What is Gastroparesis?What is Gastroparesis - How Bariatric Surgery Helps - Delayed gastric emptying

Gastroparesis, (gastro “stomach” and paresis “partial paralysis”) is a digestive problem caused by delayed stomach emptying of food without the absence of obstruction.

Once the food is passed through the mouth and esophagus, it lands in the stomach, where gastric juices aid indigestion. After a specific time,  the food moves into the small intestine. In people with delayed emptying of the stomach, the food stays in there for too long.

Symptoms of Gastroparesis

This causes a variety of symptoms, such as:

  • Reflux –  Since the food is backed up, the acid comes back to the esophagus and causes acid reflux. Chronic reflux can lead to Gastroesophageal Reflux Disease (GERD).
  • Nausea/Vomiting – When food is not moving fast enough, a buildup of pressure on nerve receptors in the stomach can cause nausea and vomiting.
  • Weight Loss – The food is not absorbed in the stomach and small intestine and causes malnutrition and weight loss.
  • Bloating – The food is not moving through the digestive tract from one portion to the next portion in a timely manner, causing bloating, gas, GI complaint, and gastric ulcers.
  • Poor Gallbladder/Pancreatic Function – The acidic environment in the small intestine triggers gallbladder and pancreatic excretion. If the food movement is not happening fast enough, it causes poor gallbladder and pancreas function.

Malabsorption of Nutrients

  • Dysfunction in the Nervous System – Neurological problems, brain decline, neurodegeneration, and muscle wasting.
  • Osteoporosis – The calcium is not absorbed and develops osteoporosis.
  • Fatigue

What is Gastroparesis - How Bariatric Surgery Helps

Who is At-Risk for Gastroparesis?

Gastroparesis is a neurological problem the parasympathetic nervous system is not working properly and can affect:

  • Kids – Spectrum disorders: ADD, ADHD, Asperger’s, Autism
  • Adults – Memory Loss, Alzheimer’s Disease, Depression, Anxiety, Mood Swings, OCD, Vestibular Disorders, Seizure Disorders

People taking Ozempic shots for weight loss are also at risk of gastric paralysis – a new study shows.

A poor or delayed gastric emptying can create inflammatory types of reactions in the small intestines, creating intestinal permeability or Leaky Gut Syndrome (microscopic permeabilities, little small microscopic holes in the digestive tract)—breakdown of the gut barrier results in leaking, allowing large protein molecules to enter your bloodstream.

Issues Caused by Gastroparesis

This, in turn, causes issues such as:

  • Autoimmune Disease
  • Food Sensitivities
  • Systemic Inflammation

Diagnosis Gastroparesis

Many patients with digestive complaints are misdiagnosed with Gastroparesis. A Gastric Emptying Test is performed to diagnose Gastroparesis properly. It is a 4-hour gastric test to make sure that, within a 4-hour period, 90% of the food is released from the stomach. Also, the blockage by upper GI will be ruled out with barium and endoscopy.

Three Types of Gastroparesis

What is Gastroparesis - How Bariatric Surgery Helps - Symptoms of Gastroparesis and Anatomy

  1. Diabetic Gastroparesis – Peripheral Neuropathy (people with type I and II have peripheral nerve damage).
  2. Post-Surgical Gastroparesis –  It happens as a result of surgery complications.
  3. Idiopathic Gastroparesis – Don’t know why it’s happening. It is a problem in the Central Nervous System (CNS) – Poor Vagus Nerve Function.

Treatment of Gastroparesis

Medical Treatment

1. The Vagus Nerve (Wandering Nerve), which comes off of the brainstem and controls all your internal functioning:

  • Swallowing
  • Stomach Contractions
  • Acid Production
  • Stomach Blood Flow
  • Gut Motility
  • Gut Immune System
  • Gallbladder and Pancreatic

2. Drug-free Functional Medicine Solution for Idiopathic Gastroparesis

Functional Neurology (FN) or Functional Medicine is a type of neurology that treats nervous system diseases without the use of drugs and surgery. The function of the Vagus Nerve can be improved with FN. The Vagus nerve can be examined through the following:

  • Palatal Paresis
  • Gag Reflex
  • Bowel Sounds

3. Functional Medicine Solution

  1. The Vagus nerve can be stimulated to fire better to improve digestion without medicine. There are 5 to 6 different stimulation that is performed over a period of time.
  2. Identify and remove gastric inflammation: Food Sensitivities, Infection, Leaky Gut Syndrome.
  3. The damages created by Gastroparesis are repaired: Nutritional Imbalances, Ulcers, Leaky Gut Syndrome, Dysbiosis, Neurological Impairments

4. Medical Solution for Idiopathic Gastroparesis

5. Pro-Kinetic drugs actually cause your stomach to contract more:

  • Erythromycin Antibiotic
  • Anti-Emetic Drugs – Slow down vomiting and nausea
  • Botox Injections to Pylorus – To relax the valve

Endoscopic Treatment

Gastroparesis, stomach diagram

  • Endoscopic Gastric Pacemaker – Similar to vBloc, a pacemaker with mild electrical signals is used to stimulate the stomach muscle to contract and improve food emptying.

Surgical Treatment

  1. Subtotal Gastrectomy – The stomach is removed in a procedure similar to RNY Gastric Bypass for patients with severe gastroparesis symptoms. A very small pouch is created that is connected to the small intestine. In essence, the stomach that is creating this problem is removed.
  2. Gastric Bypass Surgery – Patients with severe gastroparesis that are morbidly obese with a BMI of over 35 can benefit fromGastric bypass surgery treatment for Gastroparesis a laparoscopic RNY Bypass surgery. This solution works so well for patients with obesity problems. Another benefit is that those with type II diabetes can go into remission. Patients also do not require the use of prokinetics drugs after surgery.
  3. Partial Longitudinal Gastrectomy – Similar to mini-gastric sleeve surgery, partial removal of the stomach is a great surgical solution for Gastroparesis. The improvement of gastric emptying is achieved, as well as better control over diabetes since the hormones are removed when the gastric fundus is removed.

Related:

References: