Gastroparesis is a chronic condition in which the stomach cannot move food into the small intestine in a timely manner because of weak or injured muscles or nerves.
This makes it difficult for people to get enough nourishment, and they tend to experience nausea, vomiting, early fullness, and other symptoms. Dietary adjustments, medication, and surgical treatments like gastric pacemaker implants are all part of the gastroparesis treatment spectrum.
Understanding gastroparesis
Normally, stomach muscles contract to churn up food and push it into the next step in the digestive system, the small intestine. With gastroparesis, problems with the nerves or muscles in your stomach weaken or halt those contractions. The stomach can’t empty its contents into the small intestine properly, and the delay can lead to effects that make eating uncomfortable and unpredictable.
Over time, these difficulties can impact your mental health, energy levels, and capacity to take pleasure in routine meals and social events.
Symptoms and diagnosis for gastroparesis
Diagnosing the condition can be complicated because confirmation occurs only after other possible causes are ruled out through imaging and motility tests.
Some people with gastroparesis experience persistent stomach pain that interferes with their daily quality of life. Everyday challenges of living with gastroparesis may include:
- Feeling full too quickly when eating and for a long time
- Stomach discomfort after eating
- Nausea and occasional vomiting
- Unexplained gradual weight loss
- Frequent belching or burping
- Persistent bloating or swelling
To confirm gastroparesis, doctors check the patient’s gastric emptying rate to determine whether the symptoms are caused by delayed stomach emptying or another condition. In scintigraphy, the patient eats a small meal while a scanner monitors the amount of time the food remains in the stomach. A type of breath test may also be used to determine the gastric emptying rate. In this test, you eat or drink something that includes a substance that your body absorbs. The length of time needed for the substance to show up in your breath indicates how quickly your stomach empties.
Additional diagnostic procedures, like ultrasonography and upper GI endoscopy may be conducted to rule out gallbladder problems, ulcers, or obstructions that could be causing the symptoms.
What are the causes and risk factors for gastroparesis?
In roughly 25% to 50% of cases, healthcare providers can’t determine the cause. These cases are called idiopathic.
About a third of cases are related to diabetes, which affects the nerves that control your stomach muscles. Here are some of the other top triggers and influences linked to the condition:
- Complications after stomach surgery
- Viral or bacterial infections
- Medication side effects
- Hormonal or metabolic disorders
- Multiple sclerosis, Parkinson’s disease, and other nervous system diseases
Understanding the underlying reasons and contributing factors behind gastroparesis is helpful for knowing how to manage and prevent it.
Gastroparesis treatment often focuses on correcting, reversing, and/or managing any underlying illnesses that your doctor has identified as the cause of your condition. Other goals of treatment are to:
- Ease the symptoms like nausea and vomiting
- Encourage your stomach muscles to work properly
- Meet your body’s nutrition and hydration needs
Pharmacological therapies for gastroparesis
If no underlying cause can be found or treated, your doctor may prescribe prokinetic or antiemetic medications to stimulate muscle contractions and encourage proper stomach emptying.
Prokinetic agents
Prokinetic drugs are medicines that stimulate the stomach to contract and release food more quickly. Metoclopramide and erythromycin are common options.
Antiemetic medications
Patients experiencing nausea and vomiting due to gastroparesis often find relief with antiemetics. These medications alleviate stomach upset and queasiness by preventing the brain from sending impulses that cause the person to gag.
Alternative and complementary treatments
Dietary, nutritional, and alternative measures are a very important aspect of controlling gastroparesis. With proper adjustments, patients are better able to get the nutrients they need with less gas and fullness.
Dietary changes and nutritional support
A doctor or dietitian may advise you to take it easy after meals, digest each bite thoroughly, and consume smaller portions. These alterations facilitate better digestion by easing the transit of food through the stomach.
You may have to control your fiber intake and avoid high-fiber foods like fruits and vegetables. They have the potential to form a bezoar, a solid mass that forms in the stomach.
For optimal digestion and faster stomach emptying, stick to low-fat meals.
