Delayed Gastric Emptying (Gastroparesis)
The symptoms of delayed gastric emptying include nausea and vomiting. Poor emptying of the stomach can occur for several reasons:
- The outlet of the stomach (the pylorus and duodenum) may be obstructed by an ulcer or tumor, or by something large and indigestible that was swallowed.
- The pyloric sphincter at the exit of the stomach may not open enough or at the right times to allow food to pass through. This sphincter is controlled by neurological reflexes to ensure that only very tiny particles leave the stomach and also to insure that not too much acid or sugar leaves the stomach at one time, which could irritate or injure the small intestine. These reflexes depend on nerves that sometimes become damaged.
- The normally rhythmic, 3 per minute contractions of the lower part of the stomach can become disorganized so that the contents of the stomach are not pushed towards the pyloric sphincter. This also usually has a neurological basis but in many patients the cause of delayed gastric emptying is unknown, so the diagnosis given is idiopathic (meaning cause unknown) gastroparesis.
Treatment of Symptoms
Treatment of gastroparesis depends on the severity of the symptoms. Dietary changes may be helpful and include eating several small meals each day rather than three large meals. The meals should be low in fiber, fat, and roughage. Liquids are often better handled than solid food in patients with gastroparesis. For diabetic patients, controlling blood sugar levels may decrease symptoms of gastroparesis. [Ask your doctor or a registered dietician for dietary guidelines.]
Symptoms of gastroparesis may improve with treatment using medications prescribed by a doctor. In very severe cases, generally with weight loss, a feeding tube is placed in the small intestine to provide nutrition in a way that avoids the stomach.
Newer treatments are being evaluated. One, gastric electric stimulation, uses a pacemaker (a surgically implanted battery operated device) on the stomach. It may be used in some cases where all types of medications fail to adequately control the symptoms of nausea and vomiting.
Persons who experience symptoms of gastroparesis should talk to their doctor to find out what is wrong. If gastroparesis is diagnosed, the doctor can work with the patient and family to develop a treatment plan best suited for individual circumstances.