Gastroparesis Cure Support Forum

Gastroparesis (gastro-, "stomach" + -paresis, "partial paralysis"), also called delayed gastric emptying, is a medical condition consisting of a paresis (partial paralysis) of the stomach, resulting in food remaining in the stomach for a longer time than normal.

Normally, the stomach contracts to move food down into the small intestine for additional 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. Food then moves slowly or stops moving through the digestive tract.

Causes

Transient gastroparesis may arise in acute illness of any kind, as a consequence of certain cancer treatments or other drugs which affect digestive action, or due to abnormal eating patterns.

It is frequently caused by autonomic neuropathy. This may occur in people with type 1 or type 2 diabetes. In fact, diabetes mellitus has been named as the most common cause of gastroparesis, as high levels of blood glucose may affect chemical changes in the nerves.[1] The vagus nerve becomes damaged by years of high blood glucose or insufficient transport of glucose into cells resulting in gastroparesis. Other possible causes include anorexia nervosa and bulimia nervosa and damage to the vagus nerve. Gastroparesis has also been associated with connective tissue diseases such as scleroderma and Ehlers-Danlos syndrome, and neurological conditions such as Parkinson's disease.[2] It may also occur as part of a mitochondrial disorder.


Chronic gastroparesis can be caused by other types of damage to the vagus nerve, such as abdominal surgery.[3] Heavy cigarette smoking is also a plausible cause since smoking causes damage to the stomach lining.
Idiopathic gastroparesis (gastroparesis with no known cause) accounts for a third of all chronic cases; it is thought that many of these cases are due to an autoimmune response triggered by an acute viral infection[citation needed]. "Stomach flu", mononucleosis, and other ailments have been anecdotally linked to the onset of the condition, but no systematic study has proven a link.


Gastroparesis sufferers are disproportionately female. One possible explanation for this finding is that women have an inherently slower stomach emptying time than men.[4] A hormonal link has been suggested, as gastroparesis symptoms tend to worsen the week before menstruation when progesterone levels are highest.[5] Neither theory has been proven definitively.


Signs and symptoms

The most common symptoms of gastroparesis are:
Chronic nausea (93%)
Vomiting (especially of undigested food) (68-84%)
Abdominal pain (46-90%)
A feeling of fullness after eating just a few bites (60-86%)
Other symptoms include
Palpitations
Heartburn
Abdominal bloating
Erratic blood glucose levels
Lack of appetite
Gastroesophageal reflux
Spasms of the stomach wall
Weight loss and malnutrition
Morning nausea may also indicate gastroparesis. Vomiting may not occur in all cases, as sufferers may adjust their diets to include only small amounts of food.[5]


Diagnosis and treatment

Gastroparesis can be diagnosed with tests such as x rays, manometry, and gastric emptying scans. The clinical definition for gastroparesis is based solely on the emptying time of the stomach (and not on other symptoms), and severity of symptoms does not necessarily correlate with the severity of gastroparesis. Therefore, some patients may have marked gastroparesis with few, if any, serious complications.

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