Gastroparesis

What is gastroparesis?

Gastroparesis is a condition that results from nerve damage in your stomach and pylorus, the sphincter at the end of your stomach that keeps liquids and solid food inside for digestion.

This damage causes paralysis in the nerves that don’t let the pylorus open. Your stomach can no longer effectively pulverize food and empty it into your small intestine.

You may be at higher risk for gastroparesis if you’re a woman or have diabetes, Parkinson’s disease, multiple sclerosis, or other autoimmune disorders. You may also develop gastroparesis if you have a history of abdominal or esophageal surgery or use certain medications, including narcotic pain relievers.

What are the symptoms of gastroparesis?

When you have gastroparesis, you can experience one or more symptoms like:

• Bloating
• Heartburn
• Nausea and vomiting
• Upper abdominal pain
• Feeling full soon after eating

Your gastroenterology (GI) doctor will likely look into your stomach with esophagogastroduodenoscopy (EGD). Often nothing abnormal is found aside from inflammation of your stomach called gastritis. Sometimes, they find retained food or fluid in the stomach. They typically then obtain a gastric emptying study to determine if you have delayed gastric emptying for solid foods. No obstruction on EGD with delayed emptying of solids makes the diagnosis of gastroparesis.

Without treatment, gastroparesis can cause severe complications, including severe dehydration, malnutrition, and blood sugar changes. Food remaining in your stomach can also ferment and cause bacteria to grow, which can harden and prevent food from passing into your small intestine.

How is gastroparesis treated?

Initially, you may be able to treat gastroparesis with medications and diet and lifestyle changes such as dietary modification. If these therapies aren’t effective, Dr. Hughes can discuss your options for pyloroplasty and gastroelectrical stimulation.

Do I need a pyloroplasty or gastroelectrical stimulation?

That depends on your symptoms. Patients with significant upper abdominal bloating and/or pain with or without nausea and vomiting do best with pyloroplasty. These symptoms reflect a stomach under pressure. Pyloroplasty decompresses the stomach to relieve these symptoms. Patients with more nausea than bloating or pain do best with gastric stimulation.

Pyloroplasty

During an outpatient laparoscopic pyloroplasty, Dr. Hughes inserts a laparoscope with an attached camera into your stomach through small incisions in your abdomen. He cuts the pylorus open to decompress your stomach into the small intestine so food can flow into it after digestion.

After the procedure is complete, Dr. Hughes sews it shut in a crosswise fashion, so the pylorus remains open and allows food to pass through more easily.

Gastroelectrical stimulation

This procedure involves the placement of two gastric stimulator electrodes into the lower third of your stomach. The electrodes connect to a generator that sits under your skin in the abdominal wall next to your navel. They deliver energy to restore function to the pacemaker and nerve cells of the stomach.

Dr. Hughes can determine which stimulator settings you need to control your symptoms. He can also perform a follow-up procedure to change the generator battery when it becomes depleted.

To find out more about the available treatment options for gastroparesis, call Vanguard Surgical LLC today.

Treatment Options

Pyloplasty

Gastric Stimulator