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What causes gastroparesis?
Gastroparesis can be caused either by diseases of the stomach's muscles or the nerves that control the muscles, though often no specific cause is identified. The most common disease causing gastroparesis is diabetes mellitus, which damages the nerves controlling the stomach muscles.
Gastroparesis also can result from damage to the vagus nerve, the nerve that controls the stomach's muscles, that occurs during surgery on the esophagus and stomach. Scleroderma is an example of a disease in which gastroparesis is due to damage to the stomach's muscles. Occasionally, gastroparesis is caused by reflexes within the nervous system, for example, when the pancreas is inflamed (pancreatitis). In such cases, neither the nerves nor the muscles of the stomach are diseased, but messages are sent through nerves from the pancreas to the stomach which prevents the muscles from working normally.
Other causes of gastroparesis include imbalances of minerals in the blood such as potassium, calcium or magnesium, medications (such as narcotic pain-relievers), and thyroid disease. For a substantial number of patients no cause can be found for the gastroparesis, a condition termed idiopathic gastroparesis. Indeed, idiopathic gastroparesis is the second most frequent cause of gastroparesis after diabetes.
Gastroparesis can occur as an isolated problem or it can be associated with weakness of the muscles of other parts of the intestine, including the small intestine, colon and esophagus.
What are gastroparesis symptoms and signs?
The primary symptoms of gastroparesis are nausea and vomiting. Other symptoms of gastroparesis include bloating with or without abdominal distension, early satiety (feeling full quickly when eating), and in severe cases, weight loss due to a reduced intake of food because of the symptoms. Abdominal pain also is present frequently though the cause of the pain is unclear. Reduced intake of food and restriction of the types of food that are eaten can lead to nutritional deficiencies.
The vomiting of gastroparesis usually occurs after meals; however, with severe gastroparesis, vomiting may occur without eating due simply to the accumulation of secretions in the stomach. The characteristic vomiting happens several hours after a meal when the stomach is maximally distended by the presence of food and secretions stimulated by the meal. Since the grinding action of the stomach is absent, the vomited food often contains larger pieces of recognizable food. (This can be contrasted with the more common type of vomiting in which the food appears as small, uniform, unidentifiable particles.)