The nerves to the stomach can be damaged by high levels of blood glucose, so it's important to keep your blood glucose levels under control if you have diabetes. Your doctor can advise you about any changes you may need to make to your diet or medicine. For example, if you're taking insulin, you may need to divide your dose before and after meals and inject insulin into areas where absorption is typically slower, such as into your thigh.
Page last reviewed: 14 October Next review due: 14 October Symptoms of gastroparesis Symptoms of gastroparesis may include: feeling full very quickly when eating feeling sick nausea and vomiting loss of appetite weight loss bloating tummy abdominal pain or discomfort heartburn These symptoms can be mild or severe and tend to come and go.
When to seek medical advice See a GP if you're experiencing symptoms of gastroparesis, as it can lead to some potentially serious complications. These complications include: dehydration from repeated vomiting gastro-oesophageal reflux disease GORD — where stomach acid leaks out of your stomach and into your food pipe oesophagus malnutrition — when your body is not getting enough nutrients unpredictable blood sugar levels — this is a particular risk in people with diabetes Causes of gastroparesis In many cases of gastroparesis, there's no obvious cause.
Known causes of gastroparesis include: poorly controlled type 1 diabetes or type 2 diabetes a complication of some types of surgery — such as weight loss bariatric surgery or removal of part of the stomach gastrectomy Other possible causes of gastroparesis include: medicine — such as opioid painkillers for example, morphine and some antidepressants Parkinson's disease — a condition where part of the brain becomes progressively damaged over many years scleroderma — an uncommon disease that results in hard, thickened areas of skin, and sometimes problems with internal organs and blood vessels amyloidosis — a group of rare but serious diseases caused by deposits of abnormal protein in tissues and organs throughout the body Diagnosing gastroparesis To diagnose gastroparesis, a GP will ask about your symptoms and medical history, and may arrange a blood test for you.
You may be referred to hospital to have some of the following tests: barium X-ray — where you swallow a liquid containing the chemical barium, which can be seen on an X-ray and highlights how the liquid is passing through your digestive system gastric emptying scan — you eat a food often eggs containing a very small amount of a radioactive substance that can be seen on the scan.
Dietary changes You may find these tips helpful: instead of 3 meals a day, try smaller, more frequent meals — this means there's less food in your stomach and it will be easier to pass through your system try soft and liquid foods — these are easier to digest chew food well before swallowing drink non-fizzy liquids with each meal It may also help to avoid certain foods that are hard to digest, such as apples with their skin on or high-fibre foods like oranges and broccoli, plus foods that are high in fat, which can also slow down digestion.
Medicines The following medicines may be prescribed to help improve your symptoms: domperidone — which is taken before eating to contract your stomach muscles and help move food along erythromycin — an antibiotic that also helps contract the stomach and may help move food along anti-emetics — medicines that can help to stop you from feeling or being sick However, the evidence that these medicines relieve the symptoms of gastroparesis is relatively limited and they can cause side effects.
Electrical stimulation If dietary changes and medicine do not help your symptoms, a relatively new treatment called gastroelectrical stimulation may be recommended. There's also a small chance of this procedure leading to complications that would require removing the device, such as: infection the device dislodging and moving a hole forming in your stomach wall Speak to your surgeon about the possible risks.
Botulinum toxin injections More severe cases of gastroparesis may occasionally be treated by injecting botulinum toxin into the valve between your stomach and small intestine. This relaxes the valve and keeps it open for a longer period of time so food can pass through. A feeding tube If you have extremely severe gastroparesis that is not improved with dietary changes or medicine, a feeding tube may be recommended.
Surgical procedures all have inherent risks that need to be carefully weighed and understood. Most surgical treatments are irreversible, but work in carefully selected patients, having the correct surgery done, by an experienced and accomplished surgeon.
Most medications work only less than half of the time. Nonetheless, most people will respond to some therapy. If a medication causes side effects, consider a lower dose. Combining medications may be helpful. The effectiveness of various agents differs between individuals. Importantly, a medication regimen must be carefully chosen under the direction of the physician. Keep hydrated and as nutritionally fit as possible. When treatment is failing and there appear to be no other options — whether you are the patient or the physician — get another opinion.
Persistence pays off, as most people with gastroparesis ultimately will do well. IFFGD is a nonprofit education and research organization.
Our mission is to inform, assist, and support people affected by gastrointestinal disorders. Our original content is authored specifically for IFFGD readers, in response to your questions and concerns. If you found this article helpful, please consider supporting IFFGD with a small tax-deductible donation. On July 12, U. Senator Tammy Baldwin WI introduced this statement for the record on behalf of the millions of Americans affected by gastroparesis.
