Gastroparesis



Gastroparesis is a condition also known as delayed gastric emptying or stomach paralysis. Under normal conditions, food passes into your gastric tract with the help of strong contractions of the stomach muscles. In gastroparesis, these muscles do not work well or not at all and this prevents the stomach from emptying its contents effectively. This delay in the emptying of the stomach can lead to an overgrowth of bacteria and the formation of bezoars (clumps of indigestable fibers).  Gastroparesis can also cause serious problems with digestion and lead to symptoms such as nausea, vomiting, malnutrition and an imbalance in blood sugar levels.

Gastroparesis is a chronic disease with symptoms recurring over time. There is no known cure for it, but the symptoms of the condition can be reduced or treated by changing your diet or through medication.

 

Symptoms of Gastroparesis

Symptoms of gastroparesis can be mild or severe and can vary from person to person. Symptoms for gastroparesis include:

  • Distention of the abdomen
  • Nausea
  • Vomiting of undigested food
  • Heartburn
  • Premature feeling of fullness after eating
  • Hypoglycemia or hyperglycemia (if you suffer from diabetes)
  • Unexplained weight loss
  • Bloating and gas
  • Pain in the upper abdomen
  • Loss of appetite
  • Stomach spasms
  • Gastroesophageal reflux
 

Causes of Gastroparesis

  • Diabetes is one of the most common causes of gastroparesis. When this develops it is known as diabetic gastroparesis and is caused by nerve damage and muscle failure in the stomach due to high levels of blood glucose.
  • Anorexia nervosa or bulimia
  • Stomach surgery
  • Surgey on the vagus nerve in the stomach
  • Viral infections / Post viral syndromes
  • GERD or Gastroesophageal Reflux Disease
  • Diseases of the nervous system such as Parkinson’s disease, stroke, and brain injury
  • Hypothyroidism and other metabolic disorders
  • Systemic sclerosis
  • Certain medications such as some narcotics and anti-cholinergics
  • Smooth muscle disorders such as amyloidosis and scleroderma
  • Problems with the adrenal gland
  • Ulcers and tumors in the stomach that can cause scars and fibrous tissues resulting in blockages
  • Drugs such as calcium blockers and anti-depressants that weaken the stomach
  • In many cases, the cause of gastroparesis remains unknown
 

Remedies for Gastroparesis

  • The first step towards treatment for gastroparesis is to cure the underlying disorder or medical condition. For example, if high blood sugar levels are causing damage to the vagus nerve in the stomach and resulting in gastroparesis, then treatment should be directed towards stabilizing blood sugar. The second stage in treating gastroparesis involves making long-term lifestyle changes such as addressing your diet and eating habits. Consulting with a trained dietician and doctor is recommended for severe cases of gastroparesis.
  • There are now several medications available that stimulate the stomach and encourage it to work properly. Medication to treat gastroparesis should be taken half an hour or so before eating a meal, as this will give the drug enough time to be effective. Most of these medications cause the stomach to contract more often and more efficiently thereby reducing the symptoms of the condition. Medications that may be prescribed to treat gastroparesis include cholinergic drugs, erythromycin, metoclopramide and in some cases even botox injections administered into the stomach outlet. In severe cases, a gastroenterostomy may be required to create an opening between the stomach and the intestine to allow food to move through more freely.
  • There are also a number of home remedies for gastroparesis that can effectively reduce the symptoms of the condition. These natural remedies for gastroparesis are not only affordable and easily accessible but also cause none of the side effects or complications associated with medication and surgery.
  • Herbal therapy is a popular alternative treatment for gastroparesis. Herbs such as ginger, peppermint, and Melissa are very helpful in reducing discomfort and symptoms of the conditions. For example, ginger and peppermint can get rid of feelings of nausea. Ginger can be had in the form of a daily supplement (400mg doses repeated thrice a day for the best results). Ginger accelerates the emptying of the stomach naturally. Care should be taken not to consume too much ginger as it can aggravate the condition if taken in excess.
  • Swedish bitters – another herbal supplement can be taken before meals to improve the digestive process. You can find this and other herbs at health food stores.
  • Lavender can be used to calm down the digestive system and reduce spasms and pain. Melissa can improve digestion as well as act as an appetite stimulant.
  • Natural alternatives such as acupuncture and electroacupuncture are recommended for the treatment of gastroparesis. Initial reports indicate that these treatments have positive results in the reduction of symptoms. However, it is important that you consult with an experienced and trained practitioner before beginning such treatment.
 

