Gastroparesis is a gastric disorder that develops as a result of damage to nerves that control how food moves through the digestive tract. The main consequence of this disorder is that stomach emptying takes longer than normal, causing food to move very slowly through the gastrointestinal system. Gastroparesis is also known as delayed gastric emptying.
The nerve that controls the movement of food through the stomach and intestines is called the vagus nerve. The vagus nerve works by controlling muscle contractions that propel food through the digestive tract. When the nerve is damaged, the muscles do not receive the correct amount of stimulation, and food moves much more slowly through the gastrointestinal system.
Diabetes-related nerve damage is the most common cause of gastroparesis. Other causes of nerve damage include viral infections, gastroesophageal reflux disease and disorders of the nervous system, muscles or metabolism. Long-term use of medications that affect intestinal contractions, such as narcotics, can damage the vagus nerve. In some cases, the nerve damage is idiopathic, meaning that a cause cannot be found after diagnostic testing.
Damage to the vagus nerve causes symptoms that relate to the inability of the stomach and intestines to process food at a normal rate. Possible symptoms include heartburn, nausea, upper abdomen pain, vomiting, bloating, stomach spasms, gastroesophageal reflux, weight loss and feeling full after eating only a small amount of food. People with diabetes might find their blood sugar levels are more difficult to control.
Slow movement of food through the gastrointestinal tract can cause serious complications. When food remains in the stomach for too long, it can begin to ferment, causing bacterial overgrowth. The most dangerous complication is the formation of bezoars, solid masses of food that can cause vomiting and nausea and can become lodged in the stomach and block the opening of the small intestine.
Gastroparesis is a chronic condition, because damage to the vagus nerve cannot be cured. Rather than reversing the damage, treatment for this condition involves the use of medication and dietary modification to alleviate the symptoms and reduce the risk of complications. Medications prescribed to treat this condition include anti-nausea drugs, anti-emetics to decrease vomiting and drugs that help the stomach empty more quickly.
Dietary changes that can help alleviate gastroparesis symptoms include reducing fat and fiber in the diet and avoiding carbonated drinks. Fat slows down stomach emptying, and fiber is difficult to digest, which means that these nutrients can make symptoms worse and can contribute to the formation of bezoars. Eating smaller, more frequent meals can help reduce symptoms. People who do not gain a benefit from these changes might try a diet of liquid or pureed foods that are digested more easily and empty from the stomach more quickly.