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Gastroparesis

Gastroparesis is a disorder affecting the nerves and muscles of the stomach, resulting in a paralyzed stomach that cannot perform its normal function. Normally, your stomach contracts slowly to squeeze solid food into small particles, which are then pushed into the small bowel. With gastroparesis, food is not moved into the small bowel and remains in the stomach for much longer than usual. When food lingers too long in the stomach, problems such as bacterial overgrowth can develop in the small bowel. Also, the food can harden into solid masses called bezoars that may cause nausea, vomiting and an obstruction in the stomach.

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Although the cause of gastroparesis is unknown in more than half of patients, type 1 diabetes is the most common cause. It also can develop in people with type 2 diabetes, although this is less common. Other causes of gastroparesis include:

  • Postviral syndromes
  • Anorexia nervosa
  • Surgery on the stomach or vagus nerve, a nerve that runs from the brain to the abdomen
  • Medications, particularly anticholinergics and narcotics, which slow contractions in the intestine
  • Gastroesophageal reflux disease, although this is rare
  • Smooth muscle disorders such as amyloidosis and scleroderma
  • Nervous system diseases, including abdominal migraine and Parkinson's disease
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Symptoms of gastroparesis range from mild to severe and commonly include:

  • Nausea
  • Vomiting
  • An early feeling of fullness when eating
  • Weight loss
  • Abdominal bloating
  • Abdominal discomfort

A diagnosis of gastroparesis begins with X-rays and an endoscopy. If your doctor does not detect another problem, the following tests may be recommended to make a definite diagnosis.

  • Endoscopy: During this procedure, the upper portion of the gastrointestinal tract is visualized with a flexible endoscope. The areas examined include the esophagus, or the swallowing tube leading to the stomach, the stomach and the beginning of the small intestine, called the duodenum.
  • The procedure is performed using an endoscope, which is a long, thin and flexible tube with a tiny video camera and light on the end. By adjusting the various controls on the endoscope, the gastroenterologist can safely maneuver the instrument to carefully examine the inside lining of the upper digestive system. The endoscope contains a channel that allows instruments to be passed in order to take tissue samples, remove polyps and provide other therapy. The high-quality picture from the endoscope is shown on a TV monitor. In many cases, upper GI endoscopy is a more precise examination than X-ray studies.

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Dietary Requirements

Therapy for gastroparesis requires that you follow certain dietary requirements, such as eating small meals throughout the day and avoiding foods that are difficult to digest. These include fatty foods, legumes, lentils and citrus fruits. If you have gastroparesis as a complication of diabetes, you may need to increase your insulin therapy.

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UCSF Clinics & Centers

Gastroenterology

Gastroenterology at Mount Zion
1701 Divisadero St., Suite 120
San Francisco, CA 94115
Phone: (415) 502-4444
Fax: (415) 502-2249
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Gastroenterology at Parnassus
350 Parnassus Ave., Suite 410
San Francisco, CA 94143
Phone: (415) 502-2112
Fax: (415) 514-3300
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Intestinal Rehabilitation and Transplantation Program
350 Parnassus Ave., Suite 410
San Francisco, CA 94143
Phone: (877) 762-6935
Phone: (415) 353-2336
Fax: (415) 353-8917
Appointment information