There is no known cure for gastroparesis; it is usually a chronic condition. Treatment helps to manage the condition, maintain healthy and comfortable life.
Medication for gastroparesis treatment
Several medications are there to treat gastroparesis. Doctor may try different medications or combinations to find the most effective treatment. Discuss about the side effects of any medication with your doctor is important.
- Metoclopramide (Reglan) - It stimulates stomach muscle contractions to help emptying; it also helps reduce nausea and vomiting. Take Metoclopramide 20 to 30 minutes before meals and at bedtime. Side effects of this drug include fatigue, sleepiness, depression, anxiety, and problems with physical movement.
- Erythromycin - Antibiotic also improves stomach-emptying, works by increasing the contractions that move food through the stomach. Side effects include nausea, vomiting, and abdominal cramps.
- Domperidone - It works like metoclopramide to improve stomach emptying and decrease nausea and vomiting. Use of the drug is restricted in the United States.
- Other medications - may be useful to treat symptoms and problems related to gastroparesis. An antiemetic can help with nausea and vomiting; Antibiotics will clear up a bacterial infection. If you have bezoars in the stomach, the doctor may use an endoscope to inject medication into it to dissolve it.
Dietary changes in gastroparesis treatment
Doctor or dietitian may prescribe six small meals a day instead of three large ones. If less food enters the stomach each time, it may not become overly full. In more severe cases, your healthcare professional may prescribe a liquid or pureed diet.
It is better avoiding high-fat and high-fiber foods. Fat naturally slows digestion and fiber is difficult to digest. Some high-fiber foods as if oranges contain material, cannot digest. Avoid these foods because the indigestible part will remain in the stomach too long and possibly form bezoars.
If liquid or pureed diet does not work, then need surgery to insert a feeding tube. The tube, called a jejunostomy, is inserted through your abdominal skin into the small intestine straightaway bypasses stomach and places nutrients and medication directly into the small intestine. A special liquid food is useful with this tube; small intestine digests and absorbs nutrients from this food and delivered to your bloodstream quickly. Jejunostomy is helpful only when gastroparesis is severe or the tube is necessary to stabilize blood-glucose levels in people with diabetes.
Parenteral nutrition is delivering nutrients directly into the bloodstream, bypassing the digestive system. Doctor places a thin tube called a catheter in a chest vein, leaving an opening to it outside the skin. For feeding, attach a bag containing liquid nutrients or medication to the catheter. The fluid enters your bloodstream through the vein. Doctor will tell you what type of liquid nutrition to use.
It is an alternative to the jejunostomy tube and is usually a temporary method to get you through a difficult period with gastroparesis. Parenteral nutrition is useful only when gastroparesis is severe and is not manageable by other methods.
Gastric Electrical Stimulation
A gastric neuro-stimulator is a surgically implanted battery-operated device that gives mild electrical pulses to help control nausea and vomiting associated with gastroparesis. This option used only if your nausea and vomiting do not improve with medications.