Re: Gastroparesis

Posted By HFHSM.D.-jg on August 12, 1998 at 07:09:38:

In Reply to: Gastroparesis posted by Diane on August 06, 1998 at 12:46:37:






I have been diagnosed with Gastroparesis after undergoing many tests among which was a gastric emptying test.  I am currently taking Previcid, Propulsid and Domperidone daily.  I also take zofran and/or phenegren to help with the nausea.  The medicine does not seem to be helping so I have been doing some research.  Someone mentioned that Bilroth surgery might solve my problem.  I checked for information and learned that the Bilroth surgery seems to be used for chronic ulcer problems and stomach cancer.  Would this surgery be of help with the gastroparesis?
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Dear Diane:
Gastroparesis can result from several different abnormalities of function   Abnormalities of nerves (usually the vagi) innervating the stomach (e.g. due to diabetes, central nervous system problems or alcohol use) are probably the most common explanations for the problem. Increased  pyloric channel resistance or pyloric spasm due or altered gastric and antral motility, can also cause gastroparesis.  Finally, one must consider abnormalities of mineral concentrations, certain medications as well as metabolic diseases such as hypothyroidism as causes of gastroparesis.
Treatment should be aimed towards removing the treatable causes e.g. stopping medications with anticholinergic side effects, correcting electrolyte imbalances etc. The medicat treatment for gastroparesis is based on the use of prokinetic agents (Propulsid, Reglan or Domperidone), drugs that increase gastric motility.
In general, surgical procedures such as gastrojejunostomy or pyloroplasty are not helpful unless gastric outlet obstruction exists.  There has been preliminary work suggesting that electrical pacing of the stomach may improve symptoms, but this therapeutic approach is still experimental.  In some severe cases, a percutaneous endoscopic placed jejunostomy feeding tube or a surgically placed jejunostomy feeding tube may be needed to permit the patient to take sufficient calories to maintain nutrition.  
This information is presented for educational purposes only.  Always consult your personal physician for specific medical questions.
HFHSM.D.-jg
*keywords: gastroparesis
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