Gastroparesis – Diagnosis and Treatment
Diagnosis
Tests for Stomach Emptying Speed
Doctors usually start diagnosing gastroparesis by checking how fast food leaves your stomach. Gastric emptying scans are a go-to method for this.
In one test, you eat a light meal mixed with a tiny amount of radioactive material. A scanner tracks the meal as it moves through your body. This scan can show if your stomach empties too slowly, which points to gastroparesis.
| Test Name | Purpose | What It Shows |
|---|---|---|
| Gastric emptying scan | Tracks meal movement with a scanner | Speed of stomach emptying |
| Gastric emptying breath test | Measures special ingredient in breath | How fast stomach contents move |
Another method is the breath test. Here, you eat food with a special ingredient. As your body digests it, the ingredient shows up in your breath and gets measured at different times.
If the food moves slowly, doctors may suspect gastric dysmotility or even hidden gastroparesis. You might need to stop certain medications before these tests.
Looking Inside the Digestive Tract
Doctors use upper digestive tract viewing to check inside your esophagus, stomach, and the upper part of your small intestine. They use a thin, flexible tube with a camera to spot other issues that might cause similar symptoms.
This test can reveal blockages, peptic ulcers, or changes from conditions like functional dyspepsia or GERD.
Creating Body Images With Sound Waves
Doctors often use high-frequency sound wave scanning to make images of your internal organs. This helps them see if your gallbladder or kidneys cause your symptoms.
Because this test doesn’t use radiation, it’s a safe way to rule out other causes and make sure they don’t overlook hidden or tough-to-treat gastroparesis. If needed, it can point to more tests.
Approaches to Managing Gastroparesis
Dietary Adjustments to Help Manage Gastroparesis
Managing gastroparesis usually starts with changing what and how you eat. Nutrition experts often recommend eating smaller meals more often throughout the day.
This approach can help reduce that uncomfortable feeling of being overly full after meals.
Chewing food thoroughly and picking well-cooked fruits and vegetables makes things easier on your stomach. Some high-fiber foods, like oranges or broccoli, can cause blockages and are best limited.
Most people do better with low-fat meals, but if you can handle small amounts of fat, you might add them in moderation.
If you have trouble with solid foods, soups and pureed foods can make eating easier. Drinking plenty of water—about 34 to 51 ounces (1 to 1.5 liters) a day—helps too.
Simple changes, like gentle walks after meals and skipping carbonated drinks, alcohol, and smoking, can also make a difference.
A daily routine that dietitians often suggest might look like this:
| Dietary Tips for Gastroparesis | Examples |
|---|---|
| Eat smaller, more frequent meals | Six light meals instead of three large ones |
| Chew food well | Take time with each bite |
| Choose low-fiber, easily digested foods | Cooked carrots, peeled potatoes |
| Drink fluids separately from meals | Wait about an hour before or after eating |
| Avoid lying down for two hours after eating | Stay upright during digestion |
Taking a daily multivitamin and checking in regularly with a dietitian can help you avoid nutrition problems.
Medications That Help the Stomach Work Better
Doctors often prescribe medicines to help your stomach muscles work better and to ease symptoms. Prokinetic agents are commonly used in the U.S. to help speed up stomach emptying.
You can take a prokinetic agent as a pill or as a nasal spray, which tends to have fewer side effects.
An antibiotic can also help move food through your stomach, but its effect might fade over time. Some people get side effects like diarrhea. If standard treatments don’t work, some people might try domperidone.
It’s not widely approved, but doctors sometimes use it with special permission.
To control nausea and vomiting, doctors might recommend antiemetics or, for tougher cases, prochlorperazine. Managing these symptoms is important for comfort and to avoid dehydration.
All medicines have side effects, so it’s worth going over them with your healthcare provider.
Surgical Options for Gastroparesis
When someone can’t take food or liquids by mouth, doctors may suggest surgery to place a feeding tube. The tube, called a jejunostomy tube, goes straight into the small intestine.
This option comes up for people with severe gastroparesis who can’t meet their nutrition needs any other way. Sometimes, doctors use a venting tube to relieve pressure in the stomach.
| Procedure | Main Purpose |
|---|---|
| Jejunostomy tube | Provide nutrition directly to small intestine |
| Venting gastrostomy tube | Reduce pressure from stomach contents |
| Pyloroplasty | Widen the opening from stomach to intestine |
| Gastrojejunostomy | Create a new stomach-intestine connection |
Feeding tubes through the nose or mouth might work for a short time. In rare cases, when nothing else helps, nutrients go in through an intravenous line in the chest.
Doctors might consider other operations, like pyloroplasty (widening the opening between stomach and intestine), gastrojejunostomy (creating a new connection between the stomach and small intestine), or partial gastrectomy (removing part of the stomach), but these aren’t first choices.
Daily Choices and Practical Tips
Eating smaller meals more often, sticking to light, low-fat foods, and teaming up with a dietitian can help you keep a healthy weight and feel better.
These changes also support more consistent gastric emptying and may help prevent nausea, bloating, or feeling overly full after meals.
Tip: If you smoke, quitting can really help.
Alternative Medicine
Some people turn to alternative therapies to manage gastroparesis symptoms. Acupuncture is one common choice. With this method, a practitioner places very fine needles in specific spots on your body. Electroacupuncture adds a mild electric current to the needles.
Studies suggest these approaches might ease symptoms more than a fake treatment. Some individuals also try hypnotherapy as a support option. It may help with symptom relief, stress reduction, and improving gut-brain communication.
Getting Ready for Your Medical Visit
A little preparation can make your medical visit go more smoothly. Here are some ways to get organized:
- Confirm Instructions: Call the clinic ahead of time to ask about any special steps, like fasting, changing your diet, or pausing certain meds.
- Bring Support: If you can, bring a family member or friend. It helps to have another set of ears and someone to ask questions.
- Make a List: Write down your symptoms, even if they seem unrelated, and note when they started.
- Note Medical History: Include any other health problems, recent stress, or surgeries.
- Track Medicines: List all prescription drugs, over-the-counter meds, vitamins, and supplements. Add how much and how often you take them.
- Prepare Questions: Write down your questions. Here are some ideas:
| Example Questions to Ask |
|---|
| What could be causing my symptoms? |
| What tests might I need? |
| Is this health problem long-lasting? |
| What are my treatment options? |
| Are there foods that are easier on my stomach? |
| How do I handle this with my other illnesses? |
| Are there easy-to-read guides or trusted websites? |
Writing down your questions helps make sure you don’t forget anything important.
What Your Healthcare Provider May Ask
Your medical provider probably needs some details to get a better handle on your situation. They might ask things like:
- Do your symptoms stick around all the time, or do they come and go?
- How intense are your symptoms, really?
- Has anything made your symptoms better or worse?
- Did your symptoms show up suddenly, maybe after you had an infection?
- Have you had any surgeries in the past?
If you give clear and honest answers, your care team can actually make better decisions for you. With your feedback, they’ll figure out which specialists—maybe a gastroenterologist or a dietitian—should get involved, and what testing or plans might actually help.
