Gastroparesis is often a lesser-known gastrointestinal condition that affects approximately 267.7 per 100,000 adults in the United States. In recognition of Gastroparesis Awareness Month, which takes place in August each year, Steward sat down with Amy Calderon, DO, PharmD, to discuss this often under diagnosed condition and shed light on defining gastroparesis, its symptoms, underlying causes, available treatment options, and new developments in managing the condition.
Dr. Amy Calderon is a Gastroenterologist with Steward Medical Group at Trumbull Regional Medical Center in Warren, OH. Dr. Calderon earned her medical degree from the New York College of Osteopathic Medicine and completed an Internal Medicine residency at Lenox Hill Hospital in New York, NY, where she served as the chief resident from June 2013 to June 2014. Dr. Calderon then completed a fellowship in Gastroenterology at Metro Health Medical Center in Cleveland, OH.
She is board certified in both Internal Medicine and Gastroenterology. Her clinical interests include Hepatitis C, Autoimmune Hepatitis, General Gastroenterology, and Hepatology.
What is Gastroparesis?
Gastroparesis is a chronic medical condition that affects the normal movement of food through the stomach. In a healthy digestive system, the stomach contracts to help break down and move food into the small intestine for further digestion. However, in individuals with gastroparesis, these stomach contractions become weakened or may not occur at all, leading to delayed emptying of the stomach.
Because the food sits in the stomach much longer, other symptoms may present themselves. With a number of vague symptoms occurring, gastroparesis is often not the first condition to come to mind, and physicians may need to recommend a number of tests to properly diagnose it.
What are the Symptoms of Gastroparesis?
The symptoms of gastroparesis vary from person to person and may include:
- Nausea and Vomiting: Feelings of nausea and vomiting, often after meals.
- Feeling Full Quickly: Feelings of fullness even after eating small amounts of food.
- Abdominal Pain: Bloating, abdominal pain, or discomfort.
- Heartburn: Acid reflux and heartburn may occur due to delayed stomach emptying.
- Fluctuating Blood Sugar Levels: Gastroparesis can interfere with the normal digestion of food, causing unpredictable blood sugar levels, especially in individuals with diabetes.
- Unintended Weight Loss: Over time, inadequate caloric intake can lead to unintentional weight loss.
What Causes Gastroparesis?
The exact cause of gastroparesis is not always clear, but some common factors linked to its development include:
- Diabetes: High blood sugar levels can damage the muscles in the stomach, causing them to slow down.
- Post-surgical Complications: Some abdominal surgeries can inadvertently damage the stomach muscles.
- Medications: Some medications and recreational drugs, particularly those affecting the nervous system, can contribute to gastroparesis. These may include, but are not limited to, opioids, weight loss medications, marijuana, and alcohol.
- Idiopathic: In some cases, the exact cause of gastroparesis remains unknown, leading to idiopathic gastroparesis.
What Treatment Options are Available?
Presently, there is no cure for gastroparesis. The management of gastroparesis is aimed at alleviating symptoms and improving the patient’s quality of life. Treatment plans may vary depending on the severity of symptoms, underlying causes, and preexisting conditions. Some treatment options include:
- Dietary Modifications: Patients are often advised to eat smaller, more frequent meals and avoid high-fat and high-fiber foods that may be harder to digest. Four to six snack-size meals per day is recommended rather than three large meals. On days with particularly bad symptoms, patients may want to be on a liquid diet. Additionally, the Centers for Disease Control recommends increasing water intake, limiting alcohol consumption, and quitting smoking.
- Lifestyle Changes: Patients are encouraged to develop a more active lifestyle. This can aid in weight loss, which in turn helps with diabetes management.
- Medication: Currently the only FDA approved medication for gastroparesis is metoclopramide (Reglan). This drug enhances stomach contractions and promotes food movement; however, it does have potential for neurological side effects which must be clearly discussed.
- Surgery: Rarely, surgery may be considered in cases of severe gastroparesis that doesn’t respond to other treatments and when the patient is unable to keep down any food (including liquids), experiences persistent vomiting, or displays signs of severe malnutrition.
Are there any New Developments or Research?
As research continues to advance, promising developments are emerging in the field of gastroparesis management. These breakthroughs offer hope for better outcomes for patients. Some ongoing areas of research include:
- Gut Microbiome: Studies are exploring the potential link between gut bacteria and gastroparesis, which could lead to new treatment approaches.
- Electrical Stimulation Therapy: High-frequency gastric stimulation to improve gastric emptying. Stimulation is delivered via electrodes implanted in the muscle wall of the antrum.
Talk with Your Medical Provider
While gastroparesis can significantly impact a patient’s quality of life, awareness and understanding of the condition are crucial for early diagnosis and effective management. If you or someone you know is experiencing symptoms of gastroparesis, schedule an appointment with your medical provider to discuss your symptoms, current medications, and available treatment options for your personalized care.
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