On August 23, U. Senator Tammy Baldwin WI submitted an extension of remarks on behalf of the millions of Americans affected by gastroparesis recognizing. All Rights Reserved. About Gastroparesis. What is Gastroparesis? Some practical things to consider when treatment does not seem to help include: Check the diagnosis The cause matters Review the diet Consider other medications Treat the pain Manage the psychosocial aspects Know when to consider surgery Be persistent and be careful Check the Diagnosis Nausea is the hallmark symptom of gastroparesis.
The Cause of the Gastroparesis Matters In diabetic gastroparesis it is important to control the blood sugar, as intestinal motility is impaired when the blood sugar is elevated.
Review the Diet Many physicians tend to skip dietary recommendations, although it is the area of most interest to patients. Consider Other Medications The utility of the prokinetic agents is often limited by their side effects. Treat the Pain Abdominal pain may be overlooked in gastroparesis.
Gender: Women are more likely to develop gastroparesis than men. Gastroparesis Complications Complications of gastroparesis include: Dehydration Malnutrition Bacterial growth — food that stays in the stomach too long can ferment and lead to bacterial growth.
Bezoars — bezoars are solid masses that form in the stomach from undigested food. They can cause nausea, vomiting, and could be life-threatening if they block the pathway between the stomach and small intestine. Unpredictable blood sugar levels — when emptying of food from the stomach is unpredictable, blood sugar levels are also unpredictable. Gastroparesis Diagnosis In addition to reviewing your medical history, performing a physical exam, and blood tests, your doctor may recommend the following tests or procedures to aid in the diagnosis of gastroparesis: Upper Endoscopy Using a thin, lighted tube with a camera on the end, the doctor will inspect the esophagus, stomach, and the first part of the small intestine.
Gastric Emptying Study One of the most definitive tests in diagnosing gastroparesis is a gastric emptying study. SmartPill The SmartPill is a small, non-digestible wireless capsule that transmits information about digestion to a receiver the patient wears around their waist. Imaging Tests Your doctor may recommend an ultrasound or upper GI series x-ray to rule out other possible causes of your symptoms. Gastroparesis Diet Making sure you get adequate nutrition is important when managing gastroparesis.
Other gastroparesis diet advice includes: Eat smaller meals instead of 3 meals a day, have 5 or 6 smaller meals throughout the day Chew food completely Choose cooked vegetables and fruits over raw, uncooked fruits and vegetables Avoid fibrous vegetables and fruits, including broccoli and oranges Avoid fatty-foods these can slow digestion Drink plenty of water each day 1 to 1.
Starches White bread and rolls Light-colored whole wheat bread without seeds or nuts Plain bagels English muffins Corn and flour tortillas Pancakes Cream of wheat Saltines and other white crackers White potatoes and sweet potatoes without skin French fries baked only, not fried Rice Pasta Proteins Lean beef, pork, and veal Chicken and turkey not fried and without skin Lobster, crab, shrimp, oysters, clams, scallops Tuna in water, not oil Cottage cheese Tofu Eggs Fruits and vegetables Tomato sauce, puree, paste, juice Cooked carrots, beets, and mushrooms Vegetable broth and juice Fruit drinks and juices Applesauce Bananas Pears and Peaches canned Dairy Milk if tolerated Yogurt Pudding and custard Frozen Yogurt Gastroparesis Medications Metoclopramide Reglan — This medication acts on the dopamine receptors in the stomach and can stimulate the stomach muscles.
Erythromycin Eryc, E. Over time, a medication tolerance can build up making the medication less effective with long-term use. Upper endoscopy is performed using the endoscope in order to see the esophagus and stomach.
Your doctor will most likely perform an upper endoscopy to rule out a mechanical obstruction at the outlet of the stomach, also called the pylorus. Obstruction is when there is a blockage of the intestines. The outlet of the stomach can have ulceration, damage or just a clog of food blocking the path. All of these can be seen at endoscopy. Barium contrast radiography is an X-ray study. It is a commonly used procedure to diagnose gastroparesis. During the scintigraphy test, you will be given a special meal and sometimes a special drink.
The meal will be radiolabeled with a marker that can be seen by the scanner. The goal of the test is to follow this special food as it travels through your system. Unlike diagnostic procedures that require you to fast beforehand, gastric emptying scintigraphy actually requires you to eat this special meal right before the test. This procedure can help diagnose the exact cause of the gastroparesis. Doctors often use it for patients after standard treatments have failed, for surgery candidates and for patients with unexplained nausea.
A wireless motility study evaluates the time it takes for your stomach to empty. This is generally well tolerated and less invasive than other diagnostic studies. The advantage of this method is that you can continue with your normal activities while the capsule gathers the necessary information.
The goal in treating gastroparesis is to identify any reversible problems, to correct the underlying disease if possible and to help control symptoms. Treatment options range from dietary changes to medication or surgery.
0コメント