Guide to Gastroparesis

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Causes
Symptoms
Diagnosis
Treatment
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Gastroparesis is a chronic condition in which the stomach takes too long to empty and does not move food through fast enough, and can cause incapacitating nausea and vomiting.

Key Facts

  • Food is not emptied fast enough in gastroparesis.
  • Diabetes is one of the most common causes of gastroparesis, but in many cases the exact cause isn't known. Other causes include medications or effects from previous surgeries.
  • This condition requires a multidisciplinary approach - including specialists from Gastroenterology, Pain medicine, Social Work / Psychology, Foregut Surgery
  • For people suffering from severe symptoms, therapies like gastric electrical stimulation (GES) may offer relief. 

What Causes Gastroparesis?

This can have a number of different causes, including:

  • Diabetes – uncontrolled blood sugar levels can damage the nerves that signal the stomach's smooth muscles to contract
  • Neurological or autoimmune conditions such as stroke or Parkinson's disease
  • Medications – these include opioids or antidepressants
  • Surgeries – Procedures that involve the stomach or upper digestive tract can potentially damage nerves that control stomach motility.

What are the Symptoms of Gastroparesis?

The most common symptoms of gastroparesis are:

  • Nausea with or without vomiting
  • Bloating
  • Abdominal pain
  • Weight loss
  • Feeling full after eating a small amount of food

How is Gastroparesis diagnosed?

A doctor will perform tests to rule out other issues that may be causing symptoms. These tests include:

  • Upper endoscopy – This test involves a camera down your mouth into your stomach.  If they still find food in your stomach even though it has been more than 8 hours since you ate, it's a sign that you might have gastroparesis.
     
  • Contrast imaging – such as an “upper gastrointestinal series”, CT or MRI scans that can show if there is an obstruction blocking the flow of food, keeping it from leaving your stomach
     
  • Gastric emptying scan (Scintigraphy): For this test, a patient will eat a solid meal with a small and harmless amount of radioactive tracing material. An imaging device then tracks the substance to see how quickly food leaves their stomach.
     
  • Breath test: This test is used when someone can't take the gastric emptying scan. This exam also involves eating a small meal with a substance that shows up in the breath as the meal is digested. Measuring the amount of substance in the breath can show how fast food is being digested.

How is Gastroparesis Treated?

There are steps one can take to manage gastroparesis symptoms, as well as treatments that can improve how fast the stomach empties. These include:

  • Lifestyle and diet changes
    • Eat smaller and more frequent meals.
    • Eat foods that are low in fiber and fat.
    • Chew food well.
    • Eat cooked fruits and vegetables instead of raw.
    • Eliminate carbonated drinks
    • Stop smoking
    • Stop eating or drinking four hours before bed.
       
  • Medicines
    • Medicine for nausea and vomiting
    • Medicine that helps the stomach empty more quickly.
       
  • Surgery
    • Pyloroplasty: The opening between the stomach and small intestine (pyloric sphincter) is widened.
    • Peroral endoscopic myotomy (POEM): Similar to pyloroplasty, POEM uses a special endoscope to widen the pylorus.
    • Gastric Electrical Stimulation (GES): an implanted device that sends an electrical signal to the nerves controlling the smooth muscles of the stomach. This helps the stomach empty its contents into the small intestine faster.
    • Partial gastrectomy or roux en y reconstruction: may help facilitate emptying should other therapies remain unsuccessful 

Learn More About Gastric Electrical Stimulation (GES) at Columbia

Next Steps

If you'd like to learn more about treatment for gastroparesis, our team at Columbia is here to help. Call us at (212) 305-3408 or complete our online appointment request form. We accept a number of insurance plans, and our team can help confirm your coverage.