What is gastroparesis?

Gastroparesis is a condition in which food stays in the stomach for longer than normal.

Usually, the muscles of the stomach contract (squeeze) and relax. This helps break down food and mix it with acids and enzymes, so the food can start to be digested. The muscles then contract and push food out of the stomach into the first part of your small intestine (duodenum).

If you have gastroparesis, the muscles of your stomach don't work properly. This means that food is broken down less than normal, and stays in the stomach for longer.

What are the symptoms of gastroparesis?

If you have gastroparesis, you may not digest your food properly. This can make you feel bloated and nauseous after a meal.

Some people also:

• vomit, usually after meals
• feel very full or bloated after eating
• have reflux, heartburn or severe abdominal pain
• have diarrhoea, usually at night
• lose their appetite
• lose weight

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What causes gastroparesis?

The cause of gastroparesis isn't always clear. In some people, it seems related to a problem with the nerve that controls the muscles of the stomach (known as the vagus nerve). In other people, it seems to be the muscles themselves that don't work as well as they should.

People with diabetes are more likely to develop gastroparesis due to nerve damage caused by poorly controlled blood glucose levels.

Other causes include:

• stomach surgery
• some viral infections, including Epstein-Barr virus (EBV)
• diseases such as Parkinson's disease, multiple sclerosis, scleroderma, and amyloidosis
• certain medicines, such as opioids (prescribed pain-relief medicines) and some antidepressants

In some cases, there is no obvious reason for gastroparesis.

When should I see my doctor?

If you are having any of these symptoms and think you might have gastroparesis, it is important to see your doctor.

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How is gastroparesis diagnosed?

To diagnose gastroparesis, your doctor will ask about your symptoms, examine you and refer you for blood tests.

You may also be referred for investigations such as:

• a gastric emptying study
• ultrasound, CT or MRI scans
• endoscopy
• Your doctor may also refer you to a gastroenterologist (specialist in digestive disorders).

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How is gastroparesis treated?

Gastroparesis cannot be cured, but it can be treated.

Self-care at home

Things you can do at home to relieve your symptoms include:

• eating small frequent meals
• eating easy-to-digest foods (such as soft foods or liquids)
• chewing food well
• avoiding high-fat and high-fibre foods
• avoid carbonated drinks, tobacco and alcohol

If you have diabetes, controlling your blood sugar is an important part of your treatment.

High blood sugar levels are linked with delayed emptying of the stomach, so controlling your blood sugar levels can also help manage gastroparesis. Speak with your doctor or diabetes educator for tips and suggestions on how to best manage your diabetes.

Medicines

There are medicines that your doctor might prescribe to help control your symptoms. Domperidone is a medicine which improves muscle contraction in the stomach, and can help food move along the gastrointestinal tract. Metoclopramide is a medicine that can help manage nausea and vomiting.

Surgery

If your symptoms don't improve with dietary changes and medicines, your doctor may recommend a medical procedure or surgery.

Some doctors recommend inserting a pacemaker into the stomach to help the muscles in the stomach to contract. This is called gastric electrical stimulation.

In very severe cases, your doctor may recommend inserting a feeding tube, or surgery on your stomach.

Living with gastroparesis

If you have gastroparesis, eating can be a challenge.

You may find it easier to eat foods that are soft, pureed or liquid. These can be easier to digest. Your dietician can advise you what foods to eat to minimise your symptoms while making sure that you are getting the energy and nutrients you need to stay healthy.

What are the complications of gastroparesis?

Gastroparesis can cause complications including:

• weight loss and malnutrition
• low vitamin and mineral levels
• dehydration
• low energy levels

See your doctor and dietitian regularly to help prevent or manage these complications.

Can gastroparesis be prevented?

Gastroparesis usually can't be prevented.

If you have diabetes, controlling your blood sugar levels can help to prevent gastroparesis from developing or getting worse.

Resources and support

For diet and nutrition health advice visit Dietitians Australia

For information on gastroscopy (endoscopy) visit the Gastroenterological Society of Australia website.

For more information about the symptoms, diagnosis and management of gastroparesis see the Western Syndey University website.

Call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.