by Steve Bond, BScPhm, RPh, CDE

When we eat, acid and digestive enzymes mix with our food and the stomach mixes the contents to start the process of digestion. It then empties the broken-down food into the small intestine to continue the process. We use the term gastric emptying to describe this process- ‘gastric’ means “of the stomach.”  When our stomach does not empty quickly enough, we call this gastroparesis and August has been designated as Gastroparesis Awareness Month. The symptoms of gastroparesis vary from person to person and the severity of symptoms is not necessarily depending on the degree of gastric emptying. Common symptoms include fullness after meals, stomach pain, nausea, vomiting, and bloating. Weight loss may also occur due to malnutrition. People can experience belching (burping) and may find breathing difficult as the gas pushes against the diaphragm.

What causes gastroparesis? Often the cause is unknown, but certain disease states and medications put a person at higher risk. Conditions like diabetes, Parkinson’s, hypothyroidism, scleroderma, and multiple sclerosis can increase the risk. So can medications like narcotics and other medications for pain have been linked to gastroparesis as have viral and bacterial infections.

After a physical examination, your primary practitioner may order some tests such as a scope, ultrasound, or scan to examine how slowly the stomach is emptying. These tests can provide a diagnosis of gastroparesis and rule out other conditions which may have similar symptoms.

Ways to improve symptoms include eating smaller meals more frequently, chewing the food well before swallowing. Cooked fruits and vegetables are preferred over raw. Low-fat foods and adequate fluids (1-2 litres of water per day) will also aid in reducing symptoms. Carbonated drinks and alcohol should be avoided as should smoking.  Conditions such as diabetes should be optimized with the help of a diabetes educator and current medications should be reviewed to reduce the likelihood of drugs contributing to symptoms.

Medications can be prescribed that either promote gastric emptying or treat the symptoms of nausea and vomiting. In severe cases, surgical intervention may be necessary. Tubes can be inserted which vent gas from the stomach or bring food to the small intestine. This is usually a last resort when symptoms are severe, or blood sugars are not controlled.

Hopefully you now have a better understanding of gastroparesis, what to look for and how to reduce the symptoms. Take care of yourselves and each other.

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