As you probably know, eating is one of the essential things in life. The ability to enjoy food often keeps us going when we’re feeling down or stressed out, and it can be a source of joy and comfort. However, eating can become frustrating and unpleasant if you have gastroparesis or another digestive disorder affecting your body’s food digestion (such as irritable bowel syndrome). In some cases, it can even put a strain on your relationships or cause physical discomfort or pain.
If you’re suffering from gastroparesis right now and are struggling with this aspect of managing this condition—or if someone you love has been diagnosed with gastroparesis but isn’t coping well—don’t worry: there are plenty of steps you can take to help yourself feel better about the situation.
When you have gastroparesis, your stomach doesn’t empty properly, and you can end up vomiting or having diarrhoea, followed by periods where nothing comes out. This can make eating a huge challenge for anyone! Many people with gastroparesis also struggle with other digestive issues, such as constipation or irritable bowel syndrome (IBS).
What is Gastroparesis?
Gastroparesis means that the stomach is paralysed and cannot contract normally. This causes food to take longer to move through the digestive tract, leading to symptoms such as nausea, vomiting, bloating, heartburn, and diarrhoea.
Gastroparesis can be caused by essential tremor (a neurological disorder), diabetes mellitus (type 1 or type 2 diabetes), hypothyroidism (underactive thyroid), Parkinson’s disease (movement disorder), or mechanical obstruction in the lower part of the oesophagus due to tumours or scar tissue from previous surgeries.
The most common symptoms are upper abdominal pain with fullness; nausea with or without vomiting; bloating after eating only small amounts of food; loss of appetite; early satiety (feeling full quickly when eating); heartburn related to eating; excessive burping after meals because there has been no swallowing during that period.
Symptoms of gastroparesis
There are several symptoms associated with gastroparesis, including:
⦁ Nausea and vomiting
⦁ Loss of appetite
⦁ Heartburn, indigestion, or abdominal pain after eating only a small amount of food
⦁ Feeling full even though you haven’t eaten much (and feeling hungry again soon after eating)
Other possible symptoms include:
⦁ Weight loss due to poor absorption of nutrients and calories in the digestive tract
⦁ Diarrhoea that’s not related to irritable bowel syndrome (IBS) or another medical condition
⦁ Constipation that’s not associated with IBS or another medical condition
Causes of gastroparesis
There are several conditions that can cause gastroparesis, including:
⦁ Damage to the vagus nerve – The vagus nerve is a major nerve that controls digestion from the brain to the stomach and intestines. Damage to this nerve may cause gastroparesis.
⦁ Nerve damage from diabetes – Diabetes can damage the nerves that control digestion. Blood sugar levels that are too high for too long can lead to diabetic neuropathy, which affects many of the nerves in your body. If you have diabetes and have an episode where your blood sugar levels are high for a long time, your doctor may recommend treating it with insulin injections or another medication to help keep your blood sugar levels under control. If you have diabetes and experience symptoms of gastroparesis, such as nausea or vomiting after eating, talk with your doctor about what treatment options are right for you.
⦁ An autoimmune disease such as Crohn’s disease or celiac disease is – Autoimmune disorder characterised by the body’s immune system attacking a part of itself. The most common autoimmune disease is rheumatoid arthritis, in which the body’s immune system attacks its joints. Other autoimmune disorders include diabetes, lupus, and Graves’ disease. The immune system reacts to gluten in celiac disease by attacking the small intestine. Celiac disease is also commonly known as gluten-sensitive enteropathy or celiac sprue. It is an autoimmune response to consuming gluten (wheat-related protein).
⦁ Pregnancy or childbirth complications – Pregnancy and childbirth complications are linked to the development of gastroparesis, but it’s also possible for the condition to develop without any such issues. It’s also possible for people with gastroparesis to develop another type of digestive disorder. The causes of gastroparesis are still not well understood, but research is ongoing.
Treatments for gastroparesis
There are several treatment options for gastroparesis. These treatments aim to help you eat better and feel better by making it easier for food to pass through your stomach.
⦁ Medications. You may be prescribed drugs such as Metoclopramide and Domperidone, which increase the stomach’s ability to empty itself of food. These medications can also reduce nausea and vomiting associated with gastroparesis, improving your appetite and nutrition.
