Gastroparesis

Also sometimes called stomach paralysis, gastroparesis is defined as delayed gastric emptying that can’t be explained by a physical blockage or mechanical obstruction of the gastrointestinal (GI) tract.

While the exact prevalence of gastroparesis is unknown, it’s clear the issue causes a range of symptoms that significantly impact digestion — leading to nutrient deficiencies and reduced quality of life. It most commonly affects young women, but gastroparesis can occur in men and women of any age. 

Causes of Gastroparesis

Gastric emptying is an early step of digestion — when food is pushed out of the stomach so nutrients can be further digested and then absorbed. This process requires strong contractions coordinated by the muscles and nerves that line the stomach.

If gastric emptying becomes delayed, gastroparesis occurs. This delay is sometimes caused by the vagus nerve’s inability to fully signal stomach muscles to contract. This nerve can be damaged by certain disease processes or surgical procedures.

The potential causes of gastroparesis include:

• Diabetes, particularly when accompanied by complications affecting the nerves, the kidney or the eye 
• Surgical procedures that affect the stomach or esophagus
• Scleroderma, and similar conditions that affect the muscles or nerves of the GI tract
• Neurological diseases, such as Parkinson’s disease, muscular dystrophy  and multiple sclerosis  (MS)
• Hypothyroidism

In most cases, however, the underlying cause of delayed gastric emptying is unknown, which is referred to as idiopathic gastroparesis.

Symptoms of Gastroparesis

When gastric emptying is delayed, it can lead to significant digestive issues.

Gastroparesis symptoms include:

• Chronic nausea
• Frequent vomiting, especially after eating
• Feeling full before finishing a meal
• Discomfort, pain or bloating in the upper abdomen
• Loss of appetite

Left untreated, gastroparesis can lead to severe dehydration, malnutrition, unwanted weight loss and irregular blood sugar levels.

Diagnosing Gastroparesis

Evaluating gastric emptying is an essential step in the diagnosis of gastroparesis. Since its symptoms are fairly nonspecific, imaging is often needed to help rule out other potential causes, such as peptic ulcers or an issue with the gallbladder.

• Scintigraphy – a nuclear medicine study that measures stomach emptying using radioactive material added to food. After a small amount of this food is consumed by the patient, emptying is monitored for several hours using a scanner.
• Endoscopy – an imaging technique that uses a flexible tube with a tiny camera at the end to visualize the upper digestive tract for signs of inflammation or other issues that may explain a patient’s symptoms.
• Ultrasound – an imaging technique that uses sound waves to create a picture of the organs in the upper abdomen to help rule out an issue with the gallbladder or liver.

While gastroparesis can be challenging to detect, getting an accurate diagnosis is essential for effectively managing symptoms. This requires evaluation by a gastroenterologist with expertise in diagnosing and treating the condition.

Gastroparesis Treatment

Gastroparesis cannot be cured, but your doctor will help you understand the lifestyle changes you can make and the treatments needed to manage the condition, which may include:

• Dietary changes, including eating foods that are easier to digest
• Effective management of the underlying cause, such as diabetes, if present
• Medications to stimulate stomach muscles
• Medications to reduce nausea and vomiting
• Gastric stimulation via an implantable device
• Nutritional management, ranging from vitamin and mineral supplementation to the use of a feeding tube
• Surgical treatments to help promote gastric emptying or venting

Experts at Houston Methodist work together and with you to tailor treatment to your specific symptoms and any underlying conditions you may have.