Gastroparesis is a stomach disorder in which the nerves and muscles do not work properly. In a healthy digestive system, muscular contractions move food from the stomach through the digestive tract. In gastroparesis, however, the stomach muscles work poorly which prevents the stomach from emptying normally.
Abdominal surgery (surgery to the stomach or small intestine)
Medication induced (i.e. narcotics and antidepressants)
Feeling of fullness after only a few bites of food
Heartburn or gastroesophageal reflux disease (GERD)
Doctors may use several tests to help diagnose gastroparesis and rule out other conditions that may cause similar symptoms including.
1.) Measuring the time it takes for food to leave your stomach 2.) Using an endoscope to see the inside of your stomach
Treatment first involves identifying and treating the underlying condition that causes gastroparesis. For example, if diabetes is causing gastroparesis, better control of blood sugars can help reduce symptoms of gastroparesis. In addition to this, other treatments for gastroparesis include:
1.) Changes in Diet- Eating several small meals more frequently during
2.) Medications to control nausea and vomiting. These include
prochlorperazine, ondansetron (Zofran), and diphenhydramine (Benadryl). Side effects of these medicines can be significant. Discuss the risks and benefits with your physician.
3.) Medications to stimulate stomach emptying- These medications
include metoclopramide (Reglan), domperidone (not available in the USA),and erythromycin. Side effects of these medicines can be significant. Discuss the risks and benefits with your physician.
4.) Surgery for gastroparesis- stomach may be bypassed to help
Enterra (Gastric Electrical Stimulation) was approved by the FDA in 2000 as a Humanitarian Device Exemption for the treatment of patients with chronic, intractable nausea and vomiting secondary to gastroparesis from diabetes or idiopathic (unknown) causes. It involves administering high frequency- low energy stimulation to the natural pacemaker in the greater curvature of the stomach by two electrodes that are placed with the laparoscopic or open technique.
At Connecticut GI, we first attempt to treat patients with gastroparesis with dietary changes and medical therapy. However, if these treatments do not work, we will discuss with patients whether to pursue gastric electrical stimulation.
Patients who meet these criteria are candidates for this therapy:
1.) Documented gastroparesis based on 4-hour delayed gastric
2.) Nausea and vomiting cannot be controlled with antiemetics (anti-
vomiting medications) and prokinetics (medications that stimulate the stomach).
3.) Intolerance to antiemetics/prokinetics or patient declines to take
these medications due to potential side effect profile.
At Connecticut GI, we work in close collaboration with bariatric surgeons who place the device surgically. We also can place a temporary stimulator into the stomach during an upper endoscopy to see if electrical stimulation helps before surgical implantation of the device
Upper Endoscopy with Temporary Gastric Electrical Stimulation:
This procedure enables the physician to visualize your esophagus, stomach, and duodenum. The examination is performed with a thin, flexible instrument and allows your physician to observe for any abnormalities and to take biopsies if required.
Preparation prior to temporary gastric stimulator:
- Clear liquid diet day before procedure - Refrain from aspirin, aspirin products, anti-inflammatory medications
(such as Advil, Motrin, Aleve) at least 7 days prior to the procedure. You may take Tylenol.
- Notify your doctor as soon as possible if you are taking blood thinners
- If you take a medication for blood pressure, please take it early the
morning of your procedure with just a tiny sip of water. YOU WILL NOT BE PERMITTED TO DRIVE THE ENTIRE DAY OF THE UPPER ENDOSCOPY. Make sure you arrange for transportation home. You may resume normal activities the day after your procedure; however, please try to avoid getting the electrical stimulator wet. If you have any questions, please call 860-246-2571 Many insurance companies have co-pays and/or deductibles for outpatient procedures. Please check with your insurance company to see what your out of pocket expenses will be.
The preceding information is intended only to provide general information and not as a definitive
basis for diagnosis or treatment in any particular case. It is very important that you consult your doctor about your specific
Clasificación según criterios de gravedad Leve: Sin fiebre, sin síntomas ni signos de Alta hospitalaria Diarrea aguda deshidratación sin alteraciones hidroelectrolíticas. Observación e inicio Moderada: Alteraciones electrolíticas leves, vómitos, de tratamiento en dolor abdominal intenso o intolerancia oral. guardia general AUTORES: LUCÍA PARAVANO, SOL PINASCO, SILVI
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