Some of the common symptoms experienced by about 60 to 90% of individuals suffering from gastroparesis, include chronic nausea accompanied by vomiting, pain in abdomen, and feeling of fullness after first few bites. In addition, individuals would also suffer from malnutrition, bloating, heartburn, gastroesophageal reflux, palpitations, spasms in the stomach muscles and decreased appetite which eventually leads to weight loss [7].

• Malnutrition

  Other symptoms of gastroparesis include gastroesophageal reflux, palpitations, bloating, heartburn, weight loss, reduced appetite, malnutrition and changes in blood glucose levels. [symptoma.com]

  The symptoms associated with gastroparesis, such as vomiting and decreased appetite, can cause dehydration and malnutrition. [healthline.com]

  Lower fat diets can also help reduce symptoms, but again professional advice needs to be sought as low-fat diets can make malnutrition worse. [gutscharity.org.uk]

  Untreated, it can lead to dehydration, malnutrition and bezoars (hardened masses of food that can block the digestive tract). [iuhealth.org]

  Complications include malnutrition, fatigue, weight loss, vitamin deficiencies, intestinal obstruction due to bezoars, and small intestine bacterial overgrowth. [en.wikipedia.org]

• Weakness

  Normally, the stomach is seen to undergo regular muscular contractions during endoscopy and these may be weak or absent in patients with this problem. [muschealth.org]

  […] bacterial overgrowth Frequency possibly up to 4%[citation needed] Gastroparesis (gastro- from Ancient Greek γαστήρ – gaster, "stomach"; and -paresis, πάρεσις – "partial paralysis"), also called delayed gastric emptying, is a medical disorder consisting of weak [en.wikipedia.org]

  Dehydration and malnutrition can cause numerous problems, including: electrolyte imbalances decreased blood pressure increased heartbeat rapid breathing decreased urine output a weakened immune system poor wound healing muscle weakness Since gastroparesis [healthline.com]

  Other symptoms include bloating, muscle weakness, and night sweats. [badgut.org]

• Falling

  Individuals with diabetes often fall prey to gastroparesis. Improper contractions of the stomach muscles interfere with the passing of food to the small intestine for absorption of nutrients. [symptoma.com]

  But cases falling into this subtype may be from various causes, including known causes that just couldn’t be determined. Diabetes is the most common single cause of gastroparesis. Around one-third of cases are diagnosed as diabetes-related. [my.clevelandclinic.org]

  Cisapride: what wan we learn from the rise and fall of a prokinetic? J Dig Dis. 2011;12(3):147-156. https://doi.org/10.1111/j.1751-2980.2011.00491.x [ Links ] 58. Richards RD, Valenzuela GA, Davenport KG, Fisher KL, McCallum RW. [scielo.org.co]

• Feeding Difficulties

  difficulty in infants and young children Weight loss These symptoms, however, are non-specific and do not distinguish gastroparesis from a mechanical, infectious or non-infectious inflammatory or biochemical disorder that also causes delayed gastric [chop.edu]

• Aspiration

  In severe cases, reflux aspiration pneumonitis compounds the clinical picture. Other symptoms include belching and bloating-again, developing soon after meal ingestion and lasting for hours-along with visible abdominal distention. [rarediseases.org]

• Vomiting

  Fifth are stress and anxiety, which can centrally induce nausea and vomiting. [ueg.eu]

  Cardinal symptoms are early satiety, postprandial fullness, nausea, vomiting, bloating, and upper abdominal pain.[1] History and exam Key diagnostic factors postprandial fullness nausea vomiting early satiety More key diagnostic factors Other diagnostic [bestpractice.bmj.com]

  Medications to control nausea and vomiting caused by gastroparesis can include: prochlorperazine (Compro) ondansetron (Zofran) promethazine (Phenergan) Surgery If your malnutrition or vomiting remains an issue even with the use of medications, your doctor [healthline.com]

  The most common symptom of gastroparesis is vomiting. Children with this condition often get sick late in the day after a meal and commonly vomit foods eaten several hours earlier. [childrenshospital.org]

  Treatment includes dietary modifications, medications to stimulate gastric emptying, medications to reduce vomiting, and surgical approaches.[4] Signs and symptoms[edit] The most common symptoms of gastroparesis are the following:[5] Chronic nausea Vomiting [en.wikipedia.org]

• Nausea

  Fifth are stress and anxiety, which can centrally induce nausea and vomiting. [ueg.eu]

  Cardinal symptoms are early satiety, postprandial fullness, nausea, vomiting, bloating, and upper abdominal pain.[1] History and exam Key diagnostic factors postprandial fullness nausea vomiting early satiety More key diagnostic factors Other diagnostic [bestpractice.bmj.com]

  There are also other medications that may help gastroparesis symptoms, such as antiemetics (e.g. ondansetron or promethazine), which help control nausea. [patient.gastro.org]

