GASTROPARESIS is a condition that interferes with the normal, spontaneous movement of muscles in the stomach. Typically, a strong muscle contraction will push food out of the stomach into the small intestine and subsequently into parts of the digestive tract. However, if a person has gastroparesis, the stomach movements will slow down or experience complete malfunction. The stomach cannot be emptied and food eaten cannot be fully digested.

Certain medications, such as opioid painkillers, some antidepressants, and high blood pressure and allergy medications can cause a slow, gastric emptying process that results in similar symptoms. For people who have gastroparesis problems, these medications can make their condition worse. Women are more likely to experience gastroparesis than men. 

UNCOMFORTABLE SITUATION

Gastroparesis can interfere with digestion, causing nausea, vomiting and abdominal pain. It can also cause unstable blood sugar levels and malnutrition. While there is no specific cure for gastroparesis, changes to diet, along with certain medications, can provide some relief. Signs and symptoms of gastroparesis include:

• Nausea;

• Bloating;

• Abdominal pain;

• Feeling full after taking a few bites;

• Vomiting undigested food, which was eaten a few hours ago;

• Acid reflux;

• Changes in blood sugar level;

• Lack of appetite; and

• Weight loss and malnutrition

THE CAUSE

It is not always clear what causes gastroparesis, but in some cases, it can be due to damage to the nerves that control the abdominal muscles (vagus nerve). Sometimes it is also a complication of diabetes, and some people experience gastroparesis after surgery. The vagus nerve helps manage complex processes in the digestive tract, including signalling the muscles in the stomach to contract and push food into the small intestine. 

A damaged vagus nerve can't send signals normally to the abdominal muscles. This causes food to stay in the stomach and not move into the small intestine. The vagus nerve can be damaged due to diseases such as diabetes, or through surgery on the stomach or small intestine.

Factors that increase the risk of gastroparesis include:

• Diabetes;

• Abdominal or oesophageal surgery;

• Infections, usually from viruses;

• Certain medications that slow the rate of gastric emptying, such as narcotic pain medication;

• Scleroderma — an autoimmune disease;

• Diseases of the nervous system, such as Parkinson's or multiple sclerosis; and

• Underactive thyroid (hypothyroidism)

COMPLICATIONS

Gastroparesis can cause several complications, such as:

• Dehydration

Persistent vomiting can cause the body to lose a lot of water;

• Malnutrition

Lack of appetite may mean that a person is not consuming enough calories, or not be able to absorb enough nutrients as a result of vomiting;

• Undigested food that hardens and stays in the stomach

Food that is not digested can harden into a solid mass called a bezoar. Bezoars can cause nausea and vomiting. It becomes life-threatening if they block other food from getting into the small intestine;

• Unstable blood sugar level

Gastroparesis interferes with the normal movement of the stomach and causes erratic digestion and absorption of nutrients in the small intestine. This can cause changes in blood sugar levels, either too high (hyperglycaemia) or too low (hypoglycaemia). These blood sugar fluctuations can make diabetes worse. In turn, poor control of blood sugar will make gastroparesis worse; and

• Decreased quality of life

Symptoms can make it difficult for a patient to work and complete other responsibilities.

*The writer is an internal medicine, gastroenterology and hepatology specialist at KPJ Pasir Gudang Specialist Hospital.