Submitted by Thiruvelan on Tue, 04/09/2013

Gastroparesis is defining as a delayed gastric emptying with the absence of mechanical obstruction and cardinal symptoms.

Prevalence of gastroparesis is approximately 4.8 percent among people with diabetes type 1, 1 percent among people with diabetes type 2, and 0.1 percent among people without diabetes.

Gastroparesis is a condition in which your stomach cannot empty its content (Partially digested food & gastric juice) in a normal fashion. It may be due to damage to the vagus nerve, which regulates the gastrointestinal tract. A damaged vagus nerve cannot trigger the muscles in the stomach and intestine to perform its normal functioning, thus food has prevented from moving through the digestive tract properly.

Normal gastric emptying

Normally, your stomach empties its contents into the small intestine at a controlled rate. The stomach performs three types of contractions; they are:

  1. The upper part of the stomach makes slow relaxations for about a minute or more following each swallowing of food; this allows the food to enter the stomach. At the end of stomach digestion, the stomach makes a gentle contraction; this helps emptying your stomach.\
  2. The Lower part of the stomach makes a rhythmic synchronized contraction at a rate of three per minute. This creates waves of stomach content splashes against the pyloric sphincter (a muscular valve), which helps grind the food into small particles.
  3. Between meals, there are occasional strong bursting synchronized contractions along with the opening of the pyloric sphincter muscle opening. This housekeeping wave can help sweep out any indigestible food from the stomach.

Motility Disorders of the Stomach

Normal gastric emptying process is a well-coordinated effort between different regions of the stomach, duodenum as well as extrinsic regulation by central nervous system (CNS) and distal gut factors.

If there is any problem with this normal stomach movement can lead to motility disorder, which include delayed gastric emptying (gastroparesis), rapid gastric emptying (dumping syndrome), and functional dyspepsia.

What is Gastroparesis?

Gastroparesis is a mobility disorder that slows or stops the food movement from the stomach to the small intestine. Normally, the stomach muscles are controlling by the vagus nerve. This muscle contraction helps to break down food as well as move it along the gastrointestinal tract.

However, gastroparesis can occur when there is damage to the vagus nerve by illness or injury, and the stomach muscles stop working normally. Then food moves slower than usual from the stomach to the small intestine or stops it altogether.

Gastroparesis classification

Gastroparesis are subdividing into three they are diabetic gastropathy, idiopathic gastroparesis, and postsurgical gastropathy.

Gastroparesis is considering as a mobility disorder of the stomach. In particular, there is a slow in gastric emptying called delayed gastric emptying.  Majority of patients with gastroparesis are women; approximately, 82% of gastro-paretic patients were female. Women tend to exhibit slower stomach emptying rates than men, specifically during the later stage of the menstrual cycle. Experts believed that gastric muscle contractility is reducing by progesterone.

Diabetic Gastroparesis

Gastroparesis is a recognized diabetes complication occurs among individuals with long-term of type 1 diabetes. The other associated diabetes complