2337/ds19-0062
Authors:
- Jevencia Hill, Rural Health and Nutrition Agent, Lexington, Richland, and Kershaw Counties
- Jackie Gallagher, Former Rural Health and Nutrition Agent, Colleton and Hampton Counties