⦁ Dietary changes. Your doctor might recommend: eating smaller meals more frequently throughout the day (rather than three big meals), avoiding high-fibre foods that take longer to digest, drinking plenty of fluids with meals or at least an hour afterwards, choosing low-fat foods over high-fat foods when possible, avoiding carbonated beverages that can irritate your stomach lining (this includes beer), limiting alcohol consumption (if you drink) because it slows digestion even further, chewing food thoroughly before swallowing anything else while eating until all swallowed foods have been chewed well enough so that they do not get stuck in the oesophagus or stomach from being undercooked (such as raw carrots).
⦁ Surgery: Some people respond poorly to medications or dietary changes, so surgery may be needed if other treatments aren’t working very well for them; however, surgery does come with its complications, so talk about all options before deciding on one type over another—including whether any additional therapy should still be considered after going through surgery–to determine what works best for each person individually.
⦁ Gastric Electrical Stimulation: Gastric electrical stimulation (GES) is an FDA-approved treatment for severe cases of gastroparesis that don’t respond to other treatments. It involves surgically placing electrodes on your left upper abdomen near where your vagus nerve emerges from your spinal cord. The electrodes are connected to a pulse generator — a battery-powered pacemaker — that sends electrical pulses through the electrodes and into your vagus nerve when it detects certain conditions, such as nausea or vomiting, that indicate you need treatment.
⦁ Vagus nerve stimulation (tVNS): It is a treatment that uses electrical impulses to stimulate the vagus nerve. The vagus nerve is the longest of 12 cranial nerves in the body, extending from the brainstem through the neck and chest down into the abdomen.
How is vagus nerve stimulation different from other treatments?
VNS is a treatment option for people with severe forms of gastroparesis. It uses electrical impulses to stimulate the vagus nerve, which runs from the brain to the stomach and other digestive organs.
While VNS is a reversible treatment, it can be turned off if needed; it doesn’t work for everyone and isn’t FDA-approved for gastroparesis. However, it’s still an option worth considering if you’re considering surgical treatment or medication—and as always, talk with your doctor about whether VNS could be right for you.
The FDA has approved vagus nerve stimulation to treat epilepsy and depression, with some mixed results. The vagus nerve, which relays signals from the brain to the organs in your chest and abdomen, is connected to a number of other systems in your body—including muscles, your heart, and your lungs. When we feel stressed, our bodies go into fight or flight mode, releasing hormones that speed up our heart rate and make us tense. In order for us to calm down, these systems have to return to their normal state. Vagus nerve stimulation works by sending a little electrical current through an electrode implanted in the patient’s neck and into the vagus nerve itself. This stimulates the nerve and can help get the body back into its normal state as quickly as possible. However, there are also reasons why this treatment has seen mixed results. One major reason is that even though it’s been approved for depression, it’s still not clear that it works better than other existing treatments like antidepressants or psychotherapy alone—and there are also other treatment options that don’t pose any risk of serious side effects. So while it may be promising, vagus nerve stimulation is far from being a “cure-all” yet.
Short-term vagal nerve stimulation alleviated cardinal symptoms and hastened stomach emptying in a subgroup of patients with idiopathic gastroparesis, according to research published in 2020. Responders started off with a more serious gastric delay, and clinical improvement corresponded with therapy duration but not with changes in stomach emptying. To verify the findings of this pilot investigation, larger, longer-duration randomised sham-controlled studies are required.
Conclusion
We hope this article has helped you better understand gastroparesis, its symptoms and treatments. You can take steps now to start managing your symptoms and improving your quality of life.
References
⦁ Gottfried-Blackmore, A., Adler, E. P., Fernandez-Becker, N., Clarke, J., Habtezion, A., & Nguyen, L. (2020). Open-label pilot study: Non-invasive vagal nerve stimulation improves symptoms and gastric emptying in patients with idiopathic gastroparesis. Neurogastroenterology and motility: the official journal of the European Gastrointestinal Motility Society, 32(4), e13769. https://doi.org/10.1111/nmo.13769
