Several other digestive disorders exhibit symptoms of nausea and vomiting. Your
doctor will ask for some additional testing (after taking a complete medical history
and performing a physical examination) in order to determine a diagnosis. This testing
Primary Tests (required)
Upper Gastrointestinal Endoscopy. This test is used to exclude other conditions
that may be causing symptoms (e.g., ulcers, physical abnormalities, or mechanical
obstruction). A thin, flexible tube (endoscope) with a tiny camera at the tip is
passed through the mouth and guided into the stomach while the patient is asleep.
The endoscope allows the doctor to look into the stomach and at its lining for
Gastric Emptying Test (GET). This procedure measures the speed with which food
empties from the stomach and enters into the small intestine. The GET, considered
the most accurate way to diagnose gastroparesis, requires that the person eat a meal
in which a solid food (usually eggs or oatmeal) contains a small and safe amount of a
substance that will appear on a medical scan. A scanner is placed over the abdomen
to monitor the food’s movement.
Secondary Tests (may not be necessary)
Gastroduodenal Manometry. In this test, the doctor passes a thin, pressure-sensitive
tube down the throat and into the stomach and small intestine. A computer connected
to the tube monitors the strength and coordination of stomach muscle contractions
and how well the stomach is emptying.
Electrogastrography (EGG). This procedure records the electrical signals in the
stomach before and after eating. An irregular electrical rhythm may indicate the
presence of gastroparesis.
There is no cure for gastroparesis but several treatments are available that improve
symptoms and offer a more comfortable lifestyle. Treatment options include:
Nutrition Education/Diet Modifications
Patients are often initially treated with
nutrition education and diet modifications. The purpose of diet modification is
to reduce symptoms and maintain adequate fluids and nutrition. A modified diet
typically consists of liquids, restricted fats and plant fiber, and frequent small meals.
The most common drugs used to treat symptoms include:
Prokinetic drugs—used to improve the rate of stomach emptying and
thereby reduce nausea and vomiting. Examples include erythromycin (an
antibiotic) and Reglan® (metoclopramide).
Antiemetic drugs—used to control nausea and vomiting but have no effect
on stomach emptying. Examples include Compazine® (prochlorperazine) and
This therapy involves the delivery of liquid nutrients via a tube
placed directly into the stomach or small intestine. Feeding tubes are usually
temporary and used only when gastroparesis is severe.
Total Parenteral Nutrition (TPN).
TPN supplies nutrients to a person’s bloodstream
through an intravenous (IV) infusion. TPN is used only if enteral feeding is not
tolerated or is insufficient to meet caloric needs.
Surgery for gastroparesis is considered a treatment of last resort. One surgery,
called pyloroplasty, involves widening of the pyloric valve (the muscle that separates
the stomach from the upper region of the small intestine or duodenum). Another
procedure, gastrectomy, involves the removal of part or all of the stomach. Other
surgical procedures involve bypassing the lowest part of the stomach to improve
Enterra® Therapy for Gastroparesis.
This surgical option is indicated for patients
with chronic, drug-refractory (resistant to medication) nausea and vomiting due to
gastroparesis of diabetic or idiopathic origin. Enterra Therapy uses a neurostimulator
that is implanted beneath the skin and connected to two leads implanted in stomach
muscle. Your doctor can determine if you are a candidate for Enterra Therapy.
Any combination of diet modification, medication, nutritional support, and Enterra
Therapy may be necessary to control symptoms of gastroparesis.