Learn More About Gastroparesis
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Gastroparesis (also known as delayed gastric emptying) is a condition that effects the gastrointestinal system. Gastroparesis, meaning stomach paralysis/weakness, can vary in severity from one patient to another. For some patients ,Gastroparesis can mean a slow emptying time while others can have a completely paralyzed stomach that does not move contents to the small intestine.
With only 0.16% of the population effected by this condition, Gastroparesis is known as a rare condition.
There are several known causes of Gastroparesis, however, many cases are diagnosed as idiopathic (without a known cause). Causes of Gastroparesis that have been identified include:
Diabetes (the most common known cause of Gastroparesis)
An injury to the vagus nerve
Hypothyroidism
Certain autoimmune conditions
A viral infection affecting the stomach
Certain disorders of the nervous system
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Symptoms of Gastroparesis vary from person to person, however, symptoms can include:
nausea
vomiting
bloating
a full feeling after eating small amounts (early satiety)
feeling full long after eating
lack of appetite
abdominal pain (usually in the upper abdomen region)
heartburn/indigestion
weight loss
malnutrition
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A diagnosis of Gastroparesis is made after obtaining a complete patient history, evaluating symptoms, and ordering tests.
The most common test used in the diagnosis of Gastroparesis is a gastric emptying study (GES). During a GES, the patient will be asked to eat a meal with a small amount of radioactive material in it. After the patient finishes the meal, scans of their abdomen are taken at 30 minutes , 1 hour, 2 hours, and 4 hours after the meal to see how your stomach functions and how long the food stays in the stomach before entering the beginning of the small intestine.
A normal GES result:
After 30 minutes — 70% or more of the meal left in the stomach
After 1 hour — 30% - 90%
After 2 hours — 60% or less of the meal left in the stomach
After 4 hours — 10% or less of the meal left in the stomach
A delayed GES results:
Values can vary between patients but overall delayed gastric emptying is diagnosed when a greater percentage of the meal is left in the stomach after 30 mins, 1 hour, 2 hours, and 4 hours than the normal values listed above.
Rapid gastric emptying:
In contrast, rapid gastric emptying is diagnosed when a smaller percentage of the meal is left in the stomach after 30 mins, 1 hour, 2 hours, and 4 hours than the normal values listed above
It is important to note that not all cases of Gastroparesis appear on the first GES, and may require multiple scans.
If a person is unable to tolerate a GES with a meal, a liquid GES can be done where the radioactive material is mixed into a drink. Results of a liquid GES differ from a meal GES as liquid tends to empty the stomach faster than solids.
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Every case is different, however, typically the most non invasive treatment is done first.
Drug treatments
Motility medications
Metoclopramide, Erythromycin, Domperidone
Antiemetics
Ondansetron, Promethazine
Nutrition Options
eating smaller and more frequent meals
limiting hard to digest foods
Feeding tubes (NG, ND, NJ, G-tube, J-tube, GJ-tube)
Total parenteral nutrition (TPN)/Partial parenteral nutrition (PPN)
Usually done through a PICC line that delivers complete nutrition through the blood stream to bypass the GI system
Surgical interventions
Gastric Perioral Endoscopic Myotomy (G-POEM) procedure
A small incision in the pyloric muscle to keep it permanently open for food to empty stomach more easily
Gastric pacemaker
A small device implanted under the skin to stimulate the muscle and help it empty food left in the stomach
Botox injections
Botox is injected into the effected muscles in the stomach and pyloric canal to help relax the muscles therefore helping to relieve symptoms of Gastroparesis
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https://aboutgastroparesis.org/treatments/procedures-surgery/
https://rarediseases.org/rare-diseases/gastroparesis/
https://www.ncbi.nlm.nih.gov/books/NBK531503/
https://www.niddk.nih.gov/health-information/digestive-diseases/gastroparesis/symptoms-causes
https://www.mayoclinic.org/diseases-conditions/gastroparesis/symptoms-causes/syc-20355787#:~:text=Gastroparesis%20is%20a%20condition%20that,food%20through%20your%20digestive%20tract.