The stomach grinds food into small pieces and sends them to the small intestine. Gastric motility disorders include delayed gastric emptying (gastroparesis, meaning stomach paralysis), rapid gastric emptying (dumping syndrome), functional dyspepsia (indigestion), and cyclic vomiting syndrome.
In gastroparesis, the stomach doesn’t work well. It doesn’t contract, crush food, or send food to the small intestine in a normal way. Food stays in the stomach too long. Digestion isn’t normal. Food can harden into solid chunks (bezoars) that may cause nausea and vomiting and block the stomach.
Gastroparesis affects males and females of almost any age.
The most common cause is diabetes, which damages nerves that control stomach muscles. Other causes include pregnancy, uremia (kidney failure), gastritis (stomach inflammation), and ulcers. Cancer, infections, and surgery on the stomach or vagus nerve are more causes. Connective tissue disorders, anorexia, bulimia, and gastroesophageal reflux disease (GERD) can lead to these disorders. Medicines causing the conditions include narcotics, calcium channel blockers, antidepressants, and chemotherapy drugs. Endocrine, autoimmune, metabolic, nervous system, and muscle disorders are additional causes. The cause can also be unknown.
Symptoms include bloating, pain or swelling in the abdomen (belly), nausea, and vomiting. People feel full after eating just a few bites and may have no appetite. Anorexia, heartburn, gastroesophageal reflux, and abnormal blood sugar (glucose) levels may occur. People can lose weight because they don’t get enough nutrients.
For diagnosis, the health care provider may use a nuclear medicine test called a gastric emptying test (scintigraphy). The test involves eating foods or drinking liquids containing a radioactive substance. The dose isn’t dangerous. A device similar to a Geiger counter tells how fast food leaves the stomach. The health care provider will also perform a physical exam and obtain a detailed medical history to rule out other causes (drugs, diseases). The health care provider may also order breath tests, ultrasonography, upper endoscopy, computed tomography, manometry, and X-rays.
Treatment usually means drugs and nutritional support. Surgery or electrical pacing may also be used in resistant cases. Controlling diabetes or other diseases is critical. Weight loss must be watched, so added nutrition can be given if necessary. Eating smaller meals more often may help, as can low-fat, low-fiber foods and liquids (soups) or pureed foods.
Drugs help nausea and vomiting. Promotility drugs can get stomach muscles to contract. Medicines are also given for abdominal pain. Botulinum toxin (Botox) and electrical stimulation are being tried. Feeding tubes and surgery are last resort treatments.
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