What is Gastroparesis?

Gastroparesis is a digestive disorder commonly known as stomach paralysis. Normally, the stomach muscles contract to break down food as part of the digestive process and push it toward the small intestine. However, in gastroparesis, these muscle contractions slow down or stop, causing delayed emptying of the stomach at a normal rate.

This condition can lead to various symptoms and negatively affect quality of life.

There are various types of gastroparesis depending on the underlying causes and the affected nervous system.

Main types of gastroparesis:

• Diabetic Gastroparesis: This is the most common type of gastroparesis. Long-term and uncontrolled diabetes can damage the vagus nerve, which controls the digestive system, negatively affecting stomach contractions. Controlling blood sugar levels plays a critical role in managing diabetic gastroparesis.
• Idiopathic Gastroparesis: The exact cause of gastroparesis cannot be determined in this type. It is more commonly seen in young women, and symptoms gradually appear and worsen over time.
• Postoperative Gastroparesis: This type can occur after surgical interventions involving the upper digestive organs such as the stomach or esophagus. Damage to the vagus nerve during surgery or structural changes in the stomach may lead to this condition.
• Postviral Gastroparesis: Gastroparesis that develops following a viral infection. The infection may temporarily impair the function of stomach muscles. Symptoms are usually temporary and improve over time.
• Neurological Gastroparesis: Neurological diseases such as Parkinson’s disease and multiple sclerosis can cause damage to the nervous system, leading to gastroparesis. In this type, neurological symptoms may accompany digestive system symptoms.
• Drug-Induced Gastroparesis: Some medications (such as certain antidepressants, opioids, calcium channel blockers) can slow stomach emptying and cause gastroparesis. The condition may improve with discontinuation or substitution of the medication.

Each type of gastroparesis can cause different symptoms in different patients and may require different treatment approaches.

Gastroparesis is a condition where the normal muscular contractions of the stomach slow down or stop, causing delayed gastric emptying. In other words, the stomach cannot move food into the small intestine at a normal rate. There are various causes of this condition. Here are the main factors that can lead to gastroparesis:

A. Nerve Damage (Especially the Vagus Nerve):
The vagus nerve controls stomach muscle contractions and the movement of food out of the stomach. Conditions that damage this nerve can lead to gastroparesis.

• Diabetes: One of the most common causes. Long-term uncontrolled diabetes can damage the vagus nerve (diabetic neuropathy).
• Surgical Intervention: Vagus nerve damage can occur during stomach or esophageal surgeries.
• Other Nervous System Diseases: Neurological diseases such as Parkinson’s disease or multiple sclerosis can also cause gastroparesis.

B. Other Systemic Diseases:

• Scleroderma: A connective tissue disease that can impair the function of digestive system muscles.
• Amyloidosis: Abnormal protein deposits can affect digestive organs.
• Hypothyroidism: Insufficient thyroid hormone can slow stomach movements.

C. Medications:
Some drugs can slow gastric emptying, causing symptoms similar to gastroparesis:

• Opioid painkillers
• Certain antidepressants
• Some allergy medications
• Certain blood pressure drugs (calcium channel blockers)
• Anticholinergic drugs

D. Viral Infections:
Severe viral infections affecting the stomach can lead to gastroparesis, usually temporarily (postviral gastroparesis).

E. Other Potential Factors:

• Intestinal obstruction: Rarely, partial blockage can delay gastric emptying.
• Emotional stress: Stress can trigger or worsen stomach problems in some people.
• Idiopathic gastroparesis: In some cases, no clear cause can be found.

Important Note: Since many factors can cause gastroparesis, diagnosis and treatment should be managed by a gastroenterology specialist.

Gastroparesis symptoms arise when the stomach cannot move food to the small intestine at a normal rate. This condition can cause a range of uncomfortable symptoms. The symptoms of gastroparesis can vary from person to person and differ in severity.

However, the most common symptoms are:

• Bloating: A feeling of fullness, tightness, or swelling in the abdominal area, which can worsen especially after meals.
• Nausea and Vomiting: Vomiting of undigested food is a typical symptom of gastroparesis.
• Early Satiety: Feeling full quickly after eating even small amounts of food.
• Abdominal Pain: Usually intermittent and can be severe.
• Heartburn and Reflux: Burning sensation and sour taste due to stomach contents refluxing into the esophagus.
• Loss of Appetite: Appetite reduction due to delayed stomach emptying and discomfort.
• Weight Loss: Unintended weight loss due to loss of appetite and digestive problems.
• Blood Sugar Fluctuations (in diabetic patients): Difficulty controlling blood sugar levels, especially in diabetes patients.

These symptoms are not exclusive to gastroparesis and may also indicate other gastrointestinal issues.

The diagnostic process for gastroparesis includes various tests to rule out other stomach problems and confirm gastroparesis.

Common methods used in diagnosing gastroparesis:

A. Medical History and Physical Examination:

• The doctor asks detailed questions about the patient’s complaints, focusing on symptoms related to eating such as bloating, early satiety, nausea, vomiting, and abdominal pain.
• The patient’s medical history (especially diabetes, neurological diseases), medications, and previous surgeries are reviewed.
• The doctor examines the abdominal area to check for tenderness, swelling, or other abnormalities.

B. Blood Tests:

• Blood tests may be performed to evaluate electrolyte imbalances and nutritional deficiencies.
• Thyroid hormone tests may be requested to assess thyroid function.
• Additional blood tests may be done to investigate other conditions that can cause gastroparesis, such as diabetes or neurological diseases.

