Trust Your Gut

Gastroparesis is a disorder in which the stomach does not empty quickly enough. Learn ways to manage this debilitating condition both surgically and non-surgically

Contributed by: Kevin El-Hayek MD, MBA | Surgery

Your belly has ways of letting you know when something’s not right. It’s completely normal to experience occasional bloating, nausea or even vomiting when you eat something that doesn’t agree with you or when you’ve picked up a stomach bug. But if these symptoms are ongoing, you may be suffering from gastroparesis — especially if you’re one of the millions of Americans living with diabetes.

Kevin El-Hayek, MD, MBA, a MetroHealth surgeon who treats patients with this condition, answers some questions about gastroparesis.

What is gastroparesis?

“Gastroparesis is a disorder in which the stomach does not empty quickly enough,” Dr. El-Hayek explained. The condition has three main causes: diabetic, idiopathic (we don’t know why it has occurred), and post-surgical causes where the vagus nerves are damaged. The vagus nerves help signal the stomach to contract and empty into the small intestine. In gastroparesis, because food sits in the stomach for too long, patients experience nausea, vomiting, dry heaves, stomach fullness, bloating and an inability to finish a normal-sized meal.

How do the vagus nerves become damaged?

Diabetes can damage nerves throughout the body, including the vagus nerves. Sometimes, surgery (anti-reflux or hiatal hernia operations, for example) can damage the vagus nerves. Other reasons are not completely understood, but doctors think an autoimmune reaction may play a role.

Can people prevent gastroparesis?

People with diabetes can help delay or prevent gastroparesis with good blood sugar control. This helps the body’s organs, tissues and nerves stay healthy.

Are there any nonsurgical options to treat gastroparesis?

Medications can help alleviate nausea and encourage food to move out of the stomach, but they may cause side effects such as shakiness and sleepiness. Medications may also stop working after a time. For people with diabetes, following a healthy, low-sugar diet and eating frequent small meals instead of large infrequent ones is the best initial course of action.

What surgical options are available at MetroHealth?

One of the best options for treating gastroparesis is an endoscopic procedure called a per-oral pyloromyotomy, or POP. Using a flexible endoscope through the mouth, the surgeon makes an incision in the valve that connects the stomach to the small intestine. This safe and effective outpatient procedure helps the stomach empty more quickly and completely and requires less healing time than traditional surgical approaches.

What should people do if they suspect they have gastroparesis?

If you have ongoing symptoms, it’s important to see your primary care provider or a gastroenterologist. Dr. El-Hayek , is also happy to discuss surgical and endoscopic approaches to treating the condition.