Matthew Brengman, MD Advanced Surgical Partners of Virginia Parham Doctors' Hospital |
In the digestive tract of a person
suffering from gastroparesis, one or more of these processes are not
functioning correctly, the food stalls, inducing common symptoms such as
nausea, vomiting, abdominal pain, bloating, reflux, and a general feeling of being
uncomfortably full. When severe, these symptoms can lead to little no food
intake. This ongoing lack of nutrition
resulting from gastroparesis can result in significant weight loss,
hospitalization, dehydration and malnutrition.
Gastroparesis is generally a
diagnosis suspected by the above symptoms and confirmed with x-ray, endoscopy and
most commonly gastric emptying scans. The severity of the symptoms is highly
variable, as two people with diagnosed gastroparesis can have vastly different
presentations, health management needs, and quality of life.
Normally, three types of gastroparesis
exist, idiopathic, diabetic, and postsurgical, and sufferers are usually female.
Idiopathic gastroparesis is that of
unknown origin and is the most common. Sometimes it can follow gastric illness
or respiratory diseases, but most often is characterized by symptoms alone. Diabetic gastroparesis affects both
type 1 and type 2 diabetics, with obesity being a major predictor of the
disease in type 2 diabetes. Diabetic gastroparesis has multiple root causes,
all involving the impairment of gastrointestinal motility and nerve functions. Postsurgical gastroparesis is
considered a complication of routine procedures such as those to correct reflux,
peptic ulcer disease and common weight loss surgeries.
Other defined causes of
gastroparesis include radiation therapy, neurologic disorders (Parkinson’s,
stroke, multiple sclerosis, spinal injuries), eating disorders, smoking, pregnancy,
hormonal disruption diseases, Crohn’s disease, and other gastrointestinal afflictions.
Children are rarely affected by gastroparesis, but may develop it as a result of
viral infections.
There are many treatment
options for gastroparesis. Most patients
can be managed with dietary changes. When symptoms cannot be managed through dietary changes, medication
management is indicated. The most common recommended dietary change is
to eat smaller, more frequent meals, and avoid high fiber and high fat foods,
as they naturally cause delays in stomach emptying. Your physician can help
tailor your diet to meet your nutritional needs while addressing the symptoms
of the disease. Common medication management for gastroparesis includes
prokinetics (drugs that enhance gastrointestinal motility), insulin changes for
those with diabetes.
Unfortunately, some patients
with severe gastroparesis will fail these therapies. When the symptoms and nutrition cannot be
managed through medical therapy, surgical therapies are considered. Surgical therapies include feeding tubes, botox
injected into the pylorus, pyloroplasty (surgical division of the muscle at the
end of the stomach) and gastric stimulation (“gastric pacemakers”).
The combined therapies listed
above commonly lead a person suffering from gastroparesis back to a more normal
body function after treatment. These
therapies have been shown to improve and stabilize nutrition, reduce
hospitalizations and improve quality of life.
For further inquiries about surgical therapies for gastroparesis,
diabetes, obesity, or other metabolic disorders, contact Matthew Brengman, MD,
at Advanced Surgical Partners of Virginia at 804.360.0600.