Articles
GASTROPARESIS
Gastroparesis can be better described as delayed emptying of the stomach. It is diagnosed when there is impaired transit of food from the stomach to the duodenum, without any mechanical obstruction present. The Vagus nerve works to control the movement of food through the digestive tract. If this nerve is damaged, the stimulation of the stomach and intestinal muscles is effected, and they are unable to move food through the digestive tract efficiently.
Gastroparesis can be very debilitating. It often leads to decreased absorption of nutrients, as well as overall decreased intake of food, resulting in malnutrition. Nausea and vomiting impact the patients quality-of-life and can further increase the malnutrition. Malnutrition is the main cause of morbidity and mortality in patients with Gastroparesis. Nutrition intervention can help to decrease symptoms, treat specific nutrient deficiencies and improve overall quality of life.
What Causes of Gastroparesis?
The most common cause of Gastroparesis is diabetes. People with uncontrolled diabetes have pro-longed high blood sugars. This leads to damage of the blood vessels that carry oxygen and nutrients to the nerves,that overtime leads to damage of the Vagus nerve. Other causes include;
Surgery to the stomach or Vagus nerve
Viral infections
Anorexia nervosa
Medications - particularly anticholinergics and narcotics which slow muscle movement in the intestine
Smooth muscle disorders such as amyloidosis and scleroderma
Nervous system diseases such as Parkinson's disease
Metabolic disorders, including hypothyroidism
Abdominal cancers
Idiopathic cause is unknown
What are the Signs and Symptoms of Gastroparesis?
Heartburn
Pain in the upper abdomen spasms of the stomach wall
Nausea - particularly in the morning
Vomiting of undigested food sometimes hours after the meal
Early satiety sometimes after a few bites of food
Weight loss - due to poor nutrient absorption and decreased intake
Abdominal bloating
High and low blood glucose levels
Lack of appetite
Gastroesophageal reflux
Each person will experience a variety of symptoms of varying severity.
Complications of Gastroparesis
If food remains in the digestive tract too long it can ferment and lead to bacterial overgrowth. In addition, the food may harden into solid masses called bezoars. This can lead to stomach obstructions which can cause nausea and vomiting. Diabetics suffering Gastroparesis may find controlling blood glucose more difficult. If food takes longer to reach the small intestine, the absorption of the carbohydrate is also delayed. This will affect the timing that insulin is required. Gastroparesis makes predicting the time the stomach takes to empty very difficult, thus knowing when and how much insulin or medication is required is also very difficult. This leads to blood glucose levels being erratic and hard to control.
How is Gastroparesis treated?
The treatment of gastroparesis includes the use of medications, dietary changes and certain procedures that help to enhance the emptying of the stomach. The main goal is to maintain adequate nutrition.
Making dietary changes will be essential to maintaining good nutrition and good quality of life for those with Gastroparesis. Early satiety is one of the main causes of malnutrition in those with Gastroparesis. Early satiety leads to a decreased volume of food consumed, thus decreased overall kilojoules consumed. This ultimately leads to weight loss, decreased intake of nutrients, and nutrient deficiencies. Particular nutrient of concern are Iron and Vitamin B12.
Your dietitian can help you adjust your diet to suit your symptoms, and any nutrient deficiencies you may have. They can also provide recipes for liquid and pureed meals and snacks that are easier to consume and help to keep your kilojoule intake adequate.
Added to site on : Friday, 21 May 2010