Build-up of poorly digested food in the stomach due to Gastroparesis leads to the formation of a tightly packed solid mass called a bezoar. If the bezoar grows large enough to block the passage of food to the small intestine, it can be life-threatening.

As the name suggests Gastroparesis is a condition associated with the stomach. It is a condition in which the stomach muscles slow down and as a result, the stomach does not empty completely. Some amount of digested food remains in the stomach and over time it causes discomfort. Gastroparesis is often confused with indigestion because both conditions share symptoms such as nausea, fullness, and vomiting. However, they are quite different and required different modes of treatment.

Gastroparesis is not a quite common condition. 10 men and 40 women out of 1,00,000 people are diagnosed with the condition.

CAUSES OF GASTROPARESIS

The vagus nerve plays a significant part in digestion. It is responsible for contacting the stomach muscles and pushing out the food from the stomach into the intestine for the next stage of digestion. When the vagus nerve is damaged, the signals to the stomach muscles to empty the food into the small intestine are impaired. As a result, the stomach retains digested food for longer than it should. As increased food builds up in the stomach, the digestive process suffers immensely and the individual begins to show symptoms of nausea, abdominal pain, loss of appetite and vomiting. But what damages the vagus nerve? It could be a disease like diabetes. Surgery to the stomach or small intestine could also damage the vagus nerve.

RISK FACTORS FOR GASTROPARESIS

While there are no known causes for Gastroparesis, some people seem to be at a higher risk of acquiring the condition. Risk factors include:

• – Having diabetes or hypothyroidism
• – Having undergone abdominal or oesophageal surgery
• – Regular usage of narcotic pain medication
• – Being diagnosed with Scleroderma
• – Having Parkinson’s Disease or Multiple sclerosis
• – Having a viral infection
• – Having eating disorders such as Anorexia nervosa or Bulimia nervosa

SYMPTOMS OF GASTROPARESIS:

Gastroparesis symptoms include:

• – Heartburn
• – Acid Reflux
• – Nausea
• – Vomiting undigested food
• – Feeling full
• – Loss of appetite
• – Unplanned weight loss
• – Abdominal pain and bloating
• – Fluctuating blood sugar levels

Since most of these symptoms can be interpreted as indigestion or heartburn, gastroparesis often goes unnoticed for too long.

COMPLICATIONS DUE TO GASTROPARESIS

Given that most people with gastroparesis do not realise they have it, the condition can lead to certain complications.

• Malnutrition. Residual food in the stomach lowers one’s appetite. Intake of nutrients reduces and leads to undernourishment.
• Severe dehydration. Frequent vomiting causes dehydration.
• Growth of Bacteria. When food remains in the stomach for too long, it ferments and gives room for the growth of bacteria in the stomach.
• Formation of a Bezoar in the stomach. The build-up of poorly digested food in the stomach leads to the formation of a tightly pack solid mass called a bezoar. If the bezoar grows large enough to block the passage of food to the small intestine, it can be life-threatening.
• Fluctuation in Blood Sugar Levels. Gastroparesis does not cause diabetes, but poor digestion can worsen diabetes because the level of blood sugar is in constant flux. Similarly, if you have diabetes and do not keep your sugar levels under control, you can worsen gastroparesis.

TREATING GASTROPARESIS

Gastroparesis is a chronic condition and there is no treatment to cure it completely. Through medication and changes in lifestyle, the disease can be kept under control. Complications can be averted. Some modes of treatment are listed here:

• Medication to stimulate the stomach muscles. Talk to your doctor about the side effects of prolonged usage of these medications.
• Medication to reduce nausea and vomiting.
• Change in diet and eating habits.
• Avoid Carbonated drinks, alcohol, and smoking.
• Exercise on a regular basis.
• Surgical intervention (in rare cases)

SURGICAL TREATMENT FOR GASTROPARESIS

Not everyone diagnosed with gastroparesis will require surgery. Depending on how much the condition has progressed and if other modes of treatment are not helping, the doctor will need to decide on what surgical procedure is required.

One type of surgery is Gastric Electrical Stimulation. In this method, a small device called a gastric stimulator is inserted into your stomach. It has two leads attached to your stomach and gives mild electric shocks to the stomach muscles to help with vomiting.

Another surgical method is Gastric Bypass. Here a small pouch is attached to the upper part of your abdomen. This pouch is directly connected to the small intestine. The stomach pouch limits how much you can eat.

In severe cases of gastroparesis, the doctor might recommend a jejunostomy. In this procedure, a feeding tube is inserted through your abdomen directly into your small intestine. Nutrients are fed to your body only through this tube. This is only a temporary solution.

SOME DIETARY AND LIFESTYLE CHANGES TO CONSIDER:

• Have a diet rich in fibre and low in fat.
• Eat smaller meals more frequently rather than three large meals.
• Chew your food thoroughly before swallowing.
• Avoid lying down within two hours of a meal.
• Drink at least 1.5 litres of water every day.

Following a strict diet and exercise regimen, will help control Gastroparesis. Consult with your doctor regularly to track your condition.

Reviewed By:

DR.ADARSH SURENDRANATH

CONSULTANT – GASTROENTEROLOGIST

MBBS.,MD.,DM MEDICAL GASTROENTEROLOGIST