Nikki Sommer, a nurse practitioner with Key West Surgical Group, joined Good Morning Keys on Keys Talk 96.9/102.5FM this morning for Medical Matters.
Gastroparesis is when your stomach empties food too slowly and it can be a serious issue.
Sommer said, “But there’s no blockage causing it. So normally, your stomach muscles contract and move food through your intestines, but when you have gastroparesis, your muscles do not work properly, so food just sits there.”
What are the symptoms?
Sommer said, “Constant nausea, vomiting, bloating, feeling full too quickly, meaning if you eat, take a couple of bites and then you’re like, oh, I’m full. I can’t eat anymore. Or you have constant upper abdominal pain, especially when you eat. So these are the symptoms you might have if you’re experiencing gastroparesis. The feeling full fast is huge. They push their food away. And you’ll even notice, if somebody has it, they may have like they may grimace, they might feel like they’re in pain, like something’s bothering them.”
Vomiting undigested food can also happen.
Sommer said, “It could just kind of like, sit there. You’re just not digesting food like you normally should.”
Nerve damage to the stomach can happen.
Sommer said, “Common causes that create damage to the vagus nerve. A big one is diabetes. That is very common in diabetics, both in Type 1 and Type 2 diabetics, they have damage to their vagus nerve. So a lot of times, diabetics that have either been under controlled or just, especially if they were well, if you’re Type 1, you’re diagnosed when you’re very young. Type 2 diabetics that are also diagnosed when they’re very young, they tend to experience gastroparesis later on in life, after surgery, viral infections and medications, or idiopathic, meaning they don’t know what the cause is of the damage to the vagus nerve or the gastroparesis, and that actually occurs in about 50% of the cases.”
There are complications that really can cause some problems.
Sommer said, “Actually, a big one is, malnutrition. They don’t eat as much because they don’t feel like they can, and they don’t absorb the nutrients that they need. So they tend to be malnourished. Dehydration, again, not drinking enough fluid, blood sugars, things like we mentioned with our diabetic patients. Sometimes they’ll be too high, they’ll be too low. Again, it’s based on diet, so and acid reflux, which I brought this topic up today, because we have a lot of patients complaining of these symptoms, so they end up either complaining of acid reflux or GERD, not controlled by medication, having the feeling of nausea, admitting to vomiting, and having that feeling of fullness after they eat.”
How is this diagnosed?
Sommer said, “First we need to make sure there isn’t an obstruction. You can have what’s called a gastric outlet obstruction and that can cause these symptoms. So the first thing to do is to make sure that’s not occurring. One of the gold standard tests is the gastric emptying study. Basically, you go into it’s an outpatient radiologic study down here, I believe, you eat a hard boiled egg that’s injected with something and you eat it, and you come back and they scan and they monitor how much you digested the egg. It is a really long test, because I think if I remember correctly, you go back every hour for four hours.”
Once it’s diagnosed, what are the treatment options?
Sommer said, “Diet is a big step into treating this or managing it. I should say small, frequent meals, four to five times a day, small bites, and don’t eat fast, because a lot of times people eat fast. They eat quick, and they try and get as much in as possible. That’s not the best thing. So small, frequent meals, low fat and lower fiber is tended to be better with people with these conditions. But you’ve got to be careful when we talk about fiber. You need fiber too to keep yourself regular, but patients that have this condition do better with a low fiber, low fat diet. There are drugs that stimulate stomach movement and anti nausea meds can help manage gastroparesis as well. In severe cases where malnutrition is present, you might need feeding support, which would most likely mean either some type of parenteral nutrition or possibly a feeding tube, and I would assume that’s in severe cases. I’ve never seen that happen, but I’m sure it could occur. IV fluids, and then surgery would be the last resort. Again, this is something we can manage, not cure. It’s a chronic condition, but it can be manageable. It’s up to the person, if you’re diagnosed with gastroparesis, being able to be compliant with what you need to do.”
Who is at risk of gastroparesis?
Sommer said, “People with diabetes, both Type 1 and Type 2, anyone who has chronic nausea, vomiting or bloating, patients that have abdominal surgery and people on certain medications. There’s a huge list of medications that could cause gastroparesis. There was too many to list. But the Cleveland Clinic has a good patient handout, if you go there, you can see all the medications that could cause gastroparesis. Don’t ignore these symptoms, they can become serious. So if you have persistent vomiting, unintentional weight loss, severe bloating or trouble eating, reach out to your primary care doctor, of course, where we deal with this all the time. So you can also contact our office.”
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