What is gastroparesis?
Gastroparesis affects the normal movement of muscles in the stomach. This movement is called peristalsis. Normally, the muscles spontaneously contract, which moves food and fluid through the digestive tract in the gastrointestinal system. If someone has gastroparesis, the stomach’s ability to contract those muscles is slowed down. This prevents the stomach from moving food through the small and large bowel, and prevents the stomach from emptying. Gastroparesis is potentially caused by several conditions. The most common cause is taking opioid pain relievers. These narcotics slow down the stomach movement significantly.
What are the most common signs and symptoms of gastroparesis?
The most common signs and symptoms of gastroparesis are:
- Abdominal bloating
- Vomiting after eating food
- Nausea
- Feeling like you are full after eating just a few, small bites of food
- Acid reflux
- Lack of appetite
- Malnutrition
Many people do not even report any signs or symptoms with gastroparesis. It can be completely painless.
How do doctors diagnose gastroparesis?
There are several tests to help doctors diagnose gastroparesis. It is not a condition that should be diagnosed without first completing these tests:
- Scintigraphy – This is the gold standard test used to diagnose gastroparesis. The patient eats a light meal with a small amount of radioactive material. A scanner is then used to detect movement of the radioactive material through the digestive tract. It monitors the speed at which the food leaves the patient’s stomach.
- Breath tests – The patient eats good that contains a substance the body is able to absorb. After a short period of time, the substance can be detected in the breath. This test shows how fast the stomach empties itself after eating the food, as the doctor measures the quantity of the substance in the patient’s breath.
- Upper gastrointestinal endoscopy – An endoscope is a small camera on the tip of a tube that is placed down the esophagus. The scope goes into the stomach and then into the beginning of the small bowel. The camera can detect if there is food that is not moving through the stomach as it should be.
- Ultrasound – Just like during a fetal exam, the ultrasound uses sound waves to see inside the body. For gastroparesis, the ultrasound can help see whether the gallbladder or kidneys are causing problems.
At no time should a diagnosis of gastroparesis be made without first using these diagnostic studies. Improperly diagnosing gastroparesis can have devastating effects. The patient may be discharged home with a serious, life-threatening condition. Without proper treatment, the patient may die. Gastroparesis, itself, is not life-threatening. It is typically benign and harmless. Missing the true cause the patient’s pain and complaints, though, can be catastrophic.
How do I treat gastroparesis?
The primary objective is to determine what is causing the gastroparesis. That is how the doctor will determine the best way to treat it. Typically, all gastroparesis requires is a change to your diet. Your doctor may also advise you to avoid certain medications, like opioids. Gastroparesis is not usually a serious medical condition, but it is important that the diagnosis is correctly made. If a doctor misdiagnoses your condition, he or she may be missing something life-threatening. Diagnosing a patient with gastroparesis just because no other potential diagnosis fits with the assessment is called a “garbage can diagnosis.” This often results in medical malpractice. It is the doctor’s responsibility to continue running more tests and studies to reach a proper diagnosis before sending you home from the emergency department. This is true even if the radiologist misses a diagnosis on an imaging study or if laboratory tests come back inconclusive.
