In most cases, gastroparesis is a chronic (life-long) health issue that cannot be cured. Symptoms of gastroparesis can come and go. However, there are many treatment options, based on how bad your symptoms are, to help you care for gastroparesis.
Talk to your doctor, especially if you have diabetes, about what treatments make sense for you. Controlling diabetes, if you have it, is one of the most important things you can do as a patient to improve your stomach function and symptoms
Diet and eating habits
- Stay away from or limit high-fat foods and foods that have lots of fiber, such as oranges and broccoli. These can be hard to digest.
- Chew food fully.
- Consider eating six small meals a day instead of three large ones. Eating less food may make it easier for the stomach to empty, because it is not as full.
- Seeing a nutritionist is an important part of the treatment and he or she can prescribe different kinds of diet depending on the severity of your symptoms. If symptoms are severe, a doctor may prescribe a liquid or puréed diet, because liquids empty faster from the stomach.
Alternative medicine options
- Metoclopramide is the only medication that is approved by the FDA for treating gastroparesis right now. It helps your stomach muscles move to help with gastric emptying. In addition, it works on the brain to suppress nausea. However, there are some risks to this medication, the most serious of which involve temporary or permanent problems with muscle twitching or spasms.
- Erythromycin is an antibiotic that increases the movement of your muscles to help food move through your stomach. It may help some patients but the effects may wear off with time. Erythromycin can cause stomach pain and also interact with other medications that may effect your heart rhythm.
- There are also other medications that may help gastroparesis symptoms, such as antiemetics (e.g. ondansetron or promethazine), which help control nausea.
- Other drugs such as mirtazepine (an antidepressant) are also useful anti-nauseant drugs and can stimulate the appetite as well.
Other treatment options
- Ginger tea or other preparations may help relieve nausea.
- Some people also respond to acupuncture although there is as yet not enough evidence to be confident that it works.
Things to be aware of
- For patients with severe nausea and vomiting that do not get better with changes to your diet or medications, a doctor may do surgery to put a gastric neurostimulator in your stomach, which is a battery-operated device that sends electrical impulses to the stomach muscles. There is no clear evidence for the effectiveness of this therapy and the FDA has only approved it on “compassionate grounds”.
- When gastroparesis is very severe and the symptoms are not getting better with other treatment options, there are a few more options, only to be done if needed.
- A jejunostomy may be needed. Using surgery, a doctor puts a feeding tube into a part of the small intestine called the jejunum. This can be done surgically or endoscopically via the stomach, when it is called a PEG/J.
- Total parenteral nutrition (TPN), an IV liquid food mixture that is given through a tube in the chest, may also help. This may be used as a temporary treatment. The tube is put into the chest during a surgery.
- There is no evidence for supporting the use of botulinum toxin injections for the treatment of gastroparesis.
- Cutting the muscle at the pylorus (the junction between the stomach and intestine) is being performed at some centers both surgically and endoscopically but at this point is considered experimental with no strong evidence to support it.
If gastroparesis gets out of hand, it can cause:
- Severe dehydration or loss of water from the body (with vomiting that doesn’t stop).
- Esophagitis — pain and swelling in the esophagus (the tube that links the mouth and the stomach).
- Bezoars (a small mass in your stomach) that can cause nausea, vomiting, a block, or stop your body from using some medications the right way.
- Trouble controlling blood sugar levels in people with diabetes.
- Malnutrition, which can stop the body from getting the vitamins, minerals and nutrients it needs.
- Worsening quality of life – missing work and social events due to symptoms.