Feeling full even after eating a little? This could be gastroparesis!

Do you feel full after eating a small meal? Or do you feel very uncomfortable after hours of eating? If you are constantly nauseous, feel full, and have trouble eating, you should definitely be aware of this condition we are talking about today called gastroparesis. This may sound like a serious word, but let's talk about it simply.

Simply put, what is gastroparesis?

The word gastroparesis literally means "stomach dysfunction" or "stomach paralysis." To be precise, it's a condition that affects the nerves and muscles in your stomach. Normally, when we eat, the muscles in the stomach contract, which means they move like waves, mixing and crushing the food and pushing it slowly into the small intestine. This process is called ``peristalsis.''

But in someone with Gastroparesis, the muscles and nerves in the stomach don't work properly. So it takes a long time for food to move from the stomach to the small intestine, sometimes not at all. Like a car stuck in traffic, the food gets stuck in the stomach. This is what causes all those uncomfortable symptoms mentioned earlier.

If this condition persists, other problems may arise. Loss of appetite can lead to nutritional deficiencies , and it can be difficult to control blood sugar levels . Sometimes, undigested food particles accumulate in the stomach, forming a solid mass. This is called a ``Bezoar'' in medical terms.

Are there different types of this condition?

Yes, doctors usually classify this condition according to its cause.

• Diabetes-related Gastroparesis: This is the name given to this condition when it occurs as a side effect of diabetes.
• Post-surgical gastroparesis: This type of gastroparesis occurs as a complication of surgery on the stomach.
• Idiopathic Gastroparesis: Surprisingly, in most cases, no specific cause can be found for this condition. Between a quarter and a half of patients fall into this category.

Of these, the most common and most well-known cause is diabetes , which accounts for about one-third of gastroparesis cases.

What are the symptoms of someone with gastroparesis?

These symptoms are not the same for everyone, some may be very mild, while others may be so severe that they make it impossible for them to perform daily activities. Let's take a look at the main symptoms.

What are the main causes of gastroparesis?

As mentioned before, most of the time, the cause is not found. But there are a few possible causes. All of these are caused by damage to the nerves that control the stomach muscles.

Diabetes

This is the main reason. When blood sugar levels are uncontrolled and high for a long time, it damages the delicate nerves in the body. We call this ``Diabetic Neuropathy``. This damage also affects the nerves in the stomach. Then the signal to the stomach muscles to "contract" does not go properly.

Surgery

During surgery on the stomach, chest, or surrounding areas, the vagus nerve, a major nerve that controls the function of the stomach, can be damaged . This damage can cause gastroparesis. For example, this condition can be seen after surgeries such as `(Gastrectomy)` (removal of part of the stomach) or `(Cholecystectomy)` (removal of the gallbladder).

Infections

This condition can also occur after certain viruses (such as `Norovirus`, `Rotavirus`) or bacterial infections. Although it is not clear exactly how this happens, it is thought that it may be caused by the infection itself or by our immune system mistakenly damaging the nerves while fighting the infection.

Certain Drugs

Some medications you take can also temporarily impair stomach function. You should be especially careful with these medications if you already have gastroparesis.

• Strong painkillers - `(Opioids)`
• Tobacco - `(Nicotine)`
• Some antidepressants - `(Tricyclic antidepressants)`
• Some medications for high blood pressure - `(Calcium channel blockers)`
• Some medications for diabetes - `(GLP-1 antagonists)`

There are other types of medications like this, so it's very important to tell your doctor about all the medications you're taking.

What are the possible side effects of this?

Gastroparesis is not just a stomach ache. It can lead to serious complications if not managed properly.

• Weight loss and nutritional deficiencies: Frequent nausea, vomiting, and loss of appetite can lead to malnutrition, which can lead to weight loss, dehydration, and malnutrition .
• Loss of blood sugar control: This is a big problem, especially for diabetics. Because the time it takes for food to leave the stomach is disrupted, the pattern of sugar entering the blood is disrupted. Sugar can suddenly become too low (`Hypoglycemia`) or too high (`Hyperglycemia`). This is very difficult to control.
• Bezoar formation: As mentioned earlier, undigested food particles can collect in the stomach and form solid lumps that resemble stones. If these become large, they can block the passage of food out of the stomach. This is an emergency.

How does a doctor accurately diagnose this disease?

When you go to see a doctor, he will first ask you about your symptoms, any other medical conditions you have (like diabetes), and any surgeries you've had. Then, he will run some tests to see if your symptoms are caused by another blockage in your stomach.

1. Make sure there are no obstructions:

• Upper Endoscopy: A small camera is inserted through the mouth to look inside the stomach to check for tumors, ulcers, or other obstructions.
• Other scans: Tests such as a CT scan or MRI can look at the inside of the abdomen.

2. Measuring stomach function:

• Once it is confirmed that there is no obstruction, special tests are performed to see how quickly the stomach empties.
• Gastric emptying scintigraphy (GES): This is the main test for this. In this test, you eat a small amount of food (usually an egg) mixed with a radioactive substance. Then, over a period of several hours, scans are taken to see how long it takes for the food to leave the stomach.
• Breath Test: You can get an idea of ​​your stomach's function by giving it a food containing a special carbon molecule and measuring the gas you exhale.

After these tests, the doctor can tell you for sure whether you have gastroparesis or not.

What are the treatments for gastroparesis?

The nerve damage that causes this condition cannot be reversed. This means it is difficult to completely cure. However, there are many effective treatments that can help control symptoms and lead a normal life .

The main goals of treatment are:

• Stimulating the muscles of the stomach, causing food to empty faster.
• Make sure your body gets the nutrition and fluids it needs.
• Controlling symptoms like nausea and pain.
• If there is a cause for this (like diabetes), it is important to control it well.

Medications

• Prokinetics: These are the main type of medication that helps the muscles in the stomach contract. `Metoclopramide` is one approved medication for this. However, due to some side effects, it should be used only as directed by your doctor.
• Antiemetics: These help control nausea and vomiting .
• Other medications: Medications for chest inflammation, pain, and diabetes control may also be included in the treatment plan.

Changes in diet

This is a very important part of the treatment.

• Instead of three meals a day, eat 5-6 small meals.
• Reducing foods high in fat and fiber (e.g. fried foods, lots of vegetables, fruit peels) because these take longer to digest.
• Paying more attention to liquid or well-blended foods (soups, porridge, juices).

Surgery

Surgery should only be considered as a last resort if all other treatments fail.

• Pyloroplasty: A surgery to slightly widen the muscular ring (pylorus) where food passes from the stomach. This can now be done without an incision using an endoscope (the `G-POEM` method).
• Gastric Bypass: A surgery that bypasses the dysfunctional part of the stomach and creates a new path for food to pass directly into the small intestine.

What should you be careful about when living with this condition?

Gastroparesis is a lifelong condition. However, it is possible to live with it well. It is important to make small changes to your lifestyle.

• Identify what foods are good for you and what foods are bad for you. Keeping a food diary can help with this.
• Take a short walk after eating. Walking slowly can help with stomach function.
• Avoid alcohol, smoking, and other drugs completely. These further impair stomach function.
• Stay in touch with your doctor regularly. Tell him or her if there are any changes in your symptoms or if you are having difficulty with your medication.

Gastroparesis can be a challenging condition, but with the right treatment and lifestyle changes, you can manage it well and live a normal life.