What is Gastroparesis?
Gastroparesis, also called delayed gastric emptying, is a disorder in which the stomach takes too long to empty its contents. It often occurs in people with type 1 diabetes or type 2 diabetes.
Gastroparesis happens when nerves to the stomach are damaged or stop working. 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.
Diabetes can damage the vagus nerve if blood glucose levels remain high over a long period of time. High blood glucose causes chemical changes in nerves and damages the blood vessels that carry oxygen and nutrients to the nerves.
Signs and Symptoms of Gastroparesis
- vomiting of undigested food
- an early feeling of fullness when eating
- weight loss
- abdominal bloating
- erratic blood glucose levels
- lack of appetite
- gastroesophageal reflux
- spasms of the stomach wall
These symptoms may be mild or severe, depending on the person.
Complications of Gastroparesis
If food lingers too long in the stomach, it can cause problems like bacterial overgrowth from the fermentation of food. Also, the food can harden into solid masses called bezoars that may cause nausea, vomiting, and obstruction in the stomach. Bezoars can be dangerous if they block the passage of food into the small intestine.
Gastroparesis can make diabetes worse by adding to the difficulty of controlling blood glucose. When food that has been delayed in the stomach finally enters the small intestine and is absorbed, blood glucose levels rise. Since gastroparesis makes stomach emptying unpredictable, a person's blood glucose levels can be erratic and difficult to control.
Major Causes of Gastroparesis
Gastroparesis is most often caused by
- postviral syndromes
- anorexia nervosa
- surgery on the stomach or vagus nerve
- medications, particularly anticholinergics and narcotics (drugs that slow
contractions in the intestine)
- gastroesophageal reflux disease (rarely)
- smooth muscle disorders such as amyloidosis and scleroderma
- nervous system diseases, including abdominal migraine and Parkinson's disease
- metabolic disorders, including hypothyroidism