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Gastroparesis – slowed function of the STOMACH that delays the travel of gastric contents into the DUODENUM. Gastroparesis results from disturbances of or damage to the vagus NERVE (the tenth cranial nerve), which carries the nerve impulses that accelerate PERISTALSIS (rhythmic contractions of the gastrointestinal tract).
Gastroparesis most commonly occurs after a viral infection though also is a complication of DIABETES, which damages nerve structures throughout the body. Other causes include sclerotic conditions such as MULTIPLE SCLEROSIS or scleroderma, anticholinergic medications often prescribed to treat PARKINSON’S DISEASE, inadvertent damage to the vagus nerve as a complication of thoracic or HEART surgery, and intentional interruption of the vagus nerve (vagotomy) to treat conditions such as PEPTIC ULCER DISEASE. People who are on long-term PARENTERAL NUTRITION also often have gastroparesis.
Symptoms of Gastroparesis
The main symptom of gastroparesis is frequent VOMITING of undigested food hours after a meal. Other symptoms may include lack of APPETITE due to sense of fullness, NAUSEA, ABDOMINAL DISTENTION, and unintended weight loss. Gastroparesis can quickly result in DEHYDRATION, which can create significant disturbances of blood GLUCOSE and INSULIN levels in people who have diabetes. The first approach of treatment is to shift to eating numerous small meals throughout the day, attempting to slow the pace of ingestion to accommodate the stomach’s slowed functioning.
Medications to stimulate gastrointestinal motility, such as metoclopramide (Reglan), may improve gastric emptying. Control of diabetes, which may require multiple insulin doses throughout the day, is crucial. If symptoms continue, the gastroenterologist may suggest a jejunostomy tube, or feeding tube, that bypasses the stomach. Most people, however, achieve an acceptable resolution of their symptoms, even when gastroparesis persists, through nonsurgical approaches.