Gastroparesis (patient information): Difference between revisions
Line 49: | Line 49: | ||
* Use of medication that inhibits certain nerve signals ([[anticholinergic]] medication) | * Use of medication that inhibits certain nerve signals ([[anticholinergic]] medication) | ||
==How to know you have Gastroparesis?== | ==How to know you have Gastroparesis (Diagnosis)?== | ||
After performing a full physical exam and taking your medical history, your doctor may order several [[blood tests]] to check blood counts and chemical and [[electrolyte]] levels. To rule out an obstruction or other conditions, the doctor may perform the following tests: | |||
*'''Upper endoscopy.''' After giving you a [[sedative]] to help you become drowsy, the doctor passes a long, thin tube called an [[endoscope]] through your mouth and gently guides it down the throat, also called the [[esophagus]], into the stomach. Through the endoscope, the doctor can look at the lining of the stomach to check for any abnormalities. | |||
*'''Ultrasound.''' To rule out [[gallbladder disease]] and [[pancreatitis]] as sources of the problem, you may have an [[ultrasound]] test, which uses harmless sound waves to outline and define the shape of the gallbladder and pancreas. | |||
*'''Barium x ray.''' After fasting for 12 hours, you will drink a thick liquid called [[barium]], which coats the stomach, making it show up on the x ray. If you have diabetes, your doctor may have special instructions about fasting. Normally, the stomach will be empty of all food after 12 hours of fasting. Gastroparesis is likely if the x ray shows food in the stomach. Because a person with gastroparesis can sometimes have normal emptying, the doctor may repeat the test another day if gastroparesis is suspected. | |||
Once other causes have been ruled out, the doctor will perform one of the following gastric emptying tests to confirm a diagnosis of gastroparesis. | |||
*'''Gastric emptying scintigraphy.''' This test involves eating a bland meal, such as eggs or egg substitute, that contains a small amount of a radioactive substance, called radioisotope, that shows up on scans. The dose of radiation from the radioisotope is not dangerous. The scan measures the rate of [[gastric emptying]] at 1, 2, 3, and 4 hours. When more than 10 percent of the meal is still in the stomach at 4 hours, the diagnosis of gastroparesis is confirmed. | |||
*'''Breath test.''' After ingestion of a meal containing a small amount of isotope, breath samples are taken to measure the presence of the isotope in carbon dioxide, which is expelled when a person exhales. The results reveal how fast the stomach is emptying. | |||
*'''SmartPill.''' Approved by the U.S. [[Food and Drug Administration]] (FDA) in 2006, the SmartPill is a small device in capsule form that can be swallowed.The device then moves through the digestive tract and collects information about its progress that is sent to a cell phone-sized receiver worn around your waist or neck. When the capsule is passed from the body with the stool in a couple of days, you take the receiver back to the doctor, who enters the information into a computer. | |||
==When to seek urgent medical care== | ==When to seek urgent medical care== |
Revision as of 12:42, 11 August 2009
For the WikiDoc page for this topic, click here
Editor-in-Chief: Meagan E. Doherty
Please Join in Editing This Page and Apply to be an Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [1] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
What is Gastroparesis?
Gastroparesis, also called delayed gastric emptying, is a disorder in which the stomach takes too long to empty its contents. Normally, the stomach contracts to move food down into the small intestine for digestion. The vagus nerve controls the movement of food from the stomach through the digestive tract. Gastroparesis occurs when the vagus nerve is damaged and the muscles of the stomach and intestines do not work normally. Food then moves slowly or stops moving through the digestive tract.
What are the symptoms of Gastroparesis?
Signs and symptoms of gastroparesis include:
- heartburn
- pain in the upper abdomen
- nausea
- vomiting of undigested food—sometimes several hours after a meal
- early feeling of fullness after only a few bites of food
- weight loss due to poor absorption of nutrients or low calorie intake
- abdominal bloating
- high and low blood glucose levels
- lack of appetite
- gastroesophageal reflux
- spasms in the stomach area
Eating solid foods, high-fiber foods such as raw fruits and vegetables, fatty foods, or drinks high in fat or carbonation may contribute to these symptoms.
