Gastroparesis

Description

The stomach muscles do not work properly preventing the food from being pushed into the intestines leading to nausea, vomiting and stomach pain. Normally contraction of the stomach muscles pushes food into the the first part of the intestine (duodenum). In gastroparesis the muscles fail to contract. It is believed damage to the vagus nerve that controls the stomach muscles is the primary cause of this disorder. The most common causes of vagus nerve damage are surgery and diseases such as diabetes, scleroderma, medications (narcotics, antidepressants), anorexia, Parkinson's and hypothyroidism. Gastroparesis can lead to malnutrition, bacterial overgrowth in the stomach, and blood sugar fluctuations.

Symptoms

Abdominal pain, abdominal bloating, nausea, vomiting, variations in blood sugar levels, poor appetite, weight loss, malnutrition, and heart burn.

Tests

A history and physical will be done. A study that measures how long it takes the stomach to empty will be done (gastric emptying study). A tube with a camera may be passed through the mouth into the stomach (endoscopy) to rule out other causes of the symptoms.

Treatment

There is no cure for gastroparesis but therapy is aimed at reducing the symptoms. Treatment includes good glucose control, eating smaller more frequent meals, eating more low fiber and low fat foods, and drinking more fluids with the meal. Medications that stimulate stomach muscle contraction (metoclopramide, erythromycin, domperidone, cisapride) and reduce nausea and vomiting (prochlorperazine, ondansetron) are prescribed. Surgery is reserved for the most severe cases.

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