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When Your Stomach Stops

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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 such as nausea and vomiting.

Who Gets Gastroparesis? Gastroparesis most often occurs in people with diabetes, especially in those who have had diabetes for a long time. But diabetes is not the only cause of gastroparesis. Other possible culprits include the following:

  • postviral syndromes
  • anorexia nervosa
  • surgery on the stomach or vagus nerve
  • medications that slow contractions in the intestine, particularly anticholinergics and narcotics
  • smooth muscle disorders, such as amyloidosis and scleroderma
  • nervous system diseases, including abdominal migraine and Parkinson’s disease
  • metabolic disorders, including hypothyroidism

 

What Are the Symptoms? 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 It 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).

How Is It Treated? 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. (High-fiber foods to avoid include apples, berries, brussels sprouts, coconuts, green beans, figs, and oranges.) 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 Digestive Health on December 24, 2007
Reviewed September 2011


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Health After 50 Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the editors cannot be answered in this space.

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My daughter, aged 51, was diagnosed with gastroparesis after she fell off a horse in 1985. She is not diabetic. Her doctors and surgeon have been very attentive with aggresive treatments. While we realize that there is no cure for this condition, she suffers daily with the pain and many complications which has been associated with gastroparesis. She has discovered that some of the people associated with a certain hospital here in Topeka, KS has "tagged" her as being a dope addict. She would welcome any comments from those suffering with this afflication. We all know how difficult and depressing life can be in dealing with daily non-quality life.

Posted by: concernedmom | May 10, 2010 8:46 AM

I've reaad an article/advertisement that Johns Hopkins is trying alternative methods rather than prescription medications for gastroparesis because of medicine side effects (everyone knows that drug...Reglan which causes involuntary movements...there are lawsuits everywhere). Domperidone can be given but you must get FDA approval to prescribe it. Does Johns Hopkins have that approval and prescribe it? Since it's not being treated (according to the article ) with medicine can JH share the alternative ways of dealing with gastroparesis? My daughter suffers alot but won't leave school to go for treatment even though she has been diagnosed. She saw me running from doctor to doctor without treatment. No doctor in Ohio wanted to get FDA approval. What is JH doing for gastroparesis? Thank you. .

Posted by: lynnea | June 28, 2011 5:15 PM

Mom...you may contqct me via email. Gastroparesis has nothing to do with 'dope'. I don't get that.

Posted by: lynnea | June 28, 2011 5:17 PM

I have all the signs of this disorder and right now Im only eating CHicken broth. Ever time i eat solids i just get nuaseatted and comes up. I been to the ER twice at VCU and once at a local hospital near central Va and they got me to drink a bunch of easy go and half lytley this blows my stomach up like im going to explode and if i dear try eat fatty or spicy food my arms radiate get sweaty palms and fill lik eim going to faint. and yes i did passout when my brother drove me to culpeper hospital. I spent four days there and now Im back home. The scary things iis when i picked up my script the pharmacist told me not have a normal bowel for over 2 weeks is a critical thang for a person my age. I will mention im am not active as sa normal person due to lower back surgery and hip dislocation that im still trying to recover from, its been since 2007 i been on and off narcotics. I am worried that i cant kep letting this go on without being trreated the right way, and with having only state hospital insurnace policy i was told that i could not get the help i needed at the hospital in culpep. straight up . PLEASE HELP call me at 1540 854 7759 I know i dont want mor surgerys but this has gradually started get worst and i beieve it may be necessary... hard to believe but it is true

Posted by: jesrose84 | August 24, 2011 3:21 PM

Why isn't there a "stomach transplant" for this disease?? I'll trade a kidney for a stomach that doesn't hurt 24/7. Get busy doctors!

Posted by: Gammie | August 11, 2012 2:58 PM

Our daughter, 42, has just been diagnosed with this as well as paralyzed intestines. She has been on a hellish 3-year journey trying to find a doctor who understood what she had and finding some level of relief. She has lost substantial weight and now weighs less than she did when she was 18. Her only remaining option is to have a feeding tube inserted in order to obtain nourishment. She will no longer be able to eat or drink anything for the rest of her life. She tried several medications, none worked. Seems many GI docs are either not aware of this and how serious it can become...or dont believe it is not caused by drug use or some other irresponsible behavior. She has experienced very frustrating treatment by doctors and other health care givers alike. Fortunately, she has finally found a doctor in her area who has experience with this and seems to be on the better road to providing help.

Posted by: frustrated12 | September 28, 2012 12:50 PM

I have just developed these symptoms and am trying to get a diagnosis. I have all the classic symptoms as well as a couple I would love to know if others have experienced too! I am a RN and will apply this to practice as well! As evening approaches I get a feeling of dread, I have not been able to lie down in bed at all and sleep about 2-3 hours, waking to feel rested for a couple hours then need to sleep again! I am unable to get over the feeling of dread around evening and sleep. I have also been living in a recliner, and my quality of life is virtually non existent! I have trouble even doing housework. Is there anyone else who has similar symptoms? Thank you. Deb

Posted by: dhenry | January 6, 2013 12:59 PM

I was diagnosed with gastroparesis about 6 years ago. I was overweight, but not morbidly. I started losing small amounts of weight without trying. I then started having the symptoms of gastroparesis and dropped over 35 pounds in about a month. The doctors kept saying it was a good thing, and not understanding that I wasn't eating (because I felt like I would throw up even though I couldn't) and I was in a massive amount of pain. Finally I was diagnosed and told that my stomach was 93% paralyzed. I started Reglan and leveled off. Within 3-4 months of being on Reglan, I no longer had any stomach pain and was weaned off of the medicine. I have had no symptoms of pain or fullness since, but I have gained an enormous amount of weight. I weigh over eighty pounds more than when the symptoms first started, I have gained well over 100 pounds since I came off of the Reglan. I have found nothing on research for what happens when gastroparesis goes away (or that it even does) which it has for me. Can you tell me how often it reverts for people, will it come back, is it normal to gain excessive weight when the symptoms go away? Any information you can give me would be great.

Posted by: apbtmia@yahoo.com | May 10, 2016 3:53 PM

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