Gastroparesis

Gastroparesis is a neuro-muscular abnormality that causes delayed gastric emptying which, in turn, causes a premature full feeling while eating, bloating, nausea, acid reflux, regurgitation, belching, and occasional vomiting. It is a co-morbid condition associated with ME/CFS, Ehlers Danlos Syndrome, and several other diseases.

Gastroparesis may be precipitated by a viral illness such as Epstein-Barr virus or a viral infection that causes gastroenteritis or the “stomach flu." Studies have implicated an immune dysfunction, as well as, a dysfunction of the autonomic nervous system as part of the pathophysiology. It can, also, result when the vagus nerve is damaged by illness or injury. Seventy to eighty percent of individuals with primary gastroparesis are young women.

There is no cure, at present, for gastroparesis, so the primary treatment is to manage symptoms with: pro-motility medications, acid-suppressing medications, antacids, and anti-nausea medications if needed. Diet, also, plays a large role in symptom control. In particular, avoid high fat and high fiber foods, eat small portions throughout the day, and use liquid food supplements.

Gastroparesis is frequently misdiagnosed as Irritable Bowel Syndrome (IBS), but the chief difference is where the distress is occurring. Gastroparesis refers to a disorder in the upper digestion system, especially the stomach, whereas, IBS refers to the lower digestion system, especially the bowels. A series of tests may be necessary for determining if one has gastroparesis, including: endoscopy, CT scan, upper gastrointestinal (GI) series, breath test, and a Gastric emptying study. The American Motility Society has established that a 4-hour “Gastric emptying test" is the standard for diagnosing gastroparesis.

Studies

 * In 2016, Dr. Irma Rey and Dr. Nancy Klimas and several other researchers studied patients who developed gastroparesis following a viral history of flu-like symptoms or gastroenteritis. Nine at of the eleven patients studied (82 %) had active enterovirus infection on gastric biopsies.  The study conclusion was that "antiviral and/or immune therapies against enterovirus seem to be favorable, as most of our patients had resolution of their gastroparesis symptoms after treatment. This is the first study to identify enterovirus as a possible infectious etiology of idiopathic gastroparesis.


 * 2004 Gastric emptying is slow in chronic fatigue syndrome

Learn more

 * Wikipedia
 * NIH info on gastroparesis
 * Understanding Gastroparesis
 * Phoenix Rising Forum on Gastroparesis