How is gastroparesis treated?

Matthew L. Brengman, MD
There are many treatment options for gastroparesis. Most people can be managed with dietary changes. When symptoms cannot be managed through dietary changes, medication may be necessary.

Dietary changes include eating smaller, more frequent meals, and avoiding high fiber and high fat foods, as they naturally cause delays in stomach emptying. Your doctor 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) and insulin changes for those with diabetes. Surgery is also an option in severe cases.

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.

Conventional treatments for gastroparesis may include medical therapies, dietary changes, and various surgical procedures. Implantation of a gastric electrical stimulator, or "gastric pacemaker," an implanted device that helps to control nausea and vomiting, is FDA approved under investigational protocol for patients who have failed medical management.

The sleeve gastrectomy has been proven to be helpful in alleviating the symptoms of gastroparesis in a small number of patients. It is currently under investigation and offered to patients who have failed all other methods of treatment for gastroparesis.

There are some patients, however, who do not improve with current treatments and whose quality of life continues to deteriorate. If all of these fail to help, however, patients may have no choice but to receive nutrients through feeding tubes -- not an attractive option for anyone, but especially younger people.

Gastroparesis is a condition in which the stomach doesn't empty properly. Says UCLA gastroenterologist Mark Ovsiowitz, MD, "For most people, food empties from the stomach within two to four hours after eating. But for those with gastroparesis, the stomach doesn’t empty properly, which may cause severe nausea, vomiting and other problems. It’s very important to conduct a diagnostic evaluation in order to rule out possible causes of a person's symptoms." He explains that once a diagnosis of gastroparesis is confirmed, people usually begin with nonsurgical interventions, such as reducing dietary fat and fiber, eating smaller, frequent meals, or taking a prescription medication to improve motility and aid stomach emptying.

For people who do not respond well to dietary changes or medication therapy, an implanted neurostimulator may be the best option. "While the neurostimulator does not cure gastroparesis, some studies have demonstrated that the device effectively reduces symptoms in approximately 80% of people," says UCLA surgeon Darryl Hiyama, MD.
Patricia Raymond, MD
We treat slow emptying due to a narrow pylorus by dilating the channel with inflatable balloon catheters through our scopes. A gastroparesis diagnosis leads to evaluation for diabetes, low thyroid function, or electrolyte imbalance. If nothing is found, we chalk your problem up to a likely viral infection which affected your stomach nerves and place you on a low-fiber diet and perhaps some medication to enhance the stomach emptying.

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