Hydration and liquid nutrition
A liquid diet is often recommended for people with gastroparesis when solid food causes discomfort or nausea. Liquids pass through the stomach more easily, helping you stay hydrated without compromising your nutrient intake.
Smooth soups, nutritional supplement drinks, and blended meals made with milk or broth are common ways to meet your daily nutrition needs while easing digestion with a liquid or semi-liquid diet.
Alternative therapies
Researchers are investigating several alternative forms of gastroparesis treatment. Some people with gastroparesis obtain relief by using ginger, herbal medicines, acupuncture, and magnetic anti-nausea wristbands.
What are the surgical and medical options for gastroparesis?
There are surgical intervention options for gastroparesis, too. When dietary changes and medications don’t improve symptoms or nutrition, a gastric pacer implant surgery may be considered as the next option.
Gastric pacer implant surgery
When it comes to treating chronic, drug-resistant gastroparesis, whether it’s due to diabetes or something else entirely, the FDA has given the green light to Enterra Therapy for humanitarian use.
People with diabetic or idiopathic gastroparesis, whose symptoms do not improve with medicine or changes to their diet and who are between the ages of 18 and 70 are good candidates for gastric pacer implant surgery.
Enterra Therapy involves a gastric pacemaker that uses gentle electrical stimulation to calm the stomach muscles and move food more efficiently, making vomiting and nausea less likely. Here’s how the procedure works:
- Minimally invasive laparoscopic approach. The surgery uses small incisions to promote quicker, gentler recovery.
- Placement of electrodes on the stomach muscle. Electrodes deliver mild pulses to stimulate stomach contractions.
- Battery pack implantation under the skin. A small neurostimulator powers and controls the electrical signals.
- Typical surgery duration and hospital stay. The procedure lasts about two hours with a brief recovery.
Here’s what to expect:
- Recovery timeline. Most patients go home the same day and fully recover within one to two days after surgery.
- Follow-up programming and adjustments. The device’s electrical settings are customized non-invasively to manage symptoms.
- Long-term monitoring. Patients receive ongoing checkups to ensure proper function and continued symptom relief.
Enterra Therapy is specifically designed to reduce vomiting and nausea associated with diabetic or idiopathic gastroparesis. More than 15,000 patients have used this minimally invasive gastroparesis treatment method for lasting relief and improved daily comfort.
Other options for treatment
Botulinum toxin injections are sometimes prescribed to patients with gastroparesis to alleviate spasms by relaxing the muscles in the stomach. If your symptoms persist despite treatment, your doctor might recommend trying this option.
Doctors may also suggest endoscopic therapy. These are minimally invasive procedures, such as inserting a feeding tube into the small intestine to help the body get enough food and fluids. The use of a gastric venting tube is an option for reducing pressure in the stomach.
Getting help with gastroparesis
Getting a definitive diagnosis of gastroparesis is essential because it helps doctors rule out other disorders and choose the best treatment method for you.
If you notice the symptoms described here, contact Florida Medical Clinic Orlando Health. The Orlando Health Digestive Health Institute offers best-in-class clinical care including diagnostic and treatment options found only at the most advanced digestive health centers.
In addition, Dr. Ramona Ilie is the only surgeon performing the Enterra procedure in the Tampa region.
You don’t have to let gastroparesis control or limit your life. Help is available in several effective treatment options designed to manage your symptoms and restore comfort. Contact the Florida Medical Clinic Orlando Health today to learn more about advanced solutions like Enterra Therapy and other types of personalized gastroparesis treatment.
About Dr. Ilie
Dr. Ramona Ilie, a board-certified general surgeon, completed advanced fellowship training in minimally invasive surgical techniques at Emory University Hospital. She earned her medical degree from Carol Davila University of Medicine and Pharmacy and completed her surgical residency at the Cleveland Clinic Foundation.
Dr. Ilie focuses on minimally invasive abdominal surgery, including gastric pacing surgery and open abdominal wall reconstruction of the abdominal wall. With a patient-centered approach, she combines technical precision with empathy to guide patients confidently through every phase of their surgical care. Outside of her professional life, she enjoys traveling, hiking, and spending quality time with her loved ones.
Request an appointment online or call (727) 893-6840.
