Gastroparesis

What is Gastroparesis?

Gastroparesis is delayed emptying of the stomach with the absence of observable obstruction or blockage. Typically, the stomach voids its contents regularly into the small intestine. In gastroparesis, the muscle contractions that allow the food to move along the digestive tract does not function normally and the stomach does not empty quick enough.

Contributing Factors to Gastsroparesis?

The cause of gastroparesis is unclear and often idiopathic; meaning no known cause. However, in many cases it has been observed that gastroparesis is caused by damage to the vagus nerve (an important link from the gut to the brain.)

The vagus nerve is responsible for managing the mechanisms in the digestive tract. Communicating to the muscles of the stomach when to contract and move food into the small intestine. An impaired vagus nerve cannot signal normally to the stomach muscles. This causes food to stay in the stomach for a longer period of time, rather than pushing into your small intestine to continue the digestive process.

Other risk factors contributing to gastroparesis maybe:

• Diabetes

• Abdominal or esophageal surgery

• Infection or virus

• Certain medications can affect stomach motility

• People who suffer from scleroderma (a connective tissue disease) and nervous system diseases.

• Hypothyroidism (low thyroid)

Signs & Symptoms

There are a variety of signs and symptoms that may indicate that gastroparesis. Consulting with your medical team is necessary to manage symptoms and for a diagnosis.

• Nausea & vomiting

• A feeling of fullness after eating just a few bites

• Vomiting undigested food eaten a few hours earlier

• Acid reflux

• Abdominal bloating & pain

• Changes in blood sugar levels

• Lack of appetite

• Weight loss and/or weight gain

Complications & Health Concerns

There are a few other health concerns that arise due to the gastroparesis.

Dehydration: frequent vomiting and limit ability to take in water can lead to dehydration.

Malnurishment: poor assimilation of nutrients due to food not being digested and lack of appetite results in decreased calorie consumption.

Undigested Foods: when food remains in the stomach it can contribute to two things fermentation leading to proliferation of “bad” bacteria and hardening of undigested food can form something call bezoars that can lead to obstruction.

Unpredictable Blood Sugar Changes: gastroparesis can lead to irregularities in blood sugar levels.

Decreased Quality of Life: flare ups cause by gastroparesis can cause discomfort and make day to day activities challenging.

Conventional Medical Approach

Conventional medical approaches typically starts with a physical exam that will be performed by a doctor. Often follow up tests that measures how fast the stomach empties will be done to confirm the diagnosis. The following tests are performed by doctors to help diagnose gastroparesis and rule out conditions that may cause similar symptoms. Tests may include:

• Gastric emptying study

• Upper gastrointestinal (GI) endoscopy

• Ultrasound

• Upper gastrointestinal series

Is there treatment for gastroparesis?

The first step in treating gastroparesis is to treat the root cause or underlying condition. After that it is symptom management that is important and varies from person to person. Things to consider are;

• Eat 5-6 small meals a day - 1/2 -1 cup of food to avoid overfilling stomach.

• Chew food thoroughly; there are NO teeth in the stomach.

• Eat well-cooked fruits and vegetables rather than raw fruits and vegetables

• Avoid high fibre foods

• Choose mostly low-fat foods; if you can tolerate fat, add small servings of nourishing fats into your diet

• Try soups and pureed foods

• Drink about 1 to 1.5 liters of water a day; small sips throughout the day

• Exercise gently after you eat, such as going for a walk

• Avoid carbonated drinks, alcohol and smoking

• Try to avoid lying down for 2 hours after a meal

Unfortunately, in severe cases, some patients may be unable to handle any food or liquids. In these instances doctors may recommend a feeding tube (jejunostomy tube) be inserted in the small intestine. Doctors may also recommend a gastric venting tube to help alleviate pressure from gastric build-up. These procedures are usually temporary and is only used when gastroparesis is severe and can’t be managed any other way.

Nutritional Consideration

When considering nourishing ones body there are a few considerations to take into account. Firstly we want to consume foods that are easily digested. Fats and fibre are hard to digest. In the beginning completely avoiding them is ideal and slowly adding them in. When adding in fibrous foods you will want them to be well cooked, skinned, hulled or seeded. Fats while they are incredibly important for our brain and hormones. Foods high in fat do prevent the stomach from emptying. If fats are tolerated limiting to good quality fats and approx only 2 tbsp/ day.

Foods to Avoid

• carbonated beverages

• alcohol

• beans and legumes

• corn

• seeds and nuts

• broccoli and cauliflower

• cheese

• heavy cream

Foods to Include

• eggs

• smooth or creamy peanut butter

• bananas

• white breads, low fiber or refined cereals, and low fat crackers

• fruit juice

• vegetable juice - pulp free (spinach, kale, carrots)

• fruit purees

Gastoparesis is not a common condition and 1/3 of diagnosed conditions are idiopathic. It can drastically decrease ones quality of life. Learning to listen to your body and do your best to manage your symptoms is important. Focusing on your whole-self -mindset, lifestyle and nutrition!

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Disclaimer

The entire contents of this website are based upon the opinions of Green Thumb Health & Nutrition. Please note that Green Thumb Health & Nutrition is not a dietitian, physician, pharmacist or other licensed healthcare professional. The information on this website is NOT intended as medical advice, nor is it intended to replace the care of a qualified health care professional. This content is not intended to diagnose or treat any diseases. Always consult with your primary care physician or licensed healthcare provider for all diagnosis and treatment of any diseases or conditions, for medications or medical advice as well as before changing your health care regimen.