Gastroparesis - Treatments and Drugs

Treating gastroparesis begins with identifying and treating the underlying condition. For instance, if diabetes is causing your gastroparesis, your doctor will work to help you control your diabetes. Beyond this, other gastroparesis treatments may include:

Changes to your diet

Your doctor may refer you to a dietitian who can work with you to find foods that are easier for you to digest, so that you're more likely to get enough calories and nutrients from the food you eat. A dietitian might suggest that you try to:

    * Eat smaller meals more frequently.
    * Eat low-fiber forms of high-fiber foods, such as well-cooked fruits and vegetables rather than raw fruits and vegetables.
    * Choose mostly low-fat foods, but if you can tolerate them, add small servings of fatty foods to your diet.
    * Avoid fibrous fruits and vegetables, such as oranges and broccoli, that are likely to cause bezoars.
    * If liquids are easier for you to ingest, try soups and pureed foods.
    * Drink water throughout each meal.
    * Try gentle exercise after you eat, such as going for a walk.

Some people with gastroparesis may be unable to tolerate any food or liquids. In these situations, doctors may recommend a feeding tube (jejunostomy tube) be placed in the small intestine.

Feeding tubes can be passed through your nose or mouth or directly into your small intestine through your skin. The tube is usually temporary and is only used when gastroparesis is severe or when blood sugar levels can't be controlled by any other method.

Medications

Medications to treat gastroparesis may include:

    * Medications to control nausea and vomiting. Anti-emetic medications include prochlorperazine, ondansetron (Zofran) and diphenhydramine (Benadryl).
    * Medications to stimulate the stomach muscles. These medications include metoclopramide (Reglan) and erythromycin. Side effects of these medications are significant. Discuss the benefits and risks with your doctor.

Surgery

If treatment doesn't help control your nausea, vomiting or malnutrition, you may consider gastroparesis surgery. During surgery, the lower part of the stomach may be stapled or bypassed to help improve stomach emptying.

Experimental treatments

Researchers are working on new ways of treating gastroparesis, such as:

    * Injecting a nerve toxin to allow the stomach to release food. Botulinum toxin (Botox) is a nerve toxin most commonly known for its use in treating skin wrinkles. Researchers have found that Botox injections relax the pyloric muscle in some people, thereby allowing the stomach to release more food. The benefits are temporary, however, and more studies are needed to determine the overall usefulness of this treatment.
    * Implanting an electrical device to control the stomach muscles. Electrical gastric stimulation uses an electric current to cause stomach contractions. Working much like a heart pacemaker, this stomach pacemaker, consisting of a tiny generator and two electrodes, is placed in a pocket that surgeons create on the stomach's outer edge. Stomach pacemakers have been shown to improve stomach emptying and reduce nausea and vomiting in some people with gastroparesis.

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