What is gastroparesis?

Gastroparesis is a gastric disorder that develops as a result of damage to the nerves that control how food moves through the digestive tract. The main consequence of this disorder is that the emptying of the stomach takes longer than normal, which causes food to move very slowly through the gastrointestinal system. Gastroparesis is also known as delayed gastric emptying.

The nerve that controls the movement of food through the stomach and intestines is called the vagus nerve. The vagus nerve works by controlling the muscle contractions that propel food through the digestive tract. When the nerve is damaged, the muscles do not receive the correct amount of stimulation and food moves much more slowly through the gastrointestinal system.

Diabetes-related nerve damage is the most common cause of gastroparesis. Other causes of nerve damage include viral infections, gastroesophageal reflux disease, and disorders of the nervous system, muscles, or metabolism. Long-term use of medications that affect intestinal contractions, such as narcotics, can damage the vagus nerve. In some cases, nerve damage is idiopathic, meaning a cause cannot be found after diagnostic tests.

Damage to the vagus nerve causes symptoms related to the inability of the stomach and intestines to process food at a normal rate. Possible symptoms include heartburn, nausea, upper abdominal pain, vomiting, bloating, stomach cramps, gastroesophageal reflux, weight loss, and feeling full after eating only a small amount of food. People with diabetes may find their blood sugar levels more difficult to control.

The slow movement of food through the gastrointestinal tract can cause serious complications. When food sits in the stomach for too long, it can begin to ferment and cause bacterial overgrowth. The most dangerous complication is the formation of bezoars, solid masses of food that can cause vomiting and nausea and can lodge in the stomach and block the opening of the small intestine.

Gastroparesis is a chronic condition, because damage to the vagus nerve cannot be cured. Rather than reversing the damage, treatment for this condition involves the use of medications and dietary modifications to relieve symptoms and reduce the risk of complications. Medications prescribed to treat this condition include anti-nausea medications, antiemetics to decrease vomiting, and medications that help the stomach empty more quickly.

Dietary changes that may help relieve symptoms of gastroparesis include reducing fat and fiber in the diet and avoiding carbonated beverages. Fat slows stomach emptying and fiber is difficult to digest, meaning these nutrients can worsen symptoms and contribute to bezoar formation. Eating smaller, more frequent meals can help reduce symptoms. People who do not benefit from these changes can try a diet of pureed or liquid foods that are more easily digested and empty from the stomach more quickly.

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