Gastroparesis is a disorder of the digestive system defined by the abnormal movement of food from the stomach to the small intestine. The inability of the stomach to properly digest food and empty itself of its contents gives rise to several gastrointestinal symptoms and complications. The cause of the condition is not always known, though experts link diseases, disorders, and medications, depending on the case. Several treatments exist in addressing complications and managing symptoms, and individuals with gastroparesis can lead normal, healthy lives.
In a healthy digestive system, food travels through the digestive tract by way of involuntary muscle contractions in the stomach that are controlled by the vagus nerve. These contractions break food down and move the contents of the stomach into the small intestine. There, the bloodstream absorbs the nutrients, water, and electrolytes of the digested food.
Gastroparesis disrupts the healthy functioning of the digestive system. Inadequate muscle contractions in the stomach interrupt the normal movement of food, delaying or preventing the emptying of the stomach into the small intestine. This hindrance results in the disruption of proper nutrient absorption in the small intestine and can lead to a host of uncomfortable symptoms and harmful complications. There are three types of gastroparesis: idiopathic, diabetic, and postsurgical. The cause of the idiopathic type, the most prevalent of three, is unknown.
Gastroparesis typically presents with a variety of gastrointestinal disturbances, which can include nausea, vomiting, heartburn, and stomach pain. Individuals who experience the condition often report indigestion, acid reflux, bloating, and feeling full immediately after eating even a small meal. Poor appetite may also result in weight loss, dehydration, and malnutrition.
Prolonged, untreated gastroparesis can lead to serious complications that must be medically addressed before doctors can begin treating the condition itself. Dehydration and malnutrition are among the most common complications. Poorly digested food remaining in the stomach for an extended period may ferment, resulting in an overgrowth of bacteria. Undigested contents in the stomach might also develop into a bezoar, a hard mass of poorly digested food that can potentially obstruct the intestines. This complication is rare.
Gastroparesis is comorbid (often existing alongside) with several diseases and disorders, particularly those affecting the endocrine, nervous, and muscular systems, as well as the connective tissues. Comorbid conditions include hypothyroidism, scleroderma, and Parkinson's disease. Diabetes, the disease most frequently linked to gastroparesis, damages nerve cells. Damage to the vagus nerve in the digestive system results in the symptoms of gastroparesis.
Determining the presence of the condition begins with a thorough history of symptoms, previously diagnosed diseases or disorders, recent surgeries and medications, as well as a physical exam. If the physician suspects gastroparesis, he or she will order diagnostic testing to evaluate the health and functioning of the digestive system and to rule out any other conditions or obstructions.
The most common diagnostic tests to confirm gastroparesis are the gastric emptying study and the upper endoscopy. In the gastric emptying study, the individual consumes a light meal with a small amount of radioactive material in it. A scanner tracks the progress of the food through the digestive tract, focusing particularly on how long it takes for the food to pass from the stomach to the small intestines. An upper endoscopy involves threading a thin tube with a camera down the esophagus and into the stomach. The endoscope allows the physician to examine the esophagus, stomach, and upper small intestines for any abnormalities or obstructions. Diagnostic testing might also include ultrasound and x-rays. Some doctors utilize motility capsules, electronic pills that transmit digestive data to an external receiver when swallowed.
Treating gastroparesis begins with addressing any underlying diseases or disorders. The doctor may also recommend stopping medications that contribute to the condition. If symptoms persist, medicinal or surgical intervention is often necessary. Surgery is, however, typically reserved for individuals unresponsive to less invasive therapies, as well as those experiencing acute complications.
Antibiotics and dopamine-receptor antagonists can stimulate contraction of the poorly functioning stomach muscles. Antiemetics may be prescribed to ease nausea and vomiting. Surgical interventions include the placement of an electrical gastric stimulation device in the abdomen, insertion of an intestinal feeding tube, and gastrostomy.
Diet plays a significant role in managing the symptoms and potential complications of gastroparesis. Avoiding raw and fibrous fruits and vegetables, as well as foods high in fat and fiber, makes digestion easier. Drinking plenty of water also supports the function of the digestive tract. Eating smaller meals throughout the day and chewing food thoroughly reduces feelings of fullness after eating and puts less stress on the digestive system. Engaging in moderate exercise following meals encourages the movement of food and emptying of the stomach.
Gastroparesis attributable to a specific disease, disorder, or medication can potentially be resolved entirely once treatment addresses the underlying circumstances. Idiopathic gastroparesis is typically chronic, and not everyone with the condition responds well to treatment. Symptoms and complications often interfere with daily life and may lead to social, emotional, and psychological distress. Through diet, medication, and proper medical attention, however, gastroparesis can often be managed, and individuals with the condition can lead normal lives.
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