The symptoms of gastroparesis may be mild or severe, depending on the person. Symptoms can happen frequently in some people and less often in others. Many people with gastroparesis experience a wide range of symptoms, and sometimes the disorder is difficult for the physician to diagnose.
What are the causes of Gastroparesis?
The most common cause of gastroparesis is diabetes. People with diabetes have high blood glucose, also called blood sugar, which in turn causes chemical changes in nerves and damages the blood vessels that carry oxygen and nutrients to the nerves. Over time, high blood glucose can damage the vagus nerve.
Some other causes of gastroparesis are:
- surgery on the stomach or vagus nerve
- viral infections
- anorexia nervosa or bulimia
- medications(anticholinergics and narcotics)that slow contractions in the intestine
- gastroesophageal reflux disease
- smooth muscle disorders, such as amyloidosis and scleroderma
- nervous system diseases, including abdominal migraine and Parkinson’s disease
- metabolic disorders, including hypothyroidism
Many people have what is called idiopathic gastroparesis, meaning the cause is unknown and cannot be found even after medical tests.
Who is at risk for Gastroparesis?
Risk factors for gastroparesis include:
- Diabetes
- Gastrectomy
- Systemic sclerosis
- Use of medication that inhibits certain nerve signals (anticholinergic medication)
How to know you have Gastroparesis (Diagnosis)?
After performing a full physical exam and taking your medical history, your doctor may order several blood tests to check blood counts and chemical and electrolyte levels. To rule out an obstruction or other conditions, the doctor may perform the following tests:
- Upper endoscopy. After giving you a sedative to help you become drowsy, the doctor passes a long, thin tube called an endoscope through your mouth and gently guides it down the throat, also called the esophagus, into the stomach. Through the endoscope, the doctor can look at the lining of the stomach to check for any abnormalities.
- Ultrasound. To rule out gallbladder disease and pancreatitis as sources of the problem, you may have an ultrasound test, which uses harmless sound waves to outline and define the shape of the gallbladder and pancreas.
- Barium x ray. After fasting for 12 hours, you will drink a thick liquid called barium, which coats the stomach, making it show up on the x ray. If you have diabetes, your doctor may have special instructions about fasting. Normally, the stomach will be empty of all food after 12 hours of fasting. Gastroparesis is likely if the x ray shows food in the stomach. Because a person with gastroparesis can sometimes have normal emptying, the doctor may repeat the test another day if gastroparesis is suspected.
Once other causes have been ruled out, the doctor will perform one of the following gastric emptying tests to confirm a diagnosis of gastroparesis.
- Gastric emptying scintigraphy. This test involves eating a bland meal, such as eggs or egg substitute, that contains a small amount of a radioactive substance, called radioisotope, that shows up on scans. The dose of radiation from the radioisotope is not dangerous. The scan measures the rate of gastric emptying at 1, 2, 3, and 4 hours. When more than 10 percent of the meal is still in the stomach at 4 hours, the diagnosis of gastroparesis is confirmed.
- Breath test. After ingestion of a meal containing a small amount of isotope, breath samples are taken to measure the presence of the isotope in carbon dioxide, which is expelled when a person exhales. The results reveal how fast the stomach is emptying.
- SmartPill. Approved by the U.S. Food and Drug Administration (FDA) in 2006, the SmartPill is a small device in capsule form that can be swallowed.The device then moves through the digestive tract and collects information about its progress that is sent to a cell phone-sized receiver worn around your waist or neck. When the capsule is passed from the body with the stool in a couple of days, you take the receiver back to the doctor, who enters the information into a computer.
When to seek urgent medical care
Treatment options
Diseases with similar symptoms
Where to find medical care for Gastroparesis
Directions to Hospitals Treating Gastroparesis