August is Gastroparesis Awareness Month, so today we wanted to take some time to spread awareness and improve understanding of this chronic gastric disorder.
Typically, strong muscular contractions propel food through your digestive tract. In some people, however, their stomach’s motility is slowed down or doesn’t work at all, preventing it from emptying its contents properly. This is called gastroparesis, which means partial paralysis of the stomach.
How common is gastroparesis, what causes it, what are the symptoms, and how is it treated? Those are the questions we’ll be answering in this article.
How Common Is Gastroparesis?
Some research suggests that gastroparesis (also known as delayed gastric emptying) is relatively uncommon, with about ten men and 40 women having the condition out of 100,000 people.[1]
However, other research suggests that many people have undiagnosed gastroparesis, as the symptoms are similar to those of other diseases, such as GERD and irritable bowel syndrome.[2] In other words, the number of people officially diagnosed with gastroparesis might only be the tip of the iceberg.
What Are the Signs and Symptoms of Gastroparesis?
The symptoms and severity of symptoms will vary from person to person, but common signs of gastroparesis include:[3]
- Nausea
- Abdominal bloating and pain
- Lack of appetite
- An early feeling of fullness when eating
- Vomiting, particularly undigested food
- Acid reflux
- Heartburn
- Weight loss and malnutrition
- Erratic blood glucose levels
- Spasms of the stomach wall
Interestingly, some people with gastroparesis don’t have any noticeable symptoms.
What Causes Gastroparesis?
While the exact cause of gastroparesis isn’t always clear, many cases are thought to be caused by damage to the vagus nerve, which represents the main component of the parasympathetic nervous system (aka the “rest-and-digest” system).
The vagus nerve helps manage complex processes in your digestive tract, including signaling the muscles in your stomach to contract and push food through your digestive tract. A damaged vagus nerve can’t effectively send signals to your stomach, causing food to remain in your stomach longer than usual.
The two most common reasons the vagus nerve and its branches become damaged are persistent high blood sugar caused by diabetes and stomach or small intestine surgery.[4]
In nearly 36 percent of gastroparesis cases, there is no identifiable cause. This is known as idiopathic.[4]
Gastroparesis also occurs in a number of people after a viral illness, but the connection is not yet fully understood.[4]
How Is Gastroparesis Diagnosed?
If you have signs and symptoms of gastroparesis, it’s important to visit a medical professional for an evaluation. Your provider can use several tests to rule out other conditions with similar symptoms and diagnose gastroparesis.
The most commonly ordered tests include:
- Gastric emptying study: This test determines the time it takes a meal to move through your stomach. After consuming a meal tagged with a radioactive isotope, a technologist will take images of your stomach after one minute, one hour, two hours, and four hours.
- Barium contrast radiography: After fasting for 12 hours, you’ll swallow a liquid called barium, which coats the inside of the stomach, making it visible on an X-ray. If food appears in the stomach after 12 hours of fasting, gastroparesis is likely.
- SmartPill: This test entails swallowing a capsule that contains a small electronic device. As it moves through your digestive tract, it sends information to a receiver on how quickly food travels through your digestive tract.
- Upper endoscopy: For this procedure, a long, flexible tube with a tiny camera is inserted through your mouth and into your intestines to visually examine your upper digestive tract.
How Is Gastroparesis Treated?
Gastroparesis is a chronic condition, meaning treatment usually doesn’t cure the disease. However, certain medications and other changes can help you manage the symptoms.
Some medications that help those with gastroparesis include:
- Medications that stimulate the stomach muscles. These medications include metoclopramide (Reglan) and erythromycin.
- Medications that control nausea and vomiting. These medications include diphenhydramine (Benadryl, others) and ondansetron (Zofran).
How Can Diet and Lifestyle Help Manage Gastroparesis?
One of the most impactful ways to help control gastroparesis is to change your daily eating habits. Some diet and lifestyle changes that tend to be helpful include:[5]
- Eating four to six small meals per day instead of two or three large meals
- Limiting alcohol and carbonated beverages
- Substituting solid foods for pureed or liquid foods, which may empty more easily from the stomach
- Avoiding late night eating
- Avoiding high-fat foods, which can slow digestion
- Avoiding high-fiber foods, such as broccoli, whole grains, and legumes, which can slow digestion
- Eating well-cooked vegetables and fruit to lower the amount of fiber they contain
- Avoiding lying down immediately after a meal
- Stopping smoking
- Avoiding narcotic medications
- Managing underlying health conditions, such as diabetes
A trained healthcare professional can help you design an eating plan that works best for you and your needs.
