What is gastroparesis?

Gastroparesis is a condition in which food stays in the stomach for longer than normal.

Usually, the muscles around your stomach contract and grind food into small pieces, then mix those small pieces with acids and enzymes so your food can start to be digested. Then the muscles contract and push food out of the stomach into the duodenum.

If you have gastroparesis, the muscles around your stomach don’t work properly. Food isn’t broken down in the stomach as much as normal, and it stays there for longer.

What causes gastroparesis?

It is not all that clear. It seems that in some people, the nerve to the muscles around your stomach, called the vagus nerve, isn’t working properly. For some people, the muscles themselves don’t work as well as they should.

You are more at risk of developing gastroparesis if you have diabetes. It is one of the complications of nerve damage caused by poorly controlled blood glucose levels.

Other causes include:

• stomach surgery
• diseases such as Parkinson’s, multiple sclerosis, scleroderma, and amyloidosis
• certain medications, such as opioids (prescribed painkillers) and some antidepressants

In some cases, there is no obvious reason for gastroparesis.

Gastroparesis symptoms

If you have gastroparesis, you probably feel that you just don’t digest your food properly, making you feel bloated and nauseous after a meal. Some people also:

• vomit, usually after meals
• feeling very full after eating
• have reflux or heartburn
• feel pain in the abdomen
• feel bloated
• get diarrhoea, usually at night
• lose their appetite
• lose weight

If you think you might have gastroparesis, see your doctor.

Gastroparesis diagnosis

To diagnose gastroparesis, your doctor will talk to you, examine you and arrange some blood tests.

You may also be referred for other investigations, such as a ‘gastric emptying study’, an ultrasound, or endoscopy.

Management of gastroparesis

Although gastroparesis cannot be cured, the symptoms can be relieved. You can ease symptoms by:

• eating fewer, smaller meals
• eating easy-to-digest foods
• taking medicines to improve the muscles around the stomach contraction and control nausea

If things don’t improve with changes to their diet and medicine, you can have a pacemaker inserted in your stomach to stimulate the muscles in your stomach. This is called gastric electrical stimulation. Talk to your doctor.

Very severe cases may be treated by injecting botox into the valve between your stomach and small intestine, inserting a feeding tube, or surgery.