Written by Shreya Bhardwaj
Edited by Anirudh Koneru
Published on 8/31/2020
August is gastroparesis awareness month! In an attempt to promote awareness about rare conditions such as gastroparesis, we will be highlighting this disease in our article!
Description
Gastroparesis is a rare disorder in which the stomach’s peristalsis waves are abnormally slow, resulting in food not moving/moving very slowly from the stomach to the small intestine. Even though the cause of gastroparesis is not entirely known, this condition can end up interfering with the normal digestion process, resulting in nausea and vomiting. There is no definitive cure for this condition; however changes in diet, medication and certain surgical operations can effectively help to reduce symptoms.
Signs and Symptoms
There are a number of symptoms associated with gastroparesis, some of which include bloating, nausea, vomiting, weight loss, heartburn and abdominal pain. Complications can also occur as a result of the disease, such as dehydration, electrolyte abnormalities, malnutrition, vitamin deficiencies, stomach ulcers and metabolic bone disease. An important factor to keep in mind is that many people with gastroparesis are asymptomatic, meaning they do not always display symptoms.
Etiology
It is not always clear what the cause of Gastroparesis is in patients; however, it is believed to be caused by damage to the vagus nerve, which manages and controls the stomach. Strong muscular contractions propel food through the digestive tract, but if a person has gastroparesis, the stomach’s motility is slowed down or does not work at all. A normal vagus nerve effectively manages the digestive system and signals for peristaltic (stomach) contractions to occur in order to push food onwards. In contrast, a damaged vagus nerve does not send signals in a normal manner to the stomach in an attempt to start peristaltic contractions, which ultimately results in the digestive process being abnormally slow. In addition, gastroparesis can be developed within the body as a result of diabetes.
Diagnosis
In order to accurately make a diagnosis, several tests are conducted to rule out conditions with similar symptoms. The Gastric Emptying Study is the most important test in accurately diagnosing this condition, which involves eating a light meal containing a small amount of radioactive material. Afterwards, a scanner is placed on the stomach that detects the movement of the radioactive material to monitor the rate at which food leaves the stomach. Another important test is the Upper Gastrointestinal (GI) Endoscopy, in which the upper digestive system can be visually examined using a tiny camera at the end of a long, flexible tube that is inserted into the body. In addition, an Upper Gastrointestinal (GI) X-Ray Series and an ultrasound can also be used to confirm the diagnosis.
Treatment
Treatment for gastroparesis generally consists of changes in diet, medications, and surgery. In terms of changes in diet, maintaining adequate nutrition is the most important goal in the treatment of gastroparesis and it is most often recommended to eat smaller meals frequently, choosing low-fat and less fibrous foods (as it is easier on the stomach in digestion), drinking around 1 liter of water a day and taking a daily multivitamin. Certain medications can stimulate the stomach muscles such as metoclopramide and Erythromycin; however they can be accompanied with serious side effects. Medications to control nausea and vomiting can also be taken, such as prochlorperazine and diphenhydramine which help to reduce these symptoms. If there are many complications for a patient, they may choose to use a surgical route for treatment, which could consist of a jejunostomy tube within the small intestine or a gastric venting tube to help relieve gastric pressure.
Rarity
Gastroparesis is a rare condition, so much so that out of every 100,000 people in the United States, only 10 men and 40 women have gastroparesis.
Resources
There is an increasing prevalence of support groups and organizations available, which are designed to assist patients who suffer from Gastroparesis and their caretakers along with informative websites regarding details for this condition.
Below is a list of support groups and organizations with resources for those affected by Gastroparesis:
Organizations:
Facebook Groups:
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Citations:
Mayo Clinic Staff. (2019, March 30). Gastroparesis - Symptoms and Causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/gastroparesis/symptoms-causes/syc-20355787
Staff, M. C. (2019, March 30). Gastroparesis - Diagnosis and treatment. Mayo Clinic.
Gastroparesis. (2018, April 13). Genetic and Rare Diseases Information Center.
https://rarediseases.info.nih.gov/diseases/12278/gastroparesis