Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Gastroparesis
usually is treated with nutritional support, drugs for treating nausea and
vomiting, drugs that stimulate the muscle to contract, and, less often,
electrical pacing, and surgery.
Gastroparesis means weakness of the muscles of the stomach. Gastroparesis results in slow emptying of food from the stomach into the small intestine.
The stomach is a hollow organ composed primarily of muscle. Solid food that has been swallowed is stored in the stomach while it is ground into tiny pieces by the constant churning generated by rhythmic contractions of the stomach's muscles. Since smaller particles are digested better in the small intestine than larger particles, only food that has been ground into small particles is emptied from the stomach. Liquid food does not require grinding.
The ground solid and liquid food is emptied from the stomach into the small intestine slowly in a metered fashion. The metering process allows the emptied food to be well-mixed with the digestive juices of the small intestine, pancreas, and liver (bile) and to be absorbed well from the intestine. The metering process by which solid and liquid foods are emptied from the stomach is a result of a combination of relaxation of the muscle in parts of the stomach designed to accommodate food, and the pressure generated by the muscle in other parts of the stomach that pushes the food into the small intestine. (Thus, the stomach can store and empty food at the same time.) The metering also is controlled by the opening and closing of the pylorus, the muscular opening of the stomach into the small intestine.
When the contractions of the stomach's muscles are weakened, food is not thoroughly ground and does not empty into the intestine normally. Since the muscular actions whereby solid food and liquid food are emptied from the stomach are slightly different, the emptying of solids and liquids follows different time courses, and there may be slow emptying of solid food (most common), solid and liquid food (less common), or liquid food alone (least common).
Changing your eating habits can help control gastroparesis. Your doctor or dietitian may prescribe six small meals a day instead of three large ones. If less food enters the stomach each time you eat, it may not become overly full. In more severe cases, a liquid or pureed diet may be prescribed.
The doctor may recommend that you avoid high-fat and high-fiber foods. Fat naturally slows digestion - a problem you do not need if you have gastroparesis - and fiber is difficult to digest. Some high-fiber foods like oranges and broccoli contain material that cannot be digested. Avoid these foods because the indigestible part will remain in the stomach too long and possibly form bezoars.
SOURCE: National Digestive Diseases
Information Clearinghouse (NDDIC). Gastroparesis. March 20, 2012.
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