  Gastrointestinal issues like nausea, vomiting, bloating, and stomach pain are some of the most common symptoms of slow digestion. [healthline.com]

  Medications to alleviate nausea may also help symptoms as will strict control of blood sugar levels in diabetic patients. [muschealth.org]

• Abdominal Pain

  Last reviewed: 28 Feb 2023 Last updated: 26 Apr 2022 Summary Gastroparesis cardinal symptoms are early satiety, postprandial fullness, nausea, vomiting, bloating, and upper abdominal pain. [bestpractice.bmj.com]

  Symptoms of gastroparesis may include feeling bloated, vomiting, having heart burn, abdominal pain, diarrhoea, reduced appetite and weight loss. [healthdirect.gov.au]

  […] distention Hypoglycemia (in people with diabetes) Nausea Premature abdominal fullness after meals Weight loss without trying Vomiting Abdominal pain Gastroparesis Diagnosis Tests you may need include: Esophagogastroduodenoscopy (EGD) Gastric emptying [wakehealth.edu]

  Children commonly experience symptoms of vomiting, abdominal pain, weight loss, feeling full soon after starting a meal and feeling very full after eating a normal sized meal. [gutscharity.org.uk]

  Symptoms of Gastroparesis Can Include: Feeling full after only a few bites Bloating Excessive burping or belching Nausea Vomiting Weight loss due to inability to eat Vague abdominal pain Tests for Gastroparesis After taking a careful history and doing [nationwidechildrens.org]

• Dyspepsia

  First is functional dyspepsia, which is the closest mimic to gastroparesis. Functional dyspepsia can be divided into epigastric pain syndrome and postprandial distress syndrome. [ueg.eu]

  Functional dyspepsia. Nat. Rev. Dis. Primers 3, 17081 (2017). This Review presents an excellent synthesis of the state of the art and science in functional dyspepsia. PubMed Google Scholar Park, S. Y. et al. [nature.com]

  Studies of gastric emptying time in patients with non-ulcer dyspepsia. Nucl Med Commun. 2007;28(11):852-8. https://doi.org/10.1097/MNM.0b013e3282f0d167 [ Links ] 31. [scielo.org.co]

  Gastroparesis and functional dyspepsia: excerpts from the AGA./ ANMS meeting. Neurogastroenterol Motil. 2010;22:113–33. CrossRef PubMed CAS Google Scholar Horowitz M, Su YC, Rayner CK, Jones KL. [link.springer.com]

  Functional dyspepsia is usually characterised by less vomiting, more pain and other sensory symptoms than pure gastroparesis. [gutscharity.org.uk]

• Early Satiety

  Cardinal symptoms are early satiety, postprandial fullness, nausea, vomiting, bloating, and upper abdominal pain.[1] History and exam Key diagnostic factors postprandial fullness nausea vomiting early satiety More key diagnostic factors Other diagnostic [bestpractice.bmj.com]

  Symptoms Early Satiety (feeling full) nausea vomiting abdominal pain weight loss GP symptoms can vary from mild to severe and in some patients can be life-threatening due to secondary conditions such as malnutrition (when the body does not absorb enough [iffgd.org]

  Postprandial distress syndrome is characterised by symptoms of early satiety, postprandial fullness, epigastric bloating and epigastric discomfort or pain, symptoms that are almost identical to those of gastroparesis but with less nausea and vomiting. [ueg.eu]

  This can result in irregular absorption of nutrients, inadequate nutrition, and poor glycemic control.[2][3] Symptoms include nausea, vomiting, abdominal pain, feeling full soon after beginning to eat (early satiety), abdominal bloating, and heartburn [en.wikipedia.org]

  Among patients with diabetes, the most significant association with delayed GE was with the symptom of early satiety and fullness but not with nausea and vomiting (26). [journals.lww.com]

• Skin Rash

  Stop taking GIMOTI right away and get emergency help if you have any of these symptoms: swelling of your tongue, throat, lips, eyes, or face trouble swallowing or breathing skin rash, hives, sores in your mouth, or skin blisters Before starting GIMOTI [gimotirx.com]

• Polyneuropathy

  Risk factors for severity of diabetic polyneuropathy: intensive longitudinal assessment of the Rochester Diabetic Neuropathy Study cohort. Diabetes Care 22, 1479–1486 (1999). CAS PubMed Google Scholar Papanas, N. & Ziegler, D. [nature.com]

Several tests are done to diagnose the condition of gastroparesis. Various tests that are employed include the following:

• Gastric emptying study: This method is accomplished with the help of isotope labeling. In this, the individual is given small amount of food that contains radioactive elements. The food is consumed, and the scanner detects the amount of time food takes to leave the stomach [8].
• Endoscopy: With the help of this method, abnormalities in the stomach and small intestine can be determined. 
• Ultrasonography: Transabdominal sonography is indicated in patients with gastroparesis which helps in determining the proximal stomach function.

