Gastroparesis

What is gastroparesis?

When stomach muscles are strong, they contract to move food through your digestive tract. With gastroparesis, the nerves in the stomach become damaged, and the muscles don’t work as well as they should, slowing down the movement of food.

What are the symptoms of gastroparesis?

If you have gastroparesis, symptoms can include:

• Feeling full very quickly, even after eating small amounts of food

• Nausea and vomiting

• Loss of appetite and weight loss

• Stomach pain

• Bloating

• Heartburn

Gastroparesis complications

In some cases, gastroparesis can lead to more serious complications, including:

• Dehydration – Especially if gastroparesis causes you to vomit a lot

• Gastro-oesophageal reflux disease (GORD) – When stomach acid comes back up into your gullet (oesophagus)

• Malnutrition – If you aren’t eating enough, or you’re vomiting a lot your body can’t absorb enough nutrients

• Fluctuations in blood sugar levels – Caused by changing amounts of food going into your small bowel. This can be a particular problem if you have diabetes

• Bezoars (undigested food that hardens in your stomach) – These can cause nausea and vomiting and can be serious if they stop food from passing into your small intestine

What causes gastroparesis?

It’s not always clear what causes gastroparesis, and these cases are known as idiopathic gastroparesis.

The most common known causes are:

• Type 1 or type 2 diabetes – If diabetes is poorly managed it can damage cells in your stomach and the vagus nerve, which regulates your digestive system

• Complications from surgery – If your vagus nerve is damaged during surgery it can affect the function of your stomach

Other risk factors that can increase your risk of gastroparesis include:

• Infection – Usually from a virus

• Certain medications – Including opioid pain medications and some antidepressants

• Nervous system diseases, like Parkinson's disease or multiple sclerosis

• Underactive thyroid (hypothyroidism)

• Rare conditions – Like scleroderma (a disease that can cause problems with internal organs and blood vessels) and amyloidosis (caused by a build-up of abnormal protein in organs and tissues throughout the body)

How is gastroparesis diagnosed?

If you’re experiencing any symptoms of gastroparesis, your doctor will start by looking at your symptoms and medical history and taking a blood test. They may refer you to hospital for further tests, like:

• Endoscopy – This test feeds an endoscope (a thin, flexible tube) down the throat and into the stomach to look at the stomach lining

• Barium swallow – After drinking some white barium solution, you’re given an X-ray, highlighting the solution in your digestive system

• Gastric emptying scan – A radioactive substance, which can be seen on a scan, is added to the food you eat. Doctors then monitor how much of the substance is still in your stomach after four hours

• Wireless capsule test – You’re asked to swallow a small electronic device that can monitor its own speed and send the information back to a recording device

• Gastric emptying breath test – A substance is added to your food or drink and then absorbed by your body when you consume it. The amount of substance in your breath is then measured to see how fast your stomach is emptying what you’ve consumed

How is gastroparesis treated?

There’s no cure for gastroparesis, but symptoms can usually be controlled with medication and some changes to your diet.

Changes to your diet

• Eat smaller meals more often, so your stomach has less food to process at one time

• Go for softer or liquid foods whenever you can, like soups and pureed food

• Chew food properly and don’t rush meals

• Avoid fizzy drinks

• Avoid fibrous food that can be harder to digest, like oranges and broccoli

• Reduce the amount of fat you eat as this can slow down your digestion

• Drink plenty of water

You might find it helps to go for a gentle walk after eating.

Medication

The following medicines may be recommended to treat gastroparesis:

• Medication that stimulates stomach muscles – Certain medicines called dopamine antagonists and antibiotics can help the stomach to contract and help move food along. These can cause side effects and aren’t suitable for everyone

• Antiemetics – Medication that can help to ease nausea and sickness

Hospital procedures

Hospital procedures are less common, and not all are widely available on the NHS.

• Electrical stimulation – A new treatment that involves fitting a device under the skin of your tummy which sends electric impulses to stimulate the muscles that move food through your stomach

• Botulinum toxin (Botox) injections – Injections to relax the valve between your stomach and small intestine and keep it open for longer so that food can pass through

• Feeding tube – A feeding tube inserted into the digestive tract through your nose or into the bowel through an incision in your tummy may be recommended in more severe cases

• Surgery – Different types of surgery are sometimes offered to help food pass through your stomach more easily. One type of surgery involves inserting a tube into the stomach, which can be opened to release gas

How can Livi help?

A Livi doctor will ask you questions about your symptoms. They’ll make an individual assessment, recommend a treatment or refer you to a specialist if needed.