The type of treatment your doctor prescribes for your gastroparesis depends on the severity of the symptoms you have. In most patients, treatment will not cure gastroparesis. Therefore, the goal of treatment is to manage the condition and its symptoms so you can be as comfortable as possible.
While there can be other causes of gastroparesis, it is most commonly a complication of diabetes because of high blood sugar over time. As gastroparesis can lead to poor blood sugar control, it can be difficult to treat gastroparesis. What your doctor may recommend is taking insulin more often, taking your insulin after you eat instead of before, or checking your blood glucose levels frequently and administering insulin whenever it is necessary.
Whether your gastroparesis is because of diabetes or some other cause, your doctor will discuss with you other possible treatment options. Some of those include:
Dietary changes: Your doctor, and possibly a dietitian, can help you find the foods that are the easiest for you to digest, so that you will be able to take in enough nutrients and don't become malnourished. The following are some common recommendations:
- Eat six smaller meals instead of three larger ones so your stomach isn't digesting too much at any time.
- Avoid high-fat foods. Fat can slow digestion.
- Avoid high-fiber foods. Fiber is difficult to digest. Eat well-cooked fruits and vegetables rather than eating them raw.
- You can eat soup or puree your foods if these seem easier for you to digest.
- Remember to drink plenty of water during your meals.
Medications: Your doctor may prescribe a medication to either help stimulate stomach emptying or control nausea and vomiting, or both.
- Metoclopramide is a medication that has been used to help improve stomach emptying by stimulating contractions of the stomach and intestines. It acts on the dopamine receptors in the stomach and intestine. Metoclopramide also works on the part of the brain that controls the vomiting reflex, thus helping to control the feeling of nausea and the urge to vomit.
Metoclopramide, however, has gotten a "black box" warning from the FDA because of possible severe side effects, such as tardive dyskinesia. It is recommended that if this medication if prescribed, it not be taken long-term. It is important to thoroughly discuss the benefits and risks of this medication with your doctor.
- Erythromycin is an antibiotic that binds to motilin receptors in the stomach and small intestine. The benefits may last only for a short time, since if this medication is used for an extended time, so the patient's body is likely to develop a tolerance toward it. Therefore, this medication may only be prescribed when symptoms have worsened or used on an intermittent basis.
- Medications for nausea and vomiting may be prescribed to help with those possible symptoms of delayed stomach emptying.
Gastric electrical stimulation: This involves the implantation of a gastric electrical stimulator. It is about the size of a cardiac pacemaker (referred to as a gastric pacemaker), and is implanted under the skin, usually during a laparoscopic procedure. Two lead wires with electrodes are implanted into the muscles of the lower stomach wall. Mild electrical pulses are then delivered to the stomach, which will help stimulate nerves and smooth muscles in the stomach. The pacemaker can be programmed differently for each patient and can be turned off at any time when it is no longer needed.
"Gastroparesis." National Digestive Diseases Information Clearinghouse (NDDIC), NIH Publication No. 07–4348 July 2007. Web. 16 Nov 2010. http://digestive.niddk.nih.gov/ddiseases/pubs/gastroparesis/.
Jean Fox, M.D. and Amy Foxx-Orenstein, D.O., FACG. "Gastroparesis." American College of Gastroenterology, n.d. Web. 16 Nov 2010. http://www.acg.gi.org/patients/gihealth/gastroparesis.asp.
Steven R. Peikin, M.D., First. Gastrointestinal Health. Harper Perennial (Harper Collins Publishers), 1999.