Gastroparesis is a disorder affecting the stomach’s ability to empty its contents. This condition can lead to uncomfortable symptoms and impact daily life. Understanding gastroparesis involves recognizing how it alters normal digestion.
Understanding Gastroparesis
Gastroparesis, sometimes referred to as gastric stasis, literally translates to “stomach paralysis.” It is a functional disorder where the stomach’s muscular contractions, known as peristalsis, become weaker and slower. This impairment means food and liquids remain in the stomach for an extended period, a condition called delayed gastric emptying.
The stomach’s normal function involves grinding food and then pushing it into the small intestine through the pyloric valve. When the nerves and muscles responsible for this coordinated movement are affected, food does not pass through at the appropriate rate. This disruption holds up the entire digestive process, leading to issues.
Key Symptoms and Underlying Causes
Individuals with gastroparesis often experience a range of noticeable symptoms. Common complaints include nausea, vomiting, a feeling of fullness soon after starting a meal, bloating, and abdominal pain. Nausea is particularly prevalent, and vomiting undigested food eaten hours earlier can occur. Some people also report early satiety, which is the sensation of feeling full disproportionately early during a meal.
The primary cause of gastroparesis is often damage to the vagus nerve, which helps control stomach muscle movement. Diabetes is the most common known underlying cause, with high blood sugar levels damaging nerves and affecting stomach emptying (diabetic gastroparesis). When no specific cause is identified, the condition is termed idiopathic gastroparesis. Gastroparesis can also develop after surgery on or near the stomach (post-surgical gastroparesis) due to potential vagus nerve injury. Certain medications, such as opioids, can temporarily slow stomach emptying and mimic symptoms.
Is Gastroparesis Truly Rare?
Gastroparesis is not as common as some other digestive conditions, but it is not necessarily “rare,” especially within certain populations. In the United Kingdom, the diagnosed prevalence was estimated at 13.8 per 100,000 persons in 2016. In the United States, estimates suggest a prevalence of 267.7 per 100,000 adults, with “definite” gastroparesis (confirmed by specific testing) at 21.5 per 100,000.
The perception of gastroparesis being rare may stem from diagnostic challenges and potential underdiagnosis. It can be difficult to diagnose, and its symptoms sometimes overlap with other digestive disorders like functional dyspepsia. Among individuals with diabetes, the prevalence is notably higher, estimated at 9.3% globally. Specifically, 4.6% of people with Type 1 diabetes and 1.3% of those with Type 2 diabetes are estimated to have gastroparesis.
Diagnosis and Treatment Pathways
Diagnosing gastroparesis typically involves a multi-step approach, beginning with a review of medical history and a physical examination. Doctors look for signs of underlying diseases and rule out any physical obstructions in the stomach or intestines that might cause similar symptoms. Imaging tests like an upper endoscopy or upper GI series are often performed to exclude blockages.
The “gold standard” test for confirming gastroparesis is gastric emptying scintigraphy (GES). This test involves eating a meal that contains a small amount of radioactive material. A scanner then tracks how quickly the food moves through the stomach over several hours, indicating delayed emptying if a significant amount remains after a certain time. Other tests, such as a gastric motility breath test, can also measure stomach emptying.
Treatment for gastroparesis focuses on managing symptoms and improving gastric emptying, with approaches varying based on the underlying cause and symptom severity. Dietary modifications are a common first step, including eating smaller, more frequent meals, and choosing foods low in fat and fiber, as these are easier to digest. Medications may be prescribed, such as prokinetics like metoclopramide, which stimulate stomach muscle contractions to help food move through. Antiemetics are also used to control nausea and vomiting. In more severe cases that do not respond to these measures, advanced interventions such as gastric electrical stimulation (a surgically implanted device) or surgical options like pyloroplasty (which widens the stomach’s outlet) may be considered. Nutritional support, including tube feeding or intravenous nutrition, may be necessary for those unable to maintain adequate intake.