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Gastroparesis

Definition

Gastroparesis is a condition in which the stomach's ability to empty its contents is impaired, unrelated to obstruction.

Alternative Names

Gastroparesis diabeticorum; Delayed gastric emptying

Causes, incidence, and risk factors

The cause of gastroparesis is unknown, but disruption of nerve stimulation to the intestine may be responsible. The condition is a common complication of diabetes and can be a complication of some surgeries.

Risk factors for gastroparesis include diabetes, systemic sclerosis,  previous gastrectomy, and use of anticholinergic medication (medication that inhibits certain nerve signals).

Symptoms

• Nausea  
• Vomiting
• Abdominal distention
• Premature abdominal fullness after meals
• Unintentional weight loss  

Signs and tests

• Isotope study showing gastroparesis
• Upper GI series showing gastric retention
• EGD (esophagogastroduodenoscopy)

Treatment

Persons with diabetes should always control their blood sugar levels. Better control of blood sugar levels may improve symptoms of gastroparesis. Eating small meals and soft (well-cooked) foods may also help relieve some symptoms.

Medications include:

• Metoclopramide, a medicine that helps in emptying the stomach
• Serotonergic drugs, which act on serotonin receptors
• Cholinergic drugs, which act on acetylcholin nerve receptors

Other treatments may include:

• Botulinum toxin (Botox) injected into the pylorus (outlet of the stomach)
• Gastroenterostomy, a surgical procedure that creates an opening between the stomach and small intestine to allow food to move through the digestive tract more easily

Expectations (prognosis)

Many treatments seem to provide only temporary benefit.

Complications

Persistent nausea and vomiting may cause electrolyte imbalances, dehydration, and malnutrition. Diabetics may have serious complications related to poor blood sugar control.

Calling your health care provider

Apply home treatment such as dietary management. Call your provider if symptoms persist or if there are new symptoms.

Review Date:5/4/2006
Reviewed By:Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Jefferson Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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