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Diagnosis, Dietary Changes and Treatment Options for Gastroparesis

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Abstract

Gastroparesis is an ailment that attacks the alimentary canal. This paper introduces the

description of the disease with a glimpse of some of the causes. It involves the damaging of the

vagus nerve that is in charge of stomach muscle contractions. The paper then discusses the

diagnostic criteria for the disease, which include upper endoscopy and gastric manometry.

Moreover, there is a detailed discussion on the treatment options, including administering

medicines like erythromycin and surgical implant of the gastric electrical stimulator. It concludes

with the dietary changes such as taking more liquid and low-residue foods.

Keywords: Gastroparesis, vagus nerve, upper endoscopy, gastric manometry,

erythromycin, gastric electrical simulator, low-residue foods

Diagnosis, Dietary Changes and Treatment Options for Gastroparesis

Gastroparesis is a digestive disorder where the stomach delays in releasing food into the

intestines. The destruction of the vagus nerve is the most common causative agent resulting from

unattended diabetes, post-surgical complications on digestive tract organs, or other causes. The

vagus nerve is responsible for the contraction of the stomach muscles that aid food movement

along the digestive tract. The patient usually feels nauseated, upper abdominal pain, and vomits a

lot. Other symptoms include bloating, unintended weight loss, and feeling satisfied after eating

only a little food (Vijayvargiya & Camilleri, 2019).

Diagnosis

The diagnosis for gastroparesis entails a series of physical exams to confirm the validity

of the reported symptoms. The physician will also ask the patient about their medical history to

narrow down the possibility of the disease. To eliminate other conditions, the physician conducts
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examinations like blood tests, an upper endoscopy procedure, and ultrasound. Blood tests are

critical for determining malnutrition problems, dehydration, and blood sugar problems.

Ultrasound creates images of the digestive tract organs using sound waves, and the results are

essential in ruling out other diseases like pancreatitis. An upper endoscopy procedure concerns

checking the stomach lining and identifying any blockages (Szarka, & Camilleri, 2019).

Once other disorders are ruled out, the doctor proceeds to diagnose the efficiency at

which the stomach empties food into the intestines. Gastric scintigraphy aims at finding out the

rate of food digestion and unloading from the stomach. Ideally, the patient eats food containing a

small amount of radioactive material, and then the doctor begins scanning. If, after four hours,

there is still more than ten percent of the consumed food in the stomach, the patient tests positive

for gastroparesis. Another test is gastric manometry that checks electrical and muscular activity

and the digestion rate. The doctor passes a thin tube through the mouth and into the stomach to

perform the task. Other tests include barium X-ray and the smart pill.

Treatment

There are several medications that the physician may recommend to treat and relieve the

symptoms. However, if the cause of gastroparesis is an underlying condition like diabetes, the

treatment plan must begin with controlling it first. Drugs such as ondansetron help to reduce

vomiting and nausea. Metoclopramide is another medicinal drug that enables stomach muscle

contractions to help food move along the digestive tract. The patient takes the drug before eating.

It also helps to relieve vomiting although it has side effects like drowsiness and diarrhea.

Another drug is erythromycin which also activates muscle contractions, although if used for a

long time it may result in the growth of resistant bacteria (Szarka, & Camilleri, 2019).
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Surgery may also be an option, especially when the symptoms like malnutrition persist in

spite of drug administration. The procedure entails implanting a stomach stimulator called gastric

electrical simulator in the patient, to allow the stomach empty more effectively. Other options

include the introduction of jejunostomy tube that facilitates feeding of the patient by bypassing

the stomach to deliver food directly to the intestines (Szarka, & Camilleri, 2019).

Dietary Changes

Making a few changes might relieve symptoms. For example, the patient should take

more liquids and low-residue foods like water, soup, and apple sauce. The patient must also

avoid high-fiber containing foods because they are hard to digest. The same consideration

applies to hard-to-chew foods like corn and nuts. Additionally, they should adopt small frequent

meals per day instead of the conventional three large ones to avoid accumulation of food in the

stomach. Despite this change, the patient must maintain a proper nutrition amount to fight

malnutrition. Foods for consideration include cooked and/or blenderized vegetables and fruits

and bread. Furthermore, the patient should sit upright while eating to allow gravity help in food

movement. Lying down may cause food or acid to travel backwards into the throat. Besides,

gentle exercises lie walking around could alleviate the symptoms (Camilleri, 2016).
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References

Camilleri, M. (2016). Novel diet, drugs, and gastric interventions for gastroparesis. Clinical

Gastroenterology and Hepatology, 14(8), 1072-1080.

Szarka, L. A., & Camilleri, M. (2019). Evaluation of patients with suspected gastroparesis.

Gastrointestinal Endoscopy Clinics, 29(1), 39-54.

Vijayvargiya, P., & Camilleri, M. (2019). Gastroparesis. In Essential Medical Disorders of the

Stomach and Small Intestine (pp. 23-50). Springer, Cham.