Gastroparesis

What is gastroparesis?

Gastroparesis, also called delayed gastric emptying, is a disorder in which the stomach takes too long to empty its contents. Normally, the stomach contracts to move food down into the small intestine for digestion. The vagus nerve controls the movement of food from the stomach through the digestive tract. Gastroparesis occurs when the vagus nerve is damaged and the muscles of the stomach and intestines do not work normally. Food then moves slowly or stops moving through the digestive tract.

The digestive system

What causes gastroparesis?

The most common cause of gastroparesis is diabetes. People with diabetes have high blood glucose, also called blood sugar, which in turn causes chemical changes in nerves and damages the blood vessels that carry oxygen and nutrients to the nerves. Over time, high blood glucose can damage the vagus nerve.
Some other causes of gastroparesis are

• surgery on the stomach or vagus nerve
• viral infections
• anorexia nervosa or bulimia
• medications—anticholinergics and narcotics—that slow contractions in the intestine
• gastroesophageal reflux disease
• smooth muscle disorders, such as amyloidosis and scleroderma
• nervous system diseases, including abdominal migraine and Parkinson's disease
• metabolic disorders, including hypothyroidism

Many people have what is called idiopathic gastroparesis, meaning the cause is unknown and cannot be found even after medical tests.

What are the symptoms of gastroparesis?

Signs and symptoms of gastroparesis are

• heartburn
• pain in the upper abdomen
• nausea
• vomiting of undigested food—sometimes several hours after a meal
• early feeling of fullness after only a few bites of food
• weight loss due to poor absorption of nutrients or low calorie intake
• abdominal bloating
• high and low blood glucose levels
• lack of appetite
• gastroesophageal reflux
• spasms in the stomach area

Eating solid foods, high-fiber foods such as raw fruits and vegetables, fatty foods, or drinks high in fat or carbonation may contribute to these symptoms.
The symptoms of gastroparesis may be mild or severe, depending on the person. Symptoms can happen frequently in some people and less often in others. Many people with gastroparesis experience a wide range of symptoms, and sometimes the disorder is difficult for the physician to diagnose.

What are the complications of gastroparesis?

If food lingers too long in the stomach, it can cause bacterial overgrowth from the fermentation of food. Also, the food can harden into solid masses called bezoars that may cause nausea, vomiting, and obstruction in the stomach. Bezoars can be dangerous if they block the passage of food into the small intestine.
Gastroparesis can make diabetes worse by making blood glucose control more difficult. When food that has been delayed in the stomach finally enters the small intestine and is absorbed, blood glucose levels rise. Since gastroparesis makes stomach emptying unpredictable, a person's blood glucose levels can be erratic and difficult to control.