Gastroparesis, (Delayed Gastric Emptying) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

Gastroparesis is a medical disorder that decreases the ability of the stomach to empty its contents.
It does not involve an obstruction (blockage).
The spontaneous motility of the muscles in the stomach does not move normally.
Normally, strong muscular contractions push food through the digestive tract.
But in gastroparesis, the stomach's movements work poorly or not at all.
This stops the stomach from emptying properly.
Gastroparesis can affect normal digestion, produce nausea and vomiting, and induce problems with blood sugar levels and nutrition.
Some people form gastroparesis after surgery.
There is no cure for gastroparesis, but altered diet, along with medicines, can present some relief.
Gastroparesis is thought to be the result of a difficulty with the nerves and muscles regulating the emptying of the stomach.
If these nerves are injured, the muscles of the stomach may not function properly and the movement of food can slow down.
A injured vagus nerve avoids the muscles in the stomach and intestine from functioning, preventing food from moving through the digestive system properly.
Risk factors for gastroparesis are:
1. Diabetes
2. Gastrectomy (surgery to remove part of the stomach)
3. Systemic sclerosis
4. Use of medicine that blocks certain nerve signals (anticholinergic medicine)
But in many patients, gastroparesis is thought to be produced by injury to a nerve that regulates the stomach muscles (vagus nerve).
Diabetes is one of the most frequent causes for gastroparesis.
Other causes are:
1. Infections,
2. Endocrine disorders like hypothyroidism,
There are many symptoms of gastroparesis, such as:
1. Vomiting undigested food
2. Nausea
3. A feeling of fullness after eating just a few bites
4. Abdominal bloating
Diagnosis is by:
1. Gastric emptying study - most essential test
This test affects eating a light meal
A scanner that identifies the movement of the radioactive material is positioned over the abdomen to regulate the rate at which food exits the stomach
2. Gastroduodenal manometry evaluates the action of the smooth muscle of the stomach and small intestine in contracting and relaxing
Treatment is by:
1. Diet changes to soft food
If liquids are easier for the patient to swallow, make an effort to provide soups and pureed foods
Drink water throughout each meal
2. Exercise after eating
3. Feeding tube.
A transient feeding tube called a nasojejunal tube may be given to the patient first, which is placed through the nose to pass nutrients directly into their small intestine

TABLE OF CONTENT
Introduction
Chapter 1 Gastroparesis
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Peptic Ulcer
Chapter 8 Indigestion
Epilogue

• Language: English
• Publisher: Kenneth Kee
• Release date: Nov 27, 2016
• ISBN: 9781370142804

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Gastroparesis,

(Delayed Gastric Emptying)

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2016 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes the Gastroparesis, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Gastroparesis)

This eBook is licensed for the personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Condition) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Conditions into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 700 amazon kindle books and some into Smashwords.com eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical conditions.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring you the latest information about a condition or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Gastroparesis

What is Gastroparesis (Delayed Gastric Emptying)?

Gastroparesis is a medical disorder that decreases the ability of the stomach to empty its contents.

It does not affect an obstruction (blockage).

The spontaneous motility of the muscles in the stomach does not move normally.

Normally, strong muscular contractions push food through the digestive tract.

But in gastroparesis, the stomach's movements work poorly or not at all.

This stops the stomach from emptying properly.

Gastroparesis can affect normal digestion, produce nausea and vomiting, and induce problems with blood sugar levels and nutrition.

What causes gastroparesis?

Causes

The cause of gastroparesis is normally not known.

When this is the case, it is known as idiopathic gastroparesis (IG).

When people who have diabetes form gastroparesis, it is known as diabetic gastroparesis (DG).

Some people form gastroparesis after surgery.

There is no cure for gastroparesis, but altered diet, along with medicines, can present some relief.

Gastroparesis is thought to be the result of a difficulty with the nerves and muscles regulating the emptying of the stomach.

If these nerves are injured, the muscles of the stomach may not function properly and the movement of food can slow down.

An injured vagus nerve avoids the muscles in the stomach and intestine from functioning, preventing food from moving through the digestive system properly.

