Treatment of gastroparesis

Management of gastroparesis centers on hydration, dietary manipulation, nutritional supplementation, and pharmacologic therapy after gastro duodenal disease, systemic disease and offending drugs have been excluded.
 

Eating habits change

Smaller, more frequent meals
A big meal takes longer to digest than a light snack

Low-fiber foods
It is proven that fibers, found mainly in raw fruits and vegetables, whole grains, and legumes, help passing food through the intestinal tract.

Low-fat foods
Most of the doctors recommend avoiding fatty foods, but they may allow small servings of milkshakes or other rich drinks, especially between meals.

Pureed and liquid foods
Almost any kind of food can be pureed, including cooked fruits and vegetables, poached or baked chicken and fish etc.

Nutritional supplements
Since people with this gastric disorder may be deficient in important nutrients, including vitamin B-12, iron and calcium, some nutritional supplements can be crucial.   

Water
The vomiting caused by gastroparesis can lead to dehydration, so it's especially important to drink plenty of water.  

Feeding tube
Some people with a severe stomach condition can't tolerate any food or liquids. In that case, the doctors recommend placing a feeding tube in the small intestine to bypass the stomach. This tube is usually inserted directly into the small intestine through the skin and it is usually temporary. It is only used when gastroparesis is severe or when blood sugar levels can't be controlled by any other method.

Medications

Two types of medications are being used to reduce the symptoms of gastroparesis and they include:

• Anti-emetics - which help control nausea and vomiting, and
• Prokinetics - which stimulate contractions of the stomach muscles.

The most commonly used medications are:

• Metoclopramide
• Erythromycin
• Cisapride
• Tegaserod

Surgery

An operation may be the option when all other measures fail to provide relief from severe nausea and vomiting or malnutrition. The most common operation is one in which the lower part of the stomach is being stapled or bypassed to help improve stomach emptying. 

Emerging therapies

Some emerging therapies include:

• Botulinum toxin (Botox). Botox relaxes the pyloric muscle in some people, thereby allowing the stomach to release more food.  
• Electrical gastric stimulation. This is the treatment in which an electric current is used to stimulate stomach contractions. The battery-operated device is surgically implanted and emits mild electrical pulses that help control nausea and vomiting associated with gastroparesis.

Prevention

Because gastroparesis is most common in people with diabetes, controlling blood sugar levels is the best way to help prevent the disorder.