Stomach disorder can be difficult to treat

Q. In April 2000, I was diagnosed with gastroparesis. The recovery was very difficult, and I still have some gastric problems and off and on stomach issues. What is gastroparesis, and how is it treated?

A. Gastroparesis is a stomach disorder that leads to delayed emptying. This causes food to remain in the stomach for too long rather than move into the intestines for digestion. The vagus nerve, which is responsible for the action of the muscles that control these organs, becomes damaged, leading to absent or reduced movement.

Diabetes is the leading cause of gastroparesis. High blood-glucose levels can cause chemical changes and damage to the nerves and blood vessels. This is why diabetes is also one of the leading causes of neuropathy (numbness, burning and tingling due to nerve damage) of the hands and feet. If left untreated or poorly controlled, the damage can become more severe.

Symptoms can include nausea, heartburn, gastroesophageal reflux, abdominal bloating, little to no appetite, feelings of fullness after a minimal amount of food, abdominal spasms and/or pain, vomiting undigested food and more. Ingesting solid, high-fiber, fatty or carbonated foods and drinks can also contribute to or worsen symptoms.

Complications of this disorder include bacterial overgrowth due to rotting of food within the stomach and the development of bezoars (hardened masses of food), which can cause nausea, vomiting and obstruction. For those with diabetes, this sporadic emptying can cause unpredictable spikes in blood-sugar levels.

Treatment of gastroparesis depends on the severity. In very few cases, the situation may disappear. There are several medications available. Some stimulate muscle contractions within the stomach, some reduce bacterial overgrowth, and others reduce nausea and vomiting.

Doctors and dieticians may suggest eating several small meals daily to reduce the amount of food in the stomach at any one time. For more severe cases, pureed or liquid diets may be ordered. In cases in which these restrictions fail to work, feeding tubes may be necessary. Even this drastic step is not enough in certain instances, and nutrition must be delivered directly into the bloodstream. This temporary situation allows the body to become stronger and more able to tolerate other sources of nutrition.

It is important to be under the care of specialists familiar with this disorder. Gastroenterologists are a safe bet, but endocrinologists may be required if diabetes is at the root of the problem. I urge you to return to your physician to discuss your problems and develop an appropriate treatment plan.

© 2009, Newspaper Enterprise Assn.