Encyclopedia of Health and Medicine

52 The Gastrointestinal System
See also ESOPHAGEAL VARICES; HEMORRHAGE.
gastroparesis Slowed function of the STOMACH
that delays the travel of gastric contents into the
DUODENUM. Gastroparesis results from disturbances
of or damage to the vagus NERVE (the tenth cranial
nerve), which carries the nerve impulses that
accelerate PERISTALSIS (rhythmic contractions of the
gastrointestinal tract). Gastroparesis most commonly
occurs after a viral infection though also is
a complication of DIABETES, which damages nerve
structures throughout the body. Other causes
include sclerotic conditions such as MULTIPLE SCLE-
ROSIS or scleroderma, anticholinergic medications
often prescribed to treat PARKINSON’S DISEASE, inadvertent
damage to the vagus nerve as a complication
of thoracic or HEART surgery, and intentional
interruption of the vagus nerve (vagotomy) to
treat conditions such as PEPTIC ULCER DISEASE. People
who are on long-term PARENTERAL NUTRITION
also often have gastroparesis.
The main symptom of gastroparesis is frequent
VOMITING of undigested food hours after a meal.
Other symptoms may include lack of APPETITE due
to sense of fullness, NAUSEA, ABDOMINAL DISTENTION,
and unintended weight loss. Gastroparesis can
quickly result in DEHYDRATION, which can create
significant disturbances of blood GLUCOSE and
INSULIN levels in people who have diabetes. The
first approach of treatment is to shift to eating
numerous small meals throughout the day,
attempting to slow the pace of ingestion to accommodate
the stomach’s slowed functioning.
Medications to stimulate gastrointestinal motility,
such as metoclopramide (Reglan), may
improve gastric emptying. Control of diabetes,
which may require multiple insulin doses
throughout the day, is crucial. If symptoms continue,
the gastroenterologist may suggest a
jejunostomy tube, or feeding tube, that bypasses
the stomach. Most people, however, achieve an
acceptable resolution of their symptoms, even
when gastroparesis persists, through nonsurgical
approaches.
See also CRANIAL NERVES; ENTERAL NUTRITION; NUTRI-
TIONAL NEEDS; PANCREATITIS; RAPID GASTRIC EMPTYING.