Definition of Gastroparesis:

Gastroparesis is a condition that reduces the ability of the stomach to empty its contents, but there is no blockage (obstruction).

Causes, incidence, and risk factors:

The cause of gastroparesis is unknown, but it may be caused by a disruption of nerve signals to the stomach. The condition is a common complication of diabetes and can be a complication of some surgeries.

Risk factors for gastroparesis include:

• Diabetes
• Gastrectomy (surgery to remove part of the stomach)
• Systemic sclerosis
• Use of medication that blocks certain nerve signals (anticholinergic medication)

Symptoms:

• Abdominal distention
• Hypoglycemia (in people with diabetes)
• Nausea
• Premature abdominal fullness after meals
• Weight loss without trying
• Vomiting

Signs and tests:

• Esophagogastroduodenoscopy (EGD)
• Gastric emptying study (using isotope labeling)
• Upper GI series

Treatment:

People with diabetes should always control their blood sugar levels. Better control of blood sugar levels may improve symptoms of gastroparesis. Eating small meals and soft (well-cooked) foods may also help relieve some symptoms.

Medications that may help include:

• Cholinergic drugs, which act on acetylcholine nerve receptors
• Erythromycin
• Metoclopramide, a medicine that helps empty the stomach
• Serotonin antagonist drugs, which act on serotonin receptors

Other treatments may include:

• Botulinum toxin (Botox) injected into the outlet of the stomach (pylorus)
• Surgical procedure that creates an opening between the stomach and small intestine to allow food to move through the digestive tract more easily (gastroenterostomy)

Expectations (prognosis):

Many treatments seem to provide only temporary benefit.

Complications:

Persistent nausea and vomiting may cause:

• Dehydration
• Electrolyte imbalances
• Malnutrition

People with diabetes may have serious complications from poor blood sugar control.

Calling your health care provider:

Apply home treatment such as managing your diet. Call your health care provider if symptoms continue or if you have new symptoms.