• Helicobacter Pylori

  Does Helicobacter pylori infection increase gastric sensitivity in functional dyspepsia? Gut 1995;37(1):47-51. https://doi.org/10.1136/gut.37.1.47 [ Links ] 23. Salicru M, Juarez D, Genta RM. [scielo.org.co]

  Gastric accommodation in non-ulcer dyspepsia and the roles of Helicobacter pylori infection and vagal function. Gut 44, 55–64 (1999). CAS PubMed PubMed Central Google Scholar Tack, J. et al. [nature.com]

At the preliminary level, attempts are made to treat the underlying condition that is causing delayed gastric emptying. If diabetes is the cause, then medications along with dietary control are advised to control the blood sugar levels. The following methods are employed for treating gastroparesis [9]:

• Changes in dietary pattern: Foods that can be easily digested by the individuals are suggested. Raw and high fibrous food should be avoided in order to prevent the onset of bezoars. In addition, small and frequent meals are advised. Individuals are also suggested to sip in water throughout the meal.
• Medications: Medications to stimulate muscle contractions and facilitate the movement of the food through the digestive tract are given. These include erythromycin and metoclopramide. In addition, other medications such as lorazepam, prochlorperazine and diphenhydramine are administered to relieve the accompanying symptoms of gastroparesis [10].
• Surgery: Surgery is indicated in patients, who do not show signs of recovery with medications and dietary changes. Surgical interventions would include stomach bypass procedure or stomach stapling, which would help in faster gastric emptying.

Gastroparesis cannot be cured; however, the condition can be managed to a certain extent with medications. These provide temporary relief from the symptoms and individuals are also required to adhere to dietary changes to get the desired effect. When left untreated, gastroparesis can give rise to several debilitating complications.

Gastroparesis occurs due to partial paralysis of the vagus nerve that regulates the contractions of the stomach muscles. The exact factor that causes paralysis of the nerve is not known. Gastroparesis often occurs as a secondary complication in individuals with diabetes, both type 1 and type 2 [2]. In addition, certain other risk factors are also known. These include [3]:

• Gastrectomy
• Anticholinergic medications 
• Systemic sclerosis
• Infections
• Conditions such as bulimia and anorexia

The exact incidence of gastroparesis is not available. With the available data, it can be estimated that about 20% of adults in US are diagnosed with functional gastroparesis [4]. The condition is a common occurrence amongst the diabetic population. It was reported that, 30% individuals with type 2 diabetes and 25 to 55% individuals with type 1 diabetes develope gastroparesis as a secondary complication [5].

Under normal conditions, the stomach muscles contract and move the food down the digestive tract. These muscles are controlled by the vagus nerve. During conditions of illness or injury when the nerve get damaged, the contraction of the muscles is inhibited. As a result, the food is not passed on to the intestine for its further digestion and absorption process. Such a phenomenon delays the gastric emptying giving rise to the condition known as gastroparesis [6].

Diabetes has been identified as the most common cause of gastroparesis. Therefore, diabetic individuals are advised to effectively manage their condition to avoid the onset of gastroparesis. Certain medications are also known to delay the gastric emptying. Individuals should also make necessary attempts to avoid such medications.

Gastroparesis occurs without any obstruction. Individuals with diabetes often fall prey to gastroparesis [1]. Improper contractions of the stomach muscles interfere with the passing of food to the small intestine for absorption of nutrients. Gastroparesis cannot be cured; however with medications the symptoms can be controlled to a certain extent. But, in many cases, the medications employed for symptoms relief bring along several debilitating side effects.

Definition

Gastroparesis is a condition characterized by delayed gastric emptying, due to various underlying conditions. It is a common phenomenon amongst the diabetic population. In this condition, the stomach muscles undergo partial paralysis that inhibits the passage of the food to the small intestine, for its future course.

Cause

The exact cause that triggers gastric emptying is unknown. However, certain underlying disease conditions such as diabetes, viral infections, surgery, alcohol abuse, consumption of illegal drugs and medications can all lead to gastroparesis.

Symptoms

Chronic nausea is the classical symptom of gastroparesis. In addition, majority of the affected individuals also experience vomiting, abdominal pain and feeling of fullness after the first few bites of meal. Other symptoms of gastroparesis include gastroesophageal reflux, palpitations, bloating, heartburn, weight loss, reduced appetite, malnutrition and changes in blood glucose levels.

Diagnosis

Gastroparesis is diagnosed using the gastric emptying test. In this test the individual is given food containing small amounts of radioactive material to eat. With the help of scanner, the activity of the food that is ingested is studied, and the time taken for the food to leave the stomach, is also analyzed. In addition, other tests such as CT scan of the abdomen, and small intestine are carried out to look for presence of abnormalities.

Treatment

Medications and dietary changes form the basis of treatment regime for individuals with gastroparesis. Surgery is the last resort, and is used when all other methods to treat gastroparesis fail.

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