Gastroparesis Treatment: Understanding the Different Ways to Manage Delayed Stomach Emptying
Causes of Gastroparesis Treatment
Gastroparesis, or delayed stomach emptying, can develop due to several underlying medical conditions. Some of the most common causes include diabetes, surgery of the stomach or esophagus, and certain neuropathies (nerve disorders). Rarely, it may be caused by connective tissue disorders. In many cases, the exact cause remains unknown, and is considered idiopathic gastroparesis. Understanding the underlying cause helps guide treatment decisions.
Medication Gastroparesis Treatment
For mild to moderate cases of gastroparesis, lifestyle changes and prescription medication are usually the first line of treatment. Commonly prescribed prokinetic (motility-enhancing) medications include:
Metoclopramide: This is often the first medication tried as it helps stimulate stomach contractions and accelerate emptying. Potential side effects include restlessness and extrapyramidal effects.
Erythromycin: As a macrolide antibiotic, erythromycin is sometimes used at low doses for its prokinetic effects on the stomach. This carries a risk of cardiac issues at high doses.
Domperidone: Available internationally but not FDA-approved in the US, domperidone stimulates stomach emptying and reduces nausea. It crosses the blood-brain barrier less than other prokinetic drugs.
Bethanechol: Works by stimulating the parasympathetic nervous system to promote GI motility. Common side effects are facial flushing and increased saliva production.
For those who do not respond well or cannot tolerate the above medications, newer options that may be tried include: prucalopride (5-HT4 agonist) and eluxadoline (mixed opioid receptor agonist/antagonist). Treatment is individualized based on symptoms, underlying causes, and side effect profiles related to Gastroparesis Treatment .
Nutritional Therapies
Since gastroparesis delays the emptying of food from the stomach, special diets and eating strategies help optimize nutrition:
Frequent small meals throughout the day are easier to handle than large ones. Grazing provides steady calorie intake without overfilling the stomach.
Low-fat, low-fiber foods are generally better tolerated as they are quicker to empty from the stomach. High-fat, high-fiber foods can further slow down motility.
Liquids and easy to digest foods like broths, protein shakes, pureed fruits and vegetables are recommended.
Elevating the head of the bed while sleeping prevents reflux of stomach contents.
Enteral nutrition delivery via a feeding tube may be needed in severe or refractory cases to prevent malnutrition.
Gastric Neurostimulation
For select individuals where oral therapies are ineffective, gastric neurostimulation may be an option. Gastroparesis Treatment Research involves surgical implantation of a pacemaker-like device to deliver low-frequency electrical pulses to key nerve pathways in the stomach and reduce nausea/vomiting. Studies show this improves symptoms and quality of life in many patients. The device battery lasts 5-7 years on average before replacement is needed.
Surgical Procedures
When significant gastroparesis symptoms persist despite optimal medical management, surgical interventions may be considered:
Pyloroplasty: This involves cutting the pyloric muscle to widen the stomach outlet and facilitate food emptying. It provides relief in about 50% of cases.
Gastric restrictive procedures: Some bariatric weight loss surgeries like gastric bypass may benefit select gastroparetics, especially if obesity exacerbates symptoms.
Gastric pacing: Similar concept as neurostimulation but implantspacemaker leads on the external gastric muscle instead of nerves. Effectiveness is more variable than Enterra therapy.
Gastrojejunostomy: Creation of a direct connection between the stomach and small intestine bypassing the pylorus. Provides relief in 30-50% of severe refractory cases.
The decision to pursue surgical options requires weighing risks versus potential benefits, as gastroparesis management often remains challenging with currently available therapies. An individualized treatment approach guided by a gastric motility specialist yields most success.
Gastroparesis treatment aims to regulate blood sugar levels if diabetes is a cause, maximize oral intake through dietary changes, and optimize medication regimens to induce smooth muscle contractions. When these conservative measures fail to adequately control distressing symptoms, interventional options aim to restore normal gastric emptying via neurostimulation or surgical bypass procedures. A multidisciplinary team that properly diagnoses, educates and manages patients utilizing the various treatment modalities enables improved quality of life for those suffering from gastroparesis.
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Money Singh is a seasoned content writer with over four years of experience in the market research sector. Her expertise spans various industries, including food and beverages, biotechnology, chemical and materials, defense and aerospace, consumer goods, etc. (https://www.linkedin.com/in/money-singh-590844163)