Gastroparesis (Weak/Paralysed Stomach Muscles)

What is gastroparesis?

Gastroparesis refers to an abnormal condition in which the rate of emptying of stomach contents slows down significantly. This is largely due to a problem with the stomach muscles or the nerves controlling these muscles. Gastro means the stomach and paresis refers to muscle weakening or paralysis, hence the term gastroparesis.

Causes of Gastroparesis

The passage of food through the stomach is not a passive process. Muscles in the wall of the gut contract and relax in a coordinated manner in order to push the gut contents along its course. Food that enters the stomach is partially digested through chemical and enzymatic processes before being released into the duodenum.

The release of partially digested food from the stomach into the duodenum is a regulated process that can take anywhere from 45 minutes to three or more hours. Multiple factors determine the rate of gastric emptying. The main determining factors are the nature of food, amount of food, and status of nerves and muscles of the stomach.

The nature of food is one of the main factors that determines the rate of gastric emptying. For example, liquids and foods of soft consistency move out of the stomach at a faster rate than solid foods. Gastric emptying is mediated through contractions of the muscles in the wall of the stomach.

The opening of the stomach into the duodenum is regulated by a muscular sphincter, known as the pyloric sphincter. Problems with the pyloric sphincter, muscles in the wall of the stomach, and nerves that supply these muscles can lead to delayed gastric emptying or gastroparesis.

Left untreated, gastroparesis can lead to a variety of complications. Some of these complications may even be life-threatening. Some of the main complications of untreated gastroparesis are malnutrition, dehydration, huge changes in blood glucose level, and presence of hard masses in the intestine.

Read more on stuck stomach.

Signs and Symptoms

The signs and symptoms of gastroparesis are typically vague in nature, especially in the early stages of the disease. Consequently, gastroparesis may not be diagnosed in the early stages. In fact, a person may mistaken gastroparesis for some other gastrointestinal ailment based of its vague symptoms. Confirmed diagnosis of gastroparesis usually requires some diagnostic clinical investigations.

Sensation of fullness in the stomach

Feeling uncharacteristically full in the stomach after a small meal or only a few bites of food is one of the first symptoms of gastroparesis. The abnormal feeling of fullness in the stomach may also be accompanied by a loss of appetite. Since these symptoms are very vague, and are usually not accompanied by any other signs or symptoms in the early stages, people tend to ignore the condition.

Nausea and vomiting

Nausea and vomiting are common symptoms of many different types of gastrointestinal conditions. Nausea typically precedes actual vomiting. However, nausea is not followed by vomiting in all cases. These symptoms are mainly associated with an irritated stomach. The nausea in gastroparesis usually worsens after a meal, especially a large meal. When nausea is followed by vomiting, the vomitus typically contains undigested food material from the stomach.

Gastric acid reflux

Gastroparesis prevents proper digestion of food in the gastrointestinal tract. A large portion of undigested food material in the stomach is not able to reach the intestine for further digestion and elimination through feces. The accumulated food may then flow backwards into the esophagus along with the other contents of the stomach (such as gastric acid and enzymes).

Gastric acid irritates and damages the lining of the esophagus and throat, leading to a burning sensation in the chest. This painful burning sensation is commonly referred to as “heartburn”. Gastric acid reflux may also be accompanied by sensations of abdominal bloating and nausea.

Abdominal pain

Another vague symptom of gastroparesis is abdominal pain. Pain in the abdomen usually occurs after consuming certain foods, and may not be present at all times. The location of the pain typically coincides with the location of the stomach in the upper left quadrant of the abdomen. In some cases, abdominal pain may also be diffuse rather than being restricted to a single location in the abdomen.

Bloating

Abdominal bloating refers to an abnormal sensation of fullness in the stomach or abdomen. In some cases, the sensation of abdominal bloating may also be accompanied by a recognizably distended or swollen abdomen. Abdominal bloating tends to occur after eating, and may be associated with the intake of certain types of food. The extent of abdominal bloating may vary on an individual basis.

Treatment for Gastroparesis

Gastroparesis can be caused by many different factors. Therefore, effective treatment for gastroparesis depends on the identification of the underlying cause. Depending on the nature of the underlying cause, the treatment for gastroparesis may involve medications or surgery.

Regardless of the underlying cause of gastroparesis, modifications of dietary habits can have a significant impact on the severity of the disease. A dietician should be consulted for making appropriate changes to the dietary plan.

Diet for Gastroparesis

The rate of gastric emptying depends on the nature and quantity of food. Therefore, modifying the types of foods consumed can aid in the healing process. Also, eating small meals instead of large meals can help.

The following are some of the do’s and don’ts in terms of foods to consume in gastroparesis:
Vegetables and fruits with low fiber content should be eaten. They may also be cooked rather than consumed raw.

  • Fatty foods should be replaced by a low-fat diet.
  • Fried foods should be avoided. Preparation of high protein foods such as skinless chicken, lean meat, tofu, eggs, and fish should be done without frying.
  • Starches that can be consumed include breads, tortillas, muffins, rice, potatoes, bagels, and pasta.

The following are some steps that can be taken to alter lifestyle and dietary habits:

  • Instead of three large meals every day, one should take smaller and more frequent (6-8) meals daily.
  • Consumption of carbonated beverages and alcohol should be avoided.
  • Daily water consumption should be at least 1.5 liters.
  • Fiber supplements and high fiber foods should be avoided.
  • The ideal foods to be taken during gastroparesis have semi-solid or liquid consistency. However, they shouldn’t have high fat content.
  • Avoid sleeping or lying down straight after a meal. One may perform some light exercises after meals to aid digestion.

The lifestyle and dietary changes suggested above are helpful in gastroparesis regardless of the underlying cause. However, they are not intended to replace medical counsel or treatment. One must seek medical attention to get proper treatment for gastroparesis.

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