Gastroparesis

Gastroparesis, also called delayed gastric emptying, is a disorder in which the stomach takes too long to empty its contents.

The vagus nerve controls the movement of food through the digestive tract. If the vagus nerve is damaged, the muscles of the stomach and intestines do not work normally, and the movement of food is slowed or stopped.

Major Causes of Gastroparesis

• diabetes
• surgery on the stomach or vagus nerve
• postviral syndromes
  
• anorexia nervosa
• medications, particularly anticholinergics and narcotics (drugs that slow contractions in the intestine)
  
• nervous system diseases, including abdominal migraine and Parkinson's disease
• smooth muscle disorders such as amyloidosis and scleroderma
• metabolic disorders, including hypothyroidism

Diagnosis

The diagnosis of gastroparesis is confirmed through one or more of the following tests.

• Gastric manometry
  
• Radioisotope gastric-emptying scan
• Upper GI endoscopy to exclude other causes of nausea
• USS to exclude the cholecystitis and pancreatitis.

Treatment

It is important to note that in most cases treatment does not cure gastroparesis—it is usually a chronic condition. Treatment helps the patients to manage the condition so that they can be as healthy and comfortable as possible.

Removal of causes of gastroparesis is important such as better glucose control.

Dietary approach

• six small meals a day instead of three large ones.
• Low fibre diet

Prokinetic Agents

• Metocloparamide
• Domperidone
• Ondansetron
• Erythromycin

Feeding tube or parenteral therapy

Newer therapy include gastric pacemaker