Diet for Gastroparesis

Changing your diet and eating habits is imperative to control symptoms of gastroparesis. Consult with your doctor or dietician to devise the best diet for gastroparesis for your individual case. Some simple rules to follow include:

  • Eat six small meals a day instead of three large meals as smaller meals will allow your stomach to empty more easily and prevent feelings of fullness.
  • Chew your food properly and eat slowly.
  • Do not lie down immediately after a meal. Instead, walk or indulge in some light exercise to aid the digestive process.
  • If symptoms are very severe or blood glucose levels too high, you may be required to follow a liquid diet for a few days until your condition stabilizes.
  • Avoid foods high in fat and fiber as fat slows down the digestive process and fiber is difficult to digest. Avoid foods such as bacon, hot dogs, salami, cheeses, nits and pork ribs.
  • Foods high in fiber can also lead to the development of bezoars. Strike off from your diet items such as whole grains, raw fruits and vegetable, cooked celery, cabbage, corn, beans, and cauliflower. Opt instead for cooked and peeled beets, tomatoes, potatoes, mushrooms, and squash.
  • Food items such as oranges and broccoli contain substances that cannot be digested and should be avoided if you suffer from gastroparesis.
  •  Eat only pureed or ground meat.
  • If nausea is a problem, stay away from strong smelling food.
  • Avoid caffeine, spicy food, oily food, and raw mint.
  • Stop smoking and drinking as it can aggravate heartburn and GERD.
  • Drink plenty of water during the day but drink slowly and only as much as you can tolerate.
  • Foods for gastroparesis include pureed foods (almost all vegetables, fruits, poultry, meat, and cereals can be cooked and pureed to near liquid form for easy digestion). Ensure that you strain out any lumps of solid food before eating. You can also thin down the consistency with some broth or milk.
  • Powdered protein shakes, gelatine, evaporated milk, and fortified milk provide you with the necessary protein and calories you need while on a gastroparesis diet.
  • If vomiting and nausea result in dehydration and imbalance of electrolytes, increase your intake of soft drinks, juices, clear soups and broths.
  • Increase your protein intake by including skinless chicken and turkey into your diet. You may also add shrimp, tuna, and scallops along with egg whites and low-fat cheese and yogurt as they are easy to digest.
  • Include plain oats, white bread, white pasta, and white rice into your diet.
  • Opt for fruit juices over whole fruit. Canned soft fruits such as peaches and applesauce are also good alternative.

An ideal meal plan on a gastroparesis diet is as follows:

  • Breakfast – Half cup skim milk / one piece of white bread toast and one tablespoon of peanut butter
  • Mid-morning snack – Low-fat yogurt
  • Lunch – Low-fat sandwich made with tuna and white bread and low-fat cheese
  • Evening snack – Half cup tinned fruit and quarter cup cottage cheese
  • Dinner – Baked fish, mashed potatoes, cooked squash, low-fat pudding or yogurt.

Suggestions for Gastroparesis

If your doctor feels that your regular diet is not providing you with enough nutrients or stabilizing your blood sugar levels effectively, he may recommend that you have a feeding tube inserted into your abdomen. This would provide direct access into your small intestine and deliver medication and liquid nutritional supplements by bypassing the stomach altogether. This procedure is recommended only for severe cases and is a temporary treatment alternative. Once blood sugar levels are stabilized and symptoms of the condition are reduced, the tube will be removed and you can resume your normal diet.

References

  1. Kim KH, Lee MS, Choi TY, Kim TH, Ernst E. Acupuncture for symptomatic gastroparesis (Protocol). Cochrane Database of Systematic Reviews 2012, Issue 2. Art. No.: CD009676. DOI: 10.1002/14651858.CD009676.
  2. Parkman, H. P. (2010) Gastroparesis, in Practical Gastroenterology and Hepatology (eds N. J. Talley, K. R. DeVault and D. E. Fleischer), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444327311.ch46

 
Gastroparesis - Frequently asked questions