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Gastroparesis , or delayed gastric emptying, is a disorder where the food does not move or moves very slowly from the stomach to the small intestine. In gastroparesis, the muscles of the stomach do not work well and digestion takes an abnormally long time. Symptoms of gastroparesis include bloating, nausea, vomiting, weight loss due to poor absorption of nutrients, early fullness while eating meals, heartburn, and abdominal pain. Complications can occur including dehydration, electrolyte abnormalities, blood sugar abnormalities, malnutrition, vitamin deficiencies, stomach ulcers, gastroesophageal reflux, esophagitis, small bowel bacterial overgrowth, and metabolic bone disease. In rare cases, food that is poorly digested can collect in the stomach and form a bezoar, a mass of undigested material that can cause a blockage in the gastrointestinal tract. Gastroparesis is more common in people with diabetes and those who have had recent stomach or intestinal surgery. Other causes include infections, hormonal disorders like hypothyroidism, connective tissue disorders like scleroderma, autoimmune conditions, neuromuscular diseases, psychological conditions, and eating disorders. In some cases, the cause is not known (idiopathic). Diagnosis is made on the basis of a radiographic gastric emptying test.
Treatment may include dietary modifications such as adjusting the timing and size of meals, consuming more liquid-based meals, or avoiding foods that are more difficult to digest (such as fatty foods, or foods with too much fiber). Other treatments may include endoscopic procedures to break the bezoar apart and remove it, feeding tubes, surgery, placement of an electrical stimulator, and medication such as metoclopramide, domperidone, erythromycin and cisapride. With proper management many people with gastroparesis can live a relatively normal life. However, others may not tolerate treatment and may experience significant complications, a decreased quality of life, and reduced survival.
Source: GARD Last updated on 07-05-20
Most individuals with gastroparesis have persistent nausea that worsens after eating and may be associated with vomiting and abdominal pain. However, many others are so severely affected that they are not able to perform normal activities of daily living, and may have a decreased quality of life and significant psychological distress.. Studies evaluating the quality of life of individuals with gastroparesis have reported decreased physical and social functioning and reduced overall well-being. About 1 in 10 patients with gastroparesis is considered disabled. Studies have also shown that patients with gastroparesis have significantly reduced overall survival when compared with the general population.
Multiple symptoms can be associated with gastroparesis. With the delay in gastric emptying, affected individuals commonly suffer from nausea (93 percent), vomiting (68 to 84 percent), and abdominal pain (46 to 90 percent). The abdominal pain interferes with sleep in 80 percent of patients. * Patients also experience bloating, *** early fullness while eating, and loss of appetite.
As a result of the recurrent vomiting and decreased oral intake, patients with gastroparesis can develop dehydration and electrolyte abnormalities including low potassium levels and imbalances in the acid/base status of the blood. Blood sugar (glucose) levels fluctuate and are difficult to control, particularly in patients with diabetes. Malnutrition and unintentional weight loss can occur because patients eat fewer calories and absorb vitamins and nutrients poorly, and often require hydration and vitamin and nutritional supplementation. Emergency room visits and long, costly hospitalizations to provide hydration and nutritional support are common among these patients. Nutrition is often delivered directly into the intestines through feeding tubes, and in rare severe cases it may be necessary to deliver it directly into the blood.
Other complications are also associated with gastroparesis. Small bowel bacterial overgrowth (often called small intestinal bacterial overgrowth or SIBO) may worsen the digestive symptoms, malnutrition, and vitamin deficiencies; therefore, it is important to monitor for the overgrowth and to treat as necessary. Decreased intake of calcium and vitamin D and poor absorption can lead to metabolic bone disease. Secondary gastrointestinal complications can develop such as gastroesophageal reflux, stomach ulcers, esophagitis, and tears of the esophagus. Some patients with gastroparesis are also at increased risk of blood clots.
In rare, severe cases of gastroparesis, patients may develop a bezoar, a mass of poorly digested food that forms in the stomach. This mass may cause a blockage that prevents the stomach contents from emptying into the small intestine, and affected individuals may experience worsening of their nausea, vomiting, and abdominal pain. It is estimated that 6 percent of gastroparesis patients develop a bezoar, and gastroparesis is the single most common cause of bezoar formation.
Although many people can live a relatively normal life with proper management of gastroparesis, some of the medical treatments are not tolerated by patients, and management options are limited. However, new medications and surgical techniques may provide some relief for difficult-to-treat symptoms in the future.
Last updated on 05-01-20
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