Sievering Surgical Clinic

Sieveringer St 9, A-1190 Vienna Tel: 328 8777

Gastroenterology Unit

Gastroparesis

Diagnosis & Treatment

Gastroparesis

Patient information on maldigestion disorder

Definition

Gastroparesis is a condition in which the muscles in your stomach don't function normally and is the medical term for delayed stomach emptying. During the process of digestion, the stomach must contract to empty itself of food and liquid. Normally, it contracts about three times a minute. This empties the stomach within 90-120 minutes after eating. If contractions are sluggish or less frequent, stomach emptying is delayed.

But in gastroparesis, the muscles in the wall of your stomach work poorly or not at all. This prevents your stomach from emptying properly. Gastroparesis can interfere with digestion, cause nausea and vomiting, and interfere with blood sugar levels and nutrition.

Gastroparesis may be caused by various conditions such as diabetes mellitus, certain disorders of the nervous system, or certain drugs. Often however, no cause can be found although a viral infection is suspected in some. This results in bothersome and serious symptoms due to malnutrition may occure.

Symptoms

Most patients present with upper-gastrointestinal symptoms or with symptoms related to disordered gastric motor function. These include:

  • Nausea

  • Vomiting

  • Abdominal bloating

  • Abdominal pain

  • Feelings of fullness after only a few bites of food (early satiety)

  • Heartburn or gastroesophageal reflux disease (GERD)

  • Changes in blood sugar levels

  • Lack of appetite

  • Excessive weight loss

Diagnosis

Your doctor will ask for some additional testing (after taking a complete medical history and performing a physical examination) in order to determine a diagnosis. This testing may include:

  • Primary Tests

    • Upper gastrointestinal endoscopy

    • Gastric emptying test (GET)

  • Secondary Tests

    • Gastroduodenal manometry

    • Electrogastrography (EGG)

 

There is no cure for gastroparesis. Making changes to your diet may help you cope with gastroparesis signs and symptoms, but that's not always enough. The purpose of the gastroparesis diet is to reduce symptoms and maintain adequate fluids and nutrition.

Usually, the physician prescribes medication to stimulate the stomach to contract. Medications may offer some relief, but some can cause serious side effects.

Some reported amelioration following self controlled energo-neuro Adaptive Regulation (SCENAR)

Diet

There are three steps to the diet for gastroparesis

The first step diet consists of liquids, which usually leave the stomach quickly by gravity alone. Liquids prevent dehydration and keep the body supplied with vital salts and minerals.

The second step diet provides additional calories by adding a small amount of dietary fat -- less than 40 gm each day. For patients with gastroparesis, fatty foods and oils should be restricted, because they delay stomach emptying. However, patients at the Step 2 level are usually able to tolerate this amount.

The third step is designed for long-term maintenance. Fat is limited to 50 gm per day, and fibrous foods are restricted, because many plant fibers cannot be digested.

Nutrition Facts

Gastroparesis Diet

Chewing gum

Special Considerations

Step 1. Electrolyte solution and Boullion-

Diet: Patients with severe nausea and vomiting should sip small volumes of electrolytes (self-made or commercial) or boullion in order to avoid dehydration. Any liquid to be ingested should have some caloric content.  A multiple vitamin supplement should be prescribed.

Goal: To ingest 1,000 to 1,500 cc per day in multiple servings, e.g. twelve 4 oz servings over the course of 12-14 hours.

Avoid: Citrus drinks of all kinds and highly sweetened drinks. Replace them with any tee

Step 2. Soups

Diet: The diet may be advanced to include a variety of soups with noodles or rice and crackers.  These foods should be given in at least six divided meals per day. A multivitamin should be prescribed.

Goal: To ingest approximately 1,500 calories per day. Patients who can accomplish this will avoid dehydration and will hopefully ingest enough calories to maintain their weight.

Avoid: Creamy, milk-based liquids.  The fat in the meal will delay emptying of the stomach.

Step 3. Starches, chicken, and fish

Diet: Starches such as noodles, pasta, potatoes and rice are well tolerated for they are easily mixed and emptied by the stomach. Thus, soups, mashed potatoes or baked potatoes, pasta dishes, rice and baked chicken breast and fish are usually well digested sources of carbohydrate and protein. These solids should also be ingested in six small meals per day adding a one-a-day vitamin tablet.  

Goal: To find a diet of common foods that the patient finds interesting, satisfying, and that evoke minimal nausea/vomiting symptoms.

Avoid: fatty foods which delay gastric emptying and red meats and fresh vegetables which require considerable nutrition. Avoid pulpy fibrous foods that promote formation of bezoars. 

It is important to remember that the diet is trial and error and what works for one may not work for another. Further guidelines.

 

| 25.01.2011 | Read more | Print |

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