Gastroparesis – When muscles become work-shy

Contractions of muscles of digestive tract is an essential process for digestion of food. Due to these contractions, food is propelled through the digestive tract. When Gastroparesis is present, these muscles don’t work properly or don’t work at all. As a result, stomach doesn’t get emptied properly. This disease causes poor digestion.

Exact cause of this disease is unknown. One explanation that has been put forward is damage to vagus nerve which manages complex processes in digestive tract. Vagus nerve is responsible for sending signals to muscles to contract and propel food into intestines. A damaged vagus nerve fails to send appropriate signals to stomach muscles. It results into food remaining in the stomach for longer time. Reasons for damage to vagus nerve include diabetes or surgery of stomach and small intestines.

Symptoms: – Gastroparesis can cause different symptoms in different individuals.
1. Nausea and vomiting
2. Abdominal bloating
3. Feeling of fullness in stomach
4. Lack of appetite
5. Weight loss
6. Malnutrition
7. Changes in blood sugar level

Risk factors:-
1. Diabetes
2. Anorexia Nervosa
3. Bulimia Nervosa
4. Scleroderma
5. Parkinson’s disease
6. Hypothyroidism
7. Infection
8. Certain medications like narcotic pain relievers and antidepressants which slow the rate of stomach emptying

Complications:-
1. Disturbed bacteria balance in the stomach: – Food left in stomach begins to ferment and causes disturbance in bacterial balance in the stomach. Consequently, bad bacteria may outgrow good ones.
2. Formations of bezoars: – food that is left in stomach can form small masses called bezoar. These bezoars can lead to nausea and vomiting. If they got stuck in intestines, they may prevent passing the food from intestines which can be a life threatening situation.
3. Blood sugar fluctuations: – Gastroparesis doesn’t lead to diabetes. However, it may cause inconsistent food absorption which may cause fluctuations in blood sugar levels. If a person already has diabetes, this condition can be deadly for him.

Diagnosis: – Many tests are conducted to rule out possibility of other similar diseases.
1. Gastric-emptying test: – Gastric emptying test measures how long it takes for the emptying of stomach. An individual eats food that contain small amount of radioactive element. Movement of this radioactive material is detected by a scanner.
2. Upper endoscopy: – Upper endoscopy is administered to rule out possibilities of other diseases. It is also used to know digestive system abnormalities.

Treatment: – Treatment depends on underlying cause of Gastroparesis.
1. Medications: – Different medications are used to relieve the symptoms of this disease. Anti-emetic medications like diphenhydramine, diphenhydramine and lorazepam are used to alleviate nausea and vomiting. Medications like erythromycin and metoclopramide are used to stimulate the stomach muscles. These medications may have some side effects.
2. Surgery:- If medications didn’t improve the situation, doctors may opt for surgery. During surgery, lower part of stomach is stapled or bypassed to facilitate emptying of stomach.
3. Experimental treatments:-
*Botox injections to relax pyloric muscles
*Electrical gastric stimulation device to signal muscle contractions.

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