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Gastroparesis

Gastroparesis diabeticorum; Delayed gastric emptying

 

Gastroparesis is a condition that reduces the ability of the stomach to empty its contents. It does not involve a blockage (obstruction).

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 medicine that blocks certain nerve signals (anticholinergic medicine)

 

Symptoms

 

Symptoms may include:

  • Abdominal distention
  • Hypoglycemia (in people with diabetes)
  • Nausea
  • Premature abdominal fullness after meals
  • Weight loss without trying
  • Vomiting
  • Abdominal pain

 

Exams and Tests

 

Tests you may need include:

  • 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.

Medicines 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

Camilleri M, Parkman HP, Shafi MA, Abell TL, Clinical guideline: management of gastroparesis. Am J Gastroenterol. 2013; 108:18-37. PMID: 23147521 www.ncbi.nlm.nih.gov/pubmed/23147521.

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: Elsevier Saunders; 2010:chap 48.

 
  • Digestive system

    Digestive system - illustration

    The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

    Digestive system

    illustration

  • Stomach

    Stomach - illustration

    The stomach is the portion of the digestive system most responsible for breaking down food. The lower esophageal sphincter at the top of the stomach regulates food passing from the esophagus into the stomach, and prevents the contents of the stomach from reentering the esophagus. The pyloric sphincter at the bottom of the stomach governs the passage of food out of the stomach into the small intestine.

    Stomach

    illustration

    • Digestive system

      Digestive system - illustration

      The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.

      Digestive system

      illustration

    • Stomach

      Stomach - illustration

      The stomach is the portion of the digestive system most responsible for breaking down food. The lower esophageal sphincter at the top of the stomach regulates food passing from the esophagus into the stomach, and prevents the contents of the stomach from reentering the esophagus. The pyloric sphincter at the bottom of the stomach governs the passage of food out of the stomach into the small intestine.

      Stomach

      illustration

    A Closer Look

     

      Tests for Gastroparesis

       

         

        Review Date: 11/20/2014

        Reviewed By: Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Aria Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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