It may be produced by a disturbance of nerve signals to the stomach.

The disorder is a frequent complication of diabetes.

It can also occur after some surgeries.

Risk factors for gastroparesis are:

1. Diabetes

2. Gastrectomy (surgery to remove part of the stomach)

3. Systemic sclerosis

4. Use of medicine that blocks certain nerve signals (anticholinergic medicine)

But in many patients, gastroparesis is thought to be produced by injury to a nerve that regulates the stomach muscles (vagus nerve).

The vagus nerve helps control the complicated processes in the digestive tract, such as signaling the muscles in the stomach to deal with and move food into the small intestine.

An injured vagus nerve may not transmit signals normally to the stomach muscles.

This may induce food to stay in the stomach longer, rather than move normally into the small intestine to be digested.

The vagus nerve can be injured by diseases, such as diabetes, or by surgery to the stomach or small intestine.

Factors that can make it complex for the stomach to empty properly are:

1. Diabetes

2. Abdominal or esophageal surgery

3. Infection, usually a virus

4. Certain medicines that slow the rate of stomach emptying, such as narcotic pain medications

5. Certain cancer treatments, such as radiation treatment

6. Scleroderma (a connective tissue disease)

7. Nervous system diseases, such as Parkinson's or multiple sclerosis

8. Hypothyroidism (low thyroid)

9. Parkinson's disease

10. Multiple sclerosis

Young and middle-aged women tend most to form idiopathic gastroparesis.

Medicines linked with impaired gastric emptying

1. Narcotic

2. Tricyclic antidepressants

3. Calcium channel blockers

4. Clonidine

5. Dopamine agonists

6. Lithium

7. Nicotine

8. Progesterone

There are many reasons of gastroparesis.

Diabetes is one of the most frequent causes for gastroparesis.

Other causes are:

1. Infections,

2. Endocrine disorders like hypothyroidism,

3. Connective tissue disorders like scleroderma,

4. Autoimmune conditions,

5. Neuromuscular diseases,

6. Idiopathic (unknown) causes,

7. Psychological disorders,

8. Eating disorders,

9. Certain cancers,

10. Radiation treatment applied over the chest or abdomen,

11. Some chemotherapy agents, and

12. Surgery of the upper intestinal tract.

Any surgical procedure on the esophagus, stomach or duodenum may lead to damage to the vagus nerve which accounts for many sensory and motor (muscle) responses of the intestine.

In health, the vagus nerve transmits neurotransmitter impulses to the smooth muscle of the stomach that lead to contraction and forward propulsion of gastric contents.

If the vagus nerve is damaged by injury or during surgery gastric emptying may be decreased.

Symptoms of postoperative gastroparesis may form instantly, or months to years after a surgery are done.

People with eating disorders such as anorexia nervosa or bulimia may also form delayed gastric emptying.

Gastric emptying may recommence and symptoms get better when food intake and eating schedules become normal.

Medicines that produce slow emptying should normally be ceased, and reversible conditions (e.g., hypothyroid) treated before testing.

A presentation of early satiety, bloating, nausea, regurgitation or vomiting with meals would normally spark an assessment to find out the cause of symptoms.

Inflammation, ulcer disease, or blockage by a tumor can also produce these symptoms and diagnostic tests would be done to find out the cause.

Radiographical tests, endoscopic methods, and movement tests are used to rule out blockage, to observe the stomach lining and get biopsies, and to evaluate muscle contraction patterns.

What Are the Symptoms of Gastroparesis?

Symptoms

There are many symptoms of gastroparesis, such as:

1. Vomiting undigested food

2. Nausea

3. A feeling of fullness after eating just a few bites

4. Abdominal bloating

5. Abdominal pain

6. Changes in blood sugar levels

7. Lack of appetite

8. Weight loss and malnutrition

9. Abdominal distention

10. Hypoglycemia (in people with diabetes)

11. Premature abdominal fullness after meals

12. Weight loss without trying

13. Heartburn or GERD

How Is Gastroparesis