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Gastroparesis (gas-tro-pa-re-sis) is a condition in which food gets "stuck" in the stomach even though there are no physical obstacles to its movement. A surprisingly large number of people have this condition. In the United States, about one in fifty people has this digestive problem.

When your stomach doesn't pass digested food down to the small intestine, you tend to get bloating, acid reflux, nausea, and loss of appetite because you feel full fast. About 20 percent of those who have gastroparesis experience mild to severe stomach pain; it's not a universal symptom of the disease. People who have gastroparesis don't get all the nutrients their bodies need because they fill up too soon, but they also tend to be overweight.

What causes gastroparesis? 

Diabetes is often a prequel to gastroparesis. Constantly high blood sugar levels damage the vagus nerve, which serves as a kind of pacemaker for the stomach. This kind of neuropathy used to be thought to be rare, but more and more doctors are seeing gastroparesis in more and more of their diabetic patients. Since type 2 diabetics tend to have problems with overweight, their obesity can compound the symptoms of gastroparesis by putting extra pressure on the stomach. Type 1 diabetics are less likely to be overweight, but if they have gastroparesis, the symptoms tend to be even more severe.

Gastroparesis can occur after surgery. Weight reduction surgery, surgery to remove tumors, and surgery for peptic ulcer disease can all cause gastroparesis. And gastroparesis can be "idiopathic," which is another word for when doctors simply don't know what is causing a disease. Idiopathic gastroparesis is most common in women (by about a seven to one ratio over men) under the age of 40. Gastroparesis can also occur after radiation therapy, after radiofrequency ablation of the heart to treat atrial fibrillation, in hypothyroidism, in hyperparathyroidism, in multiple sclerosis, in Parkinson's disease, in Crohn's disease, after pancreatitis, and after some kinds of viral infections in children.

The severity of the symptoms does not really track to the amount of food in the stomach. Everyone has a slightly different experience of the disease. But there are interventions that are almost always helpful.

  • Stay away from fiber. Fiber slows down the transit of food through your stomach.
  • Ignore the low-glycemic index diet.You may have heard that foods that are low on the glycemic index are always healthier because your body turns their carbohydrates into sugar more slowly. Your body turns any kind of carbohydrate into sugar more slowly. You're actually better off with higher-glycemic index foods like white bread and mashed potatoes, in modest amounts.
  • Eat warm-temperature foods, not cold-temperature foods. Your stomach takes longer to digest cold foods because it has to warm them up to body temperature before they can be digested. 
  • Don't consumed iced or chilled beverages. Your stomach has to warm them up, too, and they will slow down digestion even more.
  • Avoid vinegar. It slows down the rate at which your stomach empties to the small intestine.
  • Eat just a few different kinds of food at any one meal. The more different kinds of food you eat at one time, the longer it takes your stomach to digest the entire meal.
  • Eat smaller meals more often. The truth is, most people with gastroparesis feel so bad they only eat once a day. But if you do that, you still need to eat less so your stomach doesn't have as much food to process.
  • Avoid fatty foods, fried foods, mayonnaise, olive oil, butter, vegetable oils, and olive oil. Fat slows down the digestive process. You need some fat, however, to absorb beta-carotene, lycopene, lutein, and vitamins A, D, E, and K.
  • If you are diabetic, keep your blood sugar levels down. You would usually need to get your HbA1C down to about 8.0 percent or lower to notice improvement in gastroparesis.
  • Don't take the prescription drug metoclopramide if you don't have to. It can have catastrophic side effects, such as a neurological condition called tardive dyskinesia, that never go away. It is always better to manage gastroparesis with a minimum of medication of any kind.

 

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