Gastroparesis

Gastroparesis, also called delayed gastric emptying, is a digestive disorder (Read about "Digestive System") in which the stomach takes too long to empty its contents. It often occurs in people with type 1 diabetes or type 2 diabetes. (Read about "Diabetes")

Gastroparesis often happens when nerves to the stomach are damaged or stop working. This is a type of peripheral neuropathy called autonomic neuropathy. (Read about "Peripheral Neuropathy") The vagus nerve controls the movement of food through the digestive tract. If the vagus nerve is damaged, the muscles of the stomach and intestines do not work normally and the movement of food is slowed or stopped. Gastroparesis can also develop if the muscles themselves are damaged.

Diabetes can damage the vagus nerve if blood glucose levels remain high over a long period of time. High blood glucose causes chemical changes in nerves and damages the blood vessels that carry oxygen and nutrients to the nerves. (Read about "Nervous System")

Signs and symptoms of gastroparesis, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) are:

• heartburn (Read about "Heartburn")
• nausea
• vomiting of undigested food
• an early feeling of fullness when eating
• weight loss
• abdominal bloating
• erratic blood glucose levels
• lack of appetite
• gastroesophageal reflux (Read about "GERD")
• spasms of the stomach wall

These symptoms may be mild or severe, depending on the person.

If food lingers too long in the stomach, it can cause problems like bacterial overgrowth (Read about "Microorganisms") from the fermentation of food. Also, the food can harden into solid masses called bezoars that may cause nausea, vomiting and obstruction in the stomach. Bezoars can be dangerous if they block the passage of food into the small intestine.

NIDDK says gastroparesis can be caused by:

• diabetes (Read about "Diabetes")
• post viral syndromes (Read about "Chronic Fatigue Syndrome" "Post-Polio Syndrome")
• anorexia nervosa (Read about "Eating Disorders")
• surgery on the stomach or vagus nerve
• medications, particularly anticholinergics and narcotics (drugs that slow contractions in the intestine) (Read about "Medication and Digestion")
• gastroesophageal reflux disease (rarely according to NIDDK)
• smooth muscle disorders such as amyloidosis and scleroderma (Read about "Scleroderma")
• nervous system diseases, such as Parkinson's disease (Read about "Parkinson's Disease")
• metabolic disorders, including hypothyroidism (Read about "Thyroid")

In diabetics, gastroparesis can make the diabetes worse by adding to the difficulty of controlling blood glucose. When food that has been delayed in the stomach finally enters the small intestine and is absorbed, blood glucose levels rise. Since gastroparesis makes stomach emptying unpredictable, a person's blood glucose levels can be erratic and difficult to control.

NIDDK says the primary treatment goal for gastroparesis related to diabetes is to regain control of blood glucose levels. Treatments include insulin, oral medications, changes in what and when you eat and, in severe cases, feeding tubes and intravenous feeding.

NIDDK says that in many cases, changing your eating habits can help control gastroparesis. Your doctor or dietitian will give you specific instructions, but you may be asked to eat six small meals a day instead of three large ones. If less food enters the stomach each time you eat, it may not become overly full. Or the doctor or dietitian may suggest that you try several liquid meals a day. Liquid meals provide all the nutrients found in solid foods, but can pass through the stomach more easily and quickly. The doctor may also recommend that you avoid high-fat and high-fiber foods.

NIDDK says it is important to note that in most cases, treatment does not cure gastroparesis - it is usually a chronic condition. Treatment helps you manage the condition so that you can be as healthy and comfortable as possible.