Are There Complementary Treatment Options for Gastroparesis?
Some people with gastroparesis have experienced benefits from complementary and alternative therapies, including:
- Acupuncture: This treatment involves the insertion of extremely thin needles through your skin at strategic points on your body. Studies have shown that acupuncture may ease gastroparesis symptoms more than a placebo treatment.[6]
- Botulinum toxin type A (aka Botox): Botox injections use a toxin that reduces muscle activity. In some studies, injecting the medication into the pyloric sphincter muscle relaxed the pylorus (the opening of the stomach), allowing food to empty more rapidly.[7][8]
- Vagal nerve stimulation: Ongoing studies are testing whether vagal nerve stimulation can help reduce inflammation and nerve problems associated with gastroparesis.[9]
A Final Word on Gastroparesis
Living with gastroparesis can be challenging, but fortunately, symptoms can often be effectively managed using a combination of treatments, including medications, diet adjustments, and lifestyle changes.
If you’re looking for support managing gastroparesis, consider becoming a Knew Health member. We work with our members to ensure they receive the care they need and offer a range of member perks, such as discounted supplements, discounted lab work, and health coaching. Start walking the path toward your wellness goals today.
References:
- U.S. Department of Health and Human Services. (n.d.). Definition & Facts for gastroparesis. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved July 22, 2022, from https://www.niddk.nih.gov/health-information/digestive-diseases/gastroparesis/definition-facts#:~:text=Gastroparesis%20is%20not%20common.,the%20United%20States2%2C%203
- Rey, E., Choung, R. S., Schleck, C. D., Zinsmeister, A. R., Talley, N. J., & Locke, G. R. (2012). Prevalence of hidden gastroparesis in the community: The gastroparesis “iceberg”. Journal of Neurogastroenterology and Motility, 18(1), 34–42. https://doi.org/10.5056/jnm.2012.18.1.34
- Mayo Foundation for Medical Education and Research. (2022, June 11). Gastroparesis. Mayo Clinic. Retrieved July 22, 2022, from https://www.mayoclinic.org/diseases-conditions/gastroparesis/symptoms-causes/syc-20355787
- Liu, N., & Abell, T. (2017). Gastroparesis updates on pathogenesis and Management. Gut and Liver, 11(5), 579–589. https://doi.org/10.5009/gnl16336
- Limketkai, B. N., LeBrett, W., Lin, L., & Shah, N. D. (2020). Nutritional approaches for gastroparesis. The Lancet Gastroenterology & Hepatology, 5(11), 1017–1026. https://doi.org/10.1016/s2468-1253(20)30078-9
- Xuefen, W., Ping, L., Li, L., Xiaoli, C., & Yue, Z. (2020). A clinical randomized controlled trial of acupuncture treatment of gastroparesis using different acupoints. Pain Research and Management, 2020, 1–14. https://doi.org/10.1155/2020/8751958
- Placebo controlled trial of botulinum toxin for gastroparesis – full text view. Full Text View – ClinicalTrials.gov. (n.d.). Retrieved July 22, 2022, from https://clinicaltrials.gov/ct2/show/NCT00372970
- Lacy, B. E., Crowell, M. D., Schettler-Duncan, A., Mathis, C., & Pasricha, P. J. (2004). The treatment of diabetic gastroparesis with botulinum toxin injection of the pylorus. Diabetes Care, 27(10), 2341–2347. https://doi.org/10.2337/diacare.27.10.2341
- Vagal nerve stimulation for gastroparesis – full text view. Vagal Nerve Stimulation for Gastroparesis – Full Text View – ClinicalTrials.gov. (n.d.). Retrieved July 22, 2022, from https://clinicaltrials.gov/ct2/show/NCT03120325
Disclaimer: This information is being provided to you for educational and informational purposes only. It is being provided to educate you about how to take care of your body and as a self-help tool for your own use so that you can reach your own health goals. It is not intended to treat or cure any specific illness and is not to replace the guidance provided by your own medical practitioner. This information is to be used at your own risk based on your own judgment. If you suspect you have a medical problem, we urge you to take appropriate action by seeking medical attention.
