Ask Dr. Lo - What in the World is Gastroparesis

by Dr. Thomas K. Lo, Advanced Chiropractic

Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from your stomach to your small intestine. Normally, after you swallow food, the muscles in the wall of your stomach push the food into the small intestine to continue digestion. When you have gastroparesis, your stomach muscles work poorly or not at all, and your stomach takes too long to empty its contents. Gastroparesis can delay digestion, which can lead to various symptoms and complications.

Who is more likely to get gastroparesis?

You are more likely to get gastroparesis if you have diabetes, have had certain cancer treatments like radiation therapy on your chest or stomach area, or if you have had surgery on your esophagus, stomach, or small intestine, which may injure the vagus nerve. Diabetes can also damage the vagus nerve, and nerves and special cells, called pacemaker cells, in the wall of the stomach. The vagus nerve controls the muscles of the stomach and small intestine. If the vagus nerve is damaged, or stops working, the muscles of the stomach and small intestine do not work normally. The movement of food through the digestive tract is then slowed or stopped. Gastropareses can also show up in people with scleroderma, hypothyroidism, nervous system disorders (such as migraine), Parkinson’s disease, multiple sclerosis, as well as in people with gastroesophageal reflux disease (GERD), eating disorders, and amyloidosis.

What populations are the most affected?

Gastroparesis does demonstrate a gender bias, affecting more women than men. Approximately 80 percent of idiopathic cases are women (a disease or condition which arises spontaneously or for which the cause is unknown). The prevalence of delayed gastric emptying in Type 1 diabetics has been reported to be 50 percent and in Type 2 diabetics, reports range from 30 percent to 50 percent. Post-surgical gastroparesis is recognized as inadvertent vagal nerve damage or entrapments following upper abdominal surgery; examples are fundoplication for the treatment of GERD, bariatric surgery, peptic ulcer surgery, anterior approach for spinal surgery (scoliosis), heart and lung transplant, or pancreatic surgery.

What are some of the symptoms, causes, and complications?

The symptoms of gastroparesis may include feeling full soon after starting a meal, feeling full long after eating a meal, nausea, vomiting, as well as excessive bloating and belching, pain in your upper abdomen, heartburn, and poor appetite. 

More severe symptoms include pain or cramping in your abdomen; blood glucose levels that are too high or too low; red blood in your vomit or vomit that looks like coffee grounds; sudden, sharp stomach pains that don’t go away; feeling extremely weak or fainting; and difficulty breathing. If you are dehydrated, have extreme thirst and dry mouth, are urinating less than usual, feel tired, have dark-colored urine, have sunken eyes or cheeks, light-headedness or fainting, malnourished, losing weight without trying, loss of appetite, and abnormal paleness of the skin.

Certain medicines may also contribute to delayed gastric emptying or affect motility, resulting in symptoms that are similar to those of gastroparesis. These medicines may make your symptoms worse: narcotic pain medicines, some anti-depressants (such as amitriptyline, nortriptyline, and venlafaxine), some medicines that block certain nerve signals, and some medicines used to treat overactive bladder.

Some of the complications of gastroparesis may include food that stays in the stomach too long and ferments, which can lead to the growth of bad bacteria. Food in the stomach can also harden into a solid collection, called a bezoar. Bezoars can cause obstructions in the stomach that keep food from passing into the small intestine. People who have both diabetes and gastroparesis may have more difficulty since blood sugar levels rise when food finally leaves the stomach and enters the small intestine, making blood sugar control more of a challenge.

Can gastroparesis be diagnosed?

Some ways to diagnose gastroparesis can be with physical exams, identifying your symptoms, and certain medical tests. It is important to go over the details of your current symptoms and medicines, as well as current and past health problems such as diabetes, scleroderma, nervous system disorders, and hypothyroidism.

Be sure to inform your practitioner about all prescription medicines, over-the-counter medicines, and dietary supplements you are taking; whether you have had surgery on your esophagus, stomach, or small intestine; whether you have had radiation therapy on your chest or stomach area; and if you have been diagnosed with any health issues such as diabetes, hypothyroidism, and so forth.

Can gastroparesis be treated?

Treatment of gastroparesis depends on the cause, how severe your symptoms and complications are, and how well you respond to the different treatments. Sometimes, treating the cause may stop gastroparesis. If diabetes is causing your gastroparesis, then controlling your blood glucose levels may help. When the cause is unknown, then the focus is on relieving symptoms and treating complications.

Changing your eating habits can also help control gastroparesis. Getting the right amount of nutrients, calories, and liquids will treat the disorder’s two main complications: malnutrition and dehydration.

Emphasis is also placed on helping the muscles in the wall of your stomach work better,  controlling the nausea and vomiting, and reducing the pain.

How important is controlling blood glucose levels?

If you have gastroparesis and diabetes, you will need to control your blood glucose levels, especially hyperglycemia. Hyperglycemia may further delay the emptying of food from your stomach. It is very important to make sure your blood glucose levels are not too high or too low and do not keep going up or down, so stabilizing them is important. You can prevent or delay nerve damage that can cause gastroparesis by keeping your blood glucose levels within the target range. Meal planning and physical activity are ways to help you keep your blood glucose levels within your target range.

If you struggle with health issues and would like a free screening, call the Advanced Chiropractic & Nutritional Healing Center at 240-651-1650. Dr. Lo uses Nutritional Response Testing® to analyze the body to determine the underlying causes of ill or non-optimum health. We also offer free seminars, held at the office on rotating Tuesdays and Thursdays. The office is located at 7310 Grove Road #107, Frederick, MD. Check out the website at www.doctorlo.com.