Gastroparesis │ Gastroparesis: When The Stomach Gets Sluggish

If you have diabetes, elevated glucose levels can damage nerves needed to help pass food along from the stomach through the intestines; the motility disorder called gastroparesis is one of the major complications of the disease.

Gastroparesis causes delayed emptying of food from the stomach into the intestinal tract, which can lead to feelings of early fullness and bloating, as well as heartburn, nausea and vomiting. It’s commonly associated with type 1 and type 2 diabetes; that’s because chronically high blood sugar over many years can damage nerves throughout the body. In the case of gastroparesis, poor blood sugar control can damage the vagus nerve, which helps orchestrate the complex connections in the digestive tract and affects the wavelike movements that propel digested food through the gastrointestinal (GI) tract.

“As a result, the stomach doesn’t empty very well,” advises Cindy M. Yoshida, M.D., a gastroenterologist in Charlottesville, VA, and author of No More Digestive Problems. Complicating matters is the fact that when food lingers too long in the stomach, it can become fermented, which can lead to bacterial overgrowth in the small intestine. “This can cause problems with the absorption of foods that can, in turn, lead to weight loss and metabolic problems like dehydration and electrolyte imbalances,” Dr. Yoshida explains.

Gastroparesis Diagnosis

The condition is typically diagnosed with a gastric-emptying scan: A person eats a standard meal, then the stomach is scanned to see how quickly it empties. To treat gastroparesis, dietary adjustments are usually in order: Experts recommend eating smaller, more frequent meals that are low in fat and fiber. This may help with both gastric emptying and the feelings of fullness that often haunt people with this condition. It can also help to have liquid meals—such as soups or pureed foods—which typically pass through the stomach more easily and quickly. And keeping tight control of your blood sugar can improve symptoms of gastroparesis.

Gastroparesis Treatment

A few different drugs—including pro-motility agents and antibiotics—can be used to treat gastroparesis. One emerging treatment uses Botox, which has been found to relax the muscle that lies between the stomach and small intestine. Relaxing that muscle allows the stomach to release food more readily. As with other Botox treatments, however, the results are temporary.

In another new development, gastric pacemakers have been found to help with gastroparesis. This treatment involves the surgical implantation of the device on the stomach, where it provides electrical impulses that “help mimic the normal movements of the stomach, causing it to empty faster,” says Prabhakar Swaroop, M.D., an assistant professor of gastroenterology at the St. Louis University School of Medicine. In fact, one recent study at the University of Memphis in Tennessee found that electrical stimulation decreased nausea and vomiting and improved the rate of gastric emptying in one week. Even better news is that the study also found that the results were sustained over one full year in those patients who had gastric pacemakers permanently implanted.

While there isn’t a cure, discovering the options in gastroparesis treatment can improve your quality of life.

Writer: Stacey Colino
©Diabetes Focus, Second Quarter 2007

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