C. Upper Endoscopy:

• A thin tube with a camera (endoscope) is inserted through the mouth into the stomach.
• It is used to directly visualize the stomach lining and rule out other stomach diseases like obstructions or ulcers.
• Tissue samples (biopsy) can be taken if necessary.

D. Gastric Emptying Studies:

These are the most important tests for diagnosing gastroparesis. They measure how long it takes for food to leave the stomach.

• Gastric Emptying Scintigraphy: The most commonly used method. The patient eats food containing a radioactive substance, and a scanner tracks the passage of food from the stomach to the small intestine.
• Barium Imaging: After the patient drinks a barium-containing liquid, X-rays are taken to observe the passage of food through the stomach.
• Wireless Motility Capsule: The patient swallows a wireless capsule that measures pH levels and pressure in the stomach and intestines to assess gastric motility.

E. Antral Manometry:

• This test measures the electrical activity and contractions of the stomach muscles.
• It helps identify nerve or muscle-related problems in stomach contractions.

The treatment process generally aims to control symptoms and improve quality of life. There is no cure that completely eliminates gastroparesis, but it can be managed with various methods.

A. Treating the Underlying Cause:
Diabetic Gastroparesis: One of the most common causes is diabetes. In this case, controlling blood sugar levels is fundamental to treatment. Keeping blood sugar within optimal ranges can slow vagus nerve damage and improve stomach emptying.

B. Nutrition and Dietary Changes:

• Frequent Small Meals: Eating 5-6 small meals a day to avoid overfilling the stomach and aid digestion is recommended.
• Low Fat and Low Fiber Foods: Fat and fiber can slow gastric emptying, so reducing their intake is important.
• Chewing Well: Thoroughly chewing food reduces the burden on the stomach.
• Liquid Foods: In some patients, especially severe cases, liquid or pureed foods may be better tolerated.
• Guidance from a Doctor or Dietitian: It is recommended that gastroparesis patients work with a dietitian to create a personalized diet plan.

C. Medication Treatment:

• Prokinetic Drugs: These drugs increase stomach muscle contractions and speed up gastric emptying. Examples include metoclopramide and domperidone.
• Antiemetics: Used to control nausea and vomiting.
• Other Medications: In some cases, other drugs may be prescribed to manage pain or other symptoms.

D. Endoscopic Treatment Methods:

• Pyloric Botox (Botulinum Toxin Injection): Botulinum toxin is injected into the pyloric muscle controlling the stomach outlet, temporarily relaxing the muscle to facilitate gastric emptying.
• Gastric Electrical Stimulation: Electrodes are placed to stimulate stomach muscles.

E. Surgical Treatment:

• Surgery for gastroparesis is generally considered a last resort and is uncommon.
• In some cases, placing a feeding tube (jejunostomy tube) may help patients with severe nutritional problems.

Important Notes:

• Gastroparesis is a chronic condition and may require a long-term treatment approach.
• The treatment plan is personalized based on the patient’s symptoms, severity of the disease, and underlying causes.
• It is important to stay in regular contact with your doctor and follow their recommendations.
• Avoid self-diagnosis and self-treatment methods.
• Managing gastroparesis requires patience and close cooperation with your doctor. By adhering to treatment, symptoms can be controlled and quality of life improved.

At A Life, we offer a holistic approach to treating gastroparesis. Understanding the complex nature of gastroparesis, our departments of gastroenterology, internal medicine, and dietetics work together to create the most suitable treatment plan for each patient.

Services We Provide for Gastroparesis Treatment at A Life:

• Comprehensive Evaluation:
  We use a range of tests and assessment methods to confirm the diagnosis of gastroparesis and identify underlying causes:
• Detailed medical history and physical examination: We conduct one-on-one interviews with patients to thoroughly evaluate their complaints, medical history, and lifestyle.
• Endoscopy: We perform endoscopy to visualize the esophagus, stomach, and duodenum, and take tissue samples if necessary.
• Gastric emptying study: We measure the stomach’s rate of emptying food to determine the severity of gastroparesis.
• Gastric motility studies: We assess the stomach’s electrical activity and contractions to understand the cause of gastroparesis.
• Blood tests: We conduct necessary blood tests to investigate underlying causes such as diabetes and thyroid disorders.
• Imaging methods: When needed, we use ultrasound, CT, or MRI to evaluate the structure and motility of the stomach and intestines.

Personalized Treatment:
We develop customized treatment plans based on each patient’s needs:

• Medication:

  • Antiemetics to reduce nausea and vomiting

  • Prokinetics to accelerate gastric emptying

  • Medications for reflux, constipation, and other digestive issues

• Nutritional support:

  • Dietitian support: Our expert dietitians help patients create gastroparesis-appropriate nutrition plans, which may include small and frequent meals, easily digestible foods, and adequate fluid intake.

• Lifestyle changes:

  • Stress management techniques

  • Regular exercise

  • Avoidance of smoking and alcohol

• Psychological support: Since gastroparesis can negatively impact quality of life, we provide psychological support to help patients cope with the condition.

Advantages of Gastroparesis Treatment at A Life:

• Experienced gastroenterologists: We provide services from experienced gastroenterologists specialized in diagnosing and treating gastroparesis.
• Multidisciplinary approach: We offer comprehensive treatment through collaboration between gastroenterology, internal medicine, and dietetics departments.
• Modern diagnostic and treatment methods: We use state-of-the-art equipment and modern treatment techniques.
• Patient-centered approach: We prioritize the needs and expectations of our patients.

At A Life, we strive to deliver the best healthcare services to gastroparesis patients and improve their quality of life. For more information about gastroparesis or other digestive system issues and to receive treatment at A Life, please visit our website or contact us via our phone numbers.