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Gastroparesis and delayed gastric emptying
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About gastroparesis and delayed gastric emptyingGastroparesis, also known as delayed gastric emptying, is a motility disorder in which the stomach doesn’t empty food as quickly as it should. When the GI tract works normally, the stomach should be 90 percent empty within four hours of eating a meal. When food sits in the stomach for a long time instead, it can cause pain, nausea and other uncomfortable symptoms.
What causes gastroparesis?Delayed gastric emptying can sometimes be the result of inflammation, obstruction or, in very rare cases, neuropathy (nerve problems) due to diabetes or past surgeries. In most cases the cause of gastroparesis in pediatrics is idiopathic, which means unknown.
How often does gastroparesis occur?There is no data on the prevalence of pediatric gastroparesis, but it is not a common condition. One study showed that gastroparesis could affect up to 2 percent of the general population.
How does gastroparesis develop?Although uncommon, idiopathic gastroparesis can develop after an infection, such as a stomach bug, and last from weeks to months.
What are the symptoms of gastroparesis?This condition’s symptoms can include:
- Nausea (usually after eating and often gets worse as the day progresses and the child eats more)
- Sensation of fullness in the belly
- Pain/discomfort in the upper abdomen
- Loss of appetite
- Weight gain or weight loss
Who is at risk of developing this condition?Doctors don’t know why some patients develop delayed gastric emptying after an infection. Some patients might be predisposed to developing this condition for reasons that are not yet known. Patients with migraines sometimes experience gastroparesis as well, and if the migraines are treated, the gastroparesis may improve.
Why is gastroparesis a concern?Gastroparesis can be very difficult for patients who are in constant pain, losing a lot of weight or experiencing other symptoms that interfere with daily activities. This condition can affect nutrition, weight, school attendance and overall quality of life.
How is gastroparesis diagnosed/evaluated?The doctor will first do an upper GI series and upper endoscopy (EGD) to check for other potential causes, such as inflammation or obstruction, that could explain the delayed gastric emptying. The next step is a gastric emptying study. If the doctor cannot find an obvious reason for your child’s symptoms, he or she might diagnose it as idiopathic gastroparesis, meaning that the cause is unknown. Once gastroparesis has been found, he doctor might also check for nerve damage due to diabetes, past surgeries or other causes, though such nerve damage is very rarely a cause of delayed gastric emptying in children.
What is the treatment for gastroparesis?Some medications can help accelerate gastric emptying. If that is not effective, your child’s doctor might recommend medications that don’t improve gastric function but can alleviate the nausea and discomfort of the condition just the same.
Lifestyle modifications can also help, and children with gastroparesis should try to eat small, more frequent meals and avoid high-fat, high-fiber foods, which tend to sit in the stomach longer. Your child’s doctor might also refer your child to a psychologist for cognitive behavior therapy, which can be helpful when coping with symptoms and stress of any chronic illness.
What happens after treatment?If medications aren’t effective, your child’s doctor might recommend gastric pacing. The gastric pacer is surgically implanted in the stomach and provides electrical stimulation that can relieve pain and nausea in some patients. A gastric pacer is only used after all conventional treatments have failed.
When should you contact a physician?If your child regularly experiences nausea, pain/discomfort, bloating and other symptoms after a meal, consult your pediatrician.
What is the long-term outlook for gastroparesis?Most patients who develop gastroparesis after an infection improve by six months, though some continue to experience symptoms.
How do I live with gastroparesis?It’s important to follow your doctor’s diet recommendations even if you are using medication or a gastric pacer to control your child’s symptoms. Eating small meals more often and avoiding fatty foods will be easier on your child’s stomach.
For more information about this condition, visit the International Foundation for Functional Gastrointestinal Disorders.