Saanichton, BC

Dr. Miguel A. Lipka

Gastroparesis

This is categorized under:

Gastroparesis (delayed gastric emptying) is a medical condition consisting of a partial paralysis of the stomach, resulting in food remaining in the stomach for a longer period of time than normal. Normally, the stomach contracts to move food down into the small intestine for digestion. The vagus nerve controls these contractions. Gastroparesis may occur when the vagus nerve is damaged and the muscles of the stomach and intestines do not work normally, causing food to move slowly or stop moving through the digestive tract.

Gastroparesis sufferers are disproportionately female. A possible explanation for this is that women have an inherently slower stomach emptying time than men. Hormones may also play a role, as gastroparesis symptoms tend to worsen the week before menstruation, when progesterone levels are highest.

Symptoms of gastroparesis range from mild to severe and commonly include:

  • Nausea
  • Vomiting
  • An early feeling of fullness when eating
  • Weight loss
  • Abdominal bloating
  • Abdominal discomfort

Gastroparesis may be chronic or transient. Transient gastroparesis may arise due to:

  • Acute illness of any kind
  • With the use of certain cancer treatments or other drugs which affect digestive action
  • Anorexia nervosa
  • Bulimia
  • Other abnormal eating patterns

Chronic gastroparesis is frequently due to:

  • Autonomic neuropathy
  • Type 1 diabetes or type 2 diabetes
  • The vagus nerve being damaged by years of high blood glucose
  • Fibromyalgia
  • Parkinson's disease
  • Abdominal surgery

Idiopathic gastroparesis (gastroparesis with no known cause) accounts for a third of all chronic cases.

Treatment includes dietary changes (low-fiber and low-residue diets, restrictions on fat and/or solids), oral medications, adjustments in insulin dosage for those with diabetes, a jejunostomy tube, parenteral nutrition, implanted gastric neurostimulators ("stomach pacemakers"), or botulinum toxin.

The antidepressant Mirtazapine has also proven effective in the treatment of gastroparesis unresponsive to conventional treatment. This is due to its anti-emetic and appetite stimulant properties.