Learn More About Gastroparesis

  • 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

  • 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

  • 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.

  • 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

  • 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.