Gastroparesis More Likely In Women

Ask The Expert Dr. Linda Lee, Johns Hopkins Integrative Medicine And Digestive Center

August 24, 2009

Gastroparesis, otherwise called "paralyzed stomach," affects about 25 percent of people with type 1 diabetes and 10 percent of people with type 2 diabetes. People diagnosed with a neurologic disease, such as Parkinson's, and those who have had stomach ulcer surgery may also be affected.

However, the largest group of individuals with paralyzed stomach suffers solely from this condition, without additional illness; they have what is called "idiopathic" gastroparesis. Dr. Linda Lee, board certified in internal medicine and gastroenterology and the director of the Johns Hopkins Integrative Medicine and Digestive Center, explains the disease and provides insights on symptoms, causes, diagnosis, treatments and prevention.

* Gastroparesis is a delayed emptying of the stomach that isn't due to an obstruction. Symptoms may include nausea, vomiting, bloating or abdominal pain, usually in the middle of the abdomen, which gets worse after eating. Gastroparesis may also be responsible for severe heartburn, indigestion or belching that do not get better with standard treatment for reflux. Vomiting or regurgitating food eaten more than four hours earlier suggest a gastric emptying problem.

* Some people experience mild symptoms only occasionally that improve with dietary changes or medication. Other individuals may develop such severe nausea and vomiting that they need to be hospitalized. Gastroparesis can have a negative effect on quality of life, leading to missed days at work and anxiety and depression.

* For reasons that aren't clear, women are up to seven times more likely to have gastroparesis than men. Although it is not considered a common condition, gastroparesis is probably under-recognized since its symptoms overlap with more widespread diagnoses, such as irritable bowel syndrome and gastroesophageal reflux. The association between diabetes and gastroparesis is well established, but idiopathic gastroparesis is relatively unfamiliar to many.

* Doctors diagnose gastroparesis by doing what's called a solid-phase gastric emptying scan in a radiology department. After the person eats a scrambled egg, a scan measures how quickly the egg moves from the stomach to the small intestine.

* Management of gastroparesis consists of dietary intervention as well as a pharmacologic approach.

For example, patients are cautioned about eating high-fiber or greasy foods, particularly during times when they are most symptomatic. During those times, they are advised to switch to a liquid diet and maintain hydration as well as possible, because dehydration only worsens their symptoms. To help address symptoms, medications can be used to help accelerate the emptying of the stomach or reduce nausea.

Addressing anxiety and depression is also important, because these can exacerbate symptoms.

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