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Gastroparesis
Definition
Gastroparesis is a condition that reduces the ability of the stomach to empty its contents. It does not involve a blockage (obstruction).
Alternative Names
Gastroparesis diabeticorum; Delayed gastric emptying
Causes
The exact cause of gastroparesis is unknown. It may be caused by a disruption of nerve signals to the stomach. The condition is a common complication of diabetes. It can also follow some surgeries.
Risk factors for gastroparesis include:
- Diabetes
- Gastrectomy (surgery to remove part of the stomach)
- Systemic sclerosis
- Use of medication that blocks certain nerve signals (anticholinergic medication)
Symptoms
- Abdominal distention
- Hypoglycemia (in people with diabetes)
- Nausea
- Premature abdominal fullness after meals
- Weight loss without trying
- Vomiting
Exams and Tests
- Esophagogastroduodenoscopy (EGD)
- Gastric emptying study (using isotope labeling)
- Upper GI series
Treatment
People 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 foods may also help relieve some symptoms.
Medicatines that may help include:
- Cholinergic drugs, which act on acetylcholine nerve receptors
- Erythromycin
- Metoclopramide, a medicine that helps empty the stomach
- Serotonin antagonist drugs, which act on serotonin receptors
Other treatments may include:
- Botulinum toxin (Botox) injected into the outlet of the stomach (pylorus)
- Surgical procedure that creates an opening between the stomach and small intestine to allow food to move through the digestive tract more easily (gastroenterostomy)
Outlook (Prognosis)
Many treatments seem to provide only temporary benefit.
Possible Complications
Ongoing nausea and vomiting may cause:
- Dehydration
- Electrolyte imbalances
- Malnutrition
People with diabetes may have serious complications from poor blood sugar control.
When to Contact a Medical Professional
Changes in your diet may help control symptoms. Call your health care provider if symptoms continue or if you have new symptoms.
References
Koch KL. Gastric neuromuscular function and neuromuscular disorders. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 48.
Reviewed By: George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, and Stephanie Slon.
