Dietary Changes and Gastroparesis Treatment

One of the first steps in treating gastroparesis involves making dietary changes and focusing on proper nutrition. Eating small, frequent meals throughout the day can help allow the stomach time to empty instead of trying to eat large meals all at once. High-fiber and low-fat foods are generally easier to digest. Drinking plenty of water or other clear liquids with meals can also help food pass more easily through the digestive tract. For some patients, a liquid diet may be recommended at first before slowly reintroducing soft, bland foods. Meeting nutritional needs is important, so vitamin supplements or liquid meal replacements may be useful. Working with a registered dietitian can help create an individualized eating plan.

Medications to Help Motility and Gastroparesis Treatment

Some medications can help improve gastric motility and emptying or relieve bothersome symptoms. Prokinetic agents like metoclopramide, domperidone, and erythromycin work to increase stomach contractions and speed up emptying. These medications aren't effective for all patients and side effects are possible with long-term use. Botulinum toxin injections into the stomach wall can help improve symptoms for 3-6 months by reducing muscle activity. Antinausea medications like ondansetron are often used to control nausea and vomiting. Pain relievers, antacids, and antidiarrheal drugs may provide symptom relief as needed. For severe, persistent nausea or vomiting, short-term tube feeding may be beneficial.

Gastric Pacemaker Implantation

For Gastroparesis Treatment,  patients who don't respond well to lifestyle changes or medications, gastric pacemaker implantation may be an option. Also known as gastric neurostimulation, this involves surgically placing a small battery-powered device similar to a heart pacemaker below the skin of the abdomen. Wires attached to the device deliver mild electrical pulses to areas of the stomach to coordinate muscle contractions and improve gastric emptying. While not a cure, studies show gastric pacemakers can significantly relieve symptoms and improve quality of life for many people with gastroparesis. Risks of the implantation procedure are similar to other surgeries. The device battery will need periodic replacement through minor surgery as well.

Neurolysis of the Vagus Nerve

For some gastroparesis cases caused by vagus nerve damage, a procedure called transcutaneous gastric neurostimulation or transoral gastric electrical stimulation may be performed. This involves inserting a balloon device through the mouth into the stomach. Low-level electrical pulses are then delivered through the device to the stomach muscle and surrounding nerves for 30 minutes, four times per day. The goal is to disrupt abnormal nerve signaling and restore more normal gut motility. Short term studies show it may improve symptoms for a number of months in select patients. Side effects are usually mild but risks of the procedure do exist. Further research is still needed on long-term effectiveness.

Gastric Balloon Placement

A newer interventional approach being researched involves temporary placement of an inflatable gastric balloon within the stomach to slow food emptying. The silicone rubber or saline filled balloon is endoscopically inserted and remains in the stomach for 6 months before being deflated and removed. It works primarily by creating a physical barrier that occupies space in the stomach and limits overeating. Clinical trials found gastric balloon therapy significantly reduced total gastric content volume and improved symptoms in gastroparesis individuals. Possible side effects include discomfort, nausea and risk of balloon deflation issues. More data is still needed but gastric balloons show promise as another future treatment option.

Gastric Surgery as a Last Resort

For gastroparesis patients who fail conservative treatments, surgery may be considered but usually only as a last resort option. Some possibilities include pyloroplasty to enlarge the opening from the stomach into the small intestine or gastric pacing lead placement during abdominal surgery instead of through less invasive procedures. A more complex surgery is gastric resection to remove a portion of the stomach tissue. Risks of this major abdominal operation are high and it doesn't always provide symptom relief. Due to the invasiveness and uncertainties of outcomes, surgery for gastroparesis should only be performed in carefully selected cases not helped by other treatments.

There are now several approaches available to manage gastroparesis symptoms and improve stomach emptying depending on individual factors. Diet and lifestyle modifications represent first-line strategies along with medications to promote motility or relieve symptoms. When those are insufficient, interventional procedures like gastric pacemaker implantation or neurostimulation may provide benefit. Gastric balloon therapy and even surgery are reserved for more refractory cases after other options are exhausted. Working closely with a gastroenterologist is important to determine the best treatment plan and closely monitor progress over time. A team care approach including dietitians and psychologists can also help support gastroparesis patients.

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 Money Singh is a seasoned content writer with over four years of experience in the market research sector. Her expertise spans various industries, including food and beverages, biotechnology, chemical and materials, defense and aerospace, consumer goods, etc. (https://www.linkedin.com/in/money-singh-590844163)