Johns Hopkins Health Alert
Focus on Gastroparesis
Delayed emptying of the stomach, called gastroparesis, has several possible causes but usually is a complication of diabetes.
Gastroparesis -- literally "paralyzed stomach" -- is a serious condition manifested by delayed emptying of stomach contents into the small intestine after a meal. There is no cure for gastroparesis, but treatment can speed gastric emptying and relieve gastrointestinal symptoms.
Gastroparesis most often occurs in people with diabetes, especially in those who have had diabetes for a long time. The symptoms of gastroparesis include a feeling of fullness early after a meal, bloating, heartburn, upset stomach, nausea, and vomiting. These symptoms may be constant or may flare up from time to time with periods of relief in between.
Some patients have no overt symptoms of gastroparesis, and, in people with diabetes, the only sign of gastroparesis may be difficulty controlling blood glucose. If the gastroparesis remains untreated, it can lead to additional complications including malnutrition, dehydration, and electrolyte imbalances.
How is gastroparesis diagnosed? The gold standard for diagnosing gastroparesis is a test called solid-phase gastric scintigraphy. During this study, patients have their stomach scanned after ingesting solid food containing a radioactive substance to observe how quickly the radioactive isotope leaves the stomach. Other tests to detect delayed gastric emptying include a radioisotope breath test (to detect levels of carbon dioxide in the breath), electrogastrography (which uses electrodes placed on the skin over the stomach to measure the electrical activity of the stomach’s muscles), and an upper gastrointestinal series (in which x-rays are taken of the stomach after drinking a barium-containing liquid).
Treatment of gastroparesis is often twofold. Doctors aim first to improve gastric emptying and control symptoms and second to treat the underlying disease causing gastroparesis, if present.
Doctors recommend that people with gastroparesis eat a diet low in fat and fiber. Fat slows the emptying of the stomach, and some high-fiber foods can remain in the stomach for a long time. Also, eating six small meals a day, rather than three large ones, may allow the stomach to empty its contents easier.
A number of medications are somewhat effective in promoting gastric emptying and relieving the nausea and vomiting of gastroparesis. These medications include metoclopramide (Reglan and other brands) and erythromycin (Erythrocin and other brands) for gastric emptying and prochlorperazine (compro) for nausea.
Posted in Diabetes on August 7, 2008
Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer
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