What is Gastroparesis?
What is Gastroparesis? Gastroparesis is a condition in which the movement of spontaneous (motility) of the stomach muscle is not working properly.
Under normal circumstances, food is driven by muscle contraction along the digestive tract. In patients with gastroparesis, motility of the stomach does not work perfectly or even does not work at all, thus inhibiting the process of emptying the stomach. This will certainly interfere with the whole digestive process, which then leads to nutritional disorders, blood sugar problems, and so on.
Symptoms of Gastroparesis
Symptoms commonly experienced by people with gastroparesis are:
- Abdominal pain or heartburn
- Decreased appetite.
- Weight loss.
- Very quickly feel full.
- Nausea and vomiting.
If gastroparesis is not treated, complications that may arise include:
- The cholesterol changes blood sugar levels, especially in diabetics.
- Gastro-Oesophageal Reflux Disease (GORD), in which stomach acid rises into the esophagus and irritates the inner wall of the esophagus.
- Food is left in the stomach and then clot and solidify. These clots can cause nausea and vomiting, and clog the stomach so that food can not be channeled to the intestine.
- Severe dehydration due to continuous vomiting.
- Lack of nutrients.
Causes of Gastroparesis
Until now, the cause of gastroparesis is not known for certain. However, in many cases, gastroparesis is thought to occur due to damage to the nerves that control the muscles of the stomach (vagus nerve).
The vagus nerve serves to regulate all processes in the human digestive tract, including sending signals to the stomach muscles to contract to push food into the small intestine.
Some other conditions that can also cause gastroparesis are:
- Complications of some types of surgery. Such as surgery to reduce weight (such as gastric appeal, or gastric bypass) or partial removal of the stomach (gastrectomy).
- Amyloidosis. A rare disease in which there is accumulation of abnormal proteins in tissues or organs throughout the body.
- Drugs, such as opioid pain relievers and some antidepressants.
- Scleroderma, a disease that causes hardening in some parts of the skin and sometimes also interference with internal organs and blood vessels.
- Parkinson’s disease, where there is progressive brain damage.
- Type 1 or type 2 uncontrolled diabetes.
Other factors that can also inhibit the process of emptying the stomach are:
- Infection, usually a virus.
- Abdominal or esophageal surgery.
- Abnormalities of the nervous system.
- Drugs that lower the rate of gastric emptying.
- Radiation therapy.
Diagnosis of Gastroparesis
Inspection procedures that can be performed to diagnose gastroparesis, among them:
- Hydrogen breath test. Patients will be asked to drink sugar water, then recorded levels of hydrogen in his breathing and the time detection of the gas on the patient’s breath.
- Barium Meal Test. Patients will be asked to drink barium liquid that will coat the walls of the gastrointestinal tract and clarify the picture on radiology examination. After that, X-rays are done to see abnormalities in the digestive system.
- Upper digestive endoscopy. Use a small camera, to see inside of the upper gastrointestinal tract.
- Test gastric emptying. After the patient ingests food that has been spiked by a radioactive marker, the scanner positioned on the patient’s stomach will monitor how much time it takes until the food comes out of the stomach. This is a very important check in diagnosing gastropares.
- CT and MR Enterography. Both checks are more sensitive than conventional radiological examinations to see if there is inflammation or blockage of the intestine.
- Wireless Motility Capsule. The patient will be asked to swallow a small electronic device that will record the length of gastric emptying as well as other information such as pH, pressure, and temperature along the digestive tract.
Gastroparesis treatment step begins with identifying and addressing the main cause. After that, the action that can be done is:
- Changing the food menu. Patients are advised to eat foods that are more easily digested.
- Botulinum toxin injection of the valve connecting the stomach to the small intestine (pyloric sphincter), to weaken the valve muscle so that it can open longer for gastric emptying.
- Drugs. There are two types of drugs used in gastroparesis, which are drugs to stimulate the stomach muscles and drugs to suppress nausea and vomiting.
- Electrical stimulation. Drain electricity through electrodes attached to the stomach wall, with the aim of stimulating gastric muscle movement. But the benefits of this therapy still need to be investigated further.
- Surgery. In severe cases where the patient can not eat or drink, the hose will be attached to the small intestine to insert food from the outside. Doctors can also install a ventilation hose to reduce the pressure of the contents of the stomach.