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Gastroparesis

Definition

Gastroparesis is a condition that reduces the ability of the stomach to empty its contents, but there is no blockage (obstruction).

Alternative Names

Gastroparesis diabeticorum; Delayed gastric emptying

Causes, incidence, and risk factors

The cause of gastroparesis is unknown, but it may be caused by a disruption of nerve signals to the stomach. The condition is a common complication of diabetes and can be a complication of some surgeries.

Risk factors for gastroparesis include:

• Diabetes
• Gastrectomy (surgery to remove part of the stomach)
• Systemic sclerosis
• Use of medication that blocks certain nerve signals (anticholinergic medication)

Symptoms

• Abdominal distention
• Hypoglycemia (in people with diabetes)
• Nausea
• Premature abdominal fullness after meals
• Weight loss without trying
• Vomiting

Signs and tests

• Esophagogastroduodenoscopy (EGD)
• Gastric emptying study (using isotope labeling)
• Upper GI series

Treatment

People with diabetes should always control their blood sugar levels. Better control of blood sugar levels may improve symptoms of gastroparesis. Eating small meals and soft (well-cooked) foods may also help relieve some symptoms.

Medications that may help include:

• Cholinergic drugs, which act on acetylcholine nerve receptors
• Erythromycin
• Metoclopramide, a medicine that helps empty the stomach
• Serotonin antagonist drugs, which act on serotonin receptors

Other treatments may include:

• Botulinum toxin (Botox) injected into the outlet of the stomach (pylorus)
• Surgical procedure that creates an opening between the stomach and small intestine to allow food to move through the digestive tract more easily (gastroenterostomy)

Support Groups

Expectations (prognosis)

Many treatments seem to provide only temporary benefit.

Complications

Persistent nausea and vomiting may cause:

• Dehydration
• Electrolyte imbalances
• Malnutrition

People with diabetes may have serious complications from poor blood sugar control.

Calling your health care provider

Apply home treatment such as managing your diet. Call your health care provider if symptoms continue or if you have new symptoms.

Prevention

References

Koch KL. Gastric neuromuscular function and neuromuscular disorders. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 48.