GASTROPARESIS

By: Sarah SchneiderHenry Ford College

What is Gastroparesis (GP)?

Gastroparesis means paralysis of the stomach.

GP is characterized by delayed to severely delayed stomach emptying.

Gastroparesis is in the category of gastric motility/functional disorders and most medical practitioners tend to rule out other disorders before diagnosing a patient with GP.

Prevalence

GP is more prevalent in women than in men. The true number of those affected is unknown. It is estimated that 1.5 to 5 million Americans are affected. It is likely that GP is as common as other well known disorders like Crohn's and UC.

Of those affected, 90% are women under the age of 45.

Causes

Most cases of GP are idiopathic (no one cause can be identified). The second most common cause is Diabetes (either type 1 or 2). Third cause is abdominal surgical procedures (acute and self-limits in 3 months to a year).

Both idiopathic and Diabetes caused GP can be attributed to damage to the Vagus nerve.

Symptoms

Symptoms are general and can mimic other disorders.

Main symptoms of GP are bloating, early satiety (postprandial fullness), nausea, vomiting, constipation and middle epigastric pain.

Other symptoms are wt. loss/gain, gastric reflux, H. pylori infection, fatigue, and decrease appetite.

Diagnosis

In most cases it takes years to be diagnosed as patients are typically over tested.

Most definitive test is the Gastric Scintography or Gastric Emptying Study.

EGD is used to rule out mechanical obstruction and confirm diagnosis.

Management
(Currently no cure)

Dietary- Frequent small meals, avoid high fat foods, low fiber, chew (masticate) well before swallowing, ingest water and fruit juices, avoid carbinated drinks, avoid milk and whole dairy, take peels off fruits and vegetables, daily multivitamin, and Ensure clear/Enlive supplements.

Puree foods as necessary.

Pharm: ondansetron, Reglan, Compazine PPIs, H2 receptor agonists, Miralax, Milk of Magnesium, benadryl, Phenergan, Tigan, Tums, erythromycin, Unisom, acidophilis, Gas-X.

Other methods of management

Surgical placement of a gastric pacer (actual pacemaker for the stomach) and stomach transplant.

J-tube placement, gastric button, and TPN.

Botox injections to relax the pyloric sphincter and accupuncture.

Quality of Life

Gastroparesis affects every aspect of a patient's life. As treatments for GP continue to evolve, therapies to help patients address the psychological impact and the feelings of loss need to be addressed.

Often times, GP patients need to prepare foods a certain way or plan for consequences of eating the wrong foods when trying to avoid awkwardness when traveling, at a restaurant, dating, or at social gatherings.

Overall, depending on the severity, GP quality of life is fair to good once on an effective management plan. Each plan is different for every patient. Flare-ups may occur, but can be controlled. However, consequences of GP are elyte imbalances, malnutrition, bezors (hardened undigested food), and dentition issues.

Video
https://youtu.be/OMyaT6uxrTc

G-PACT Gastroparesis awareness and info:https://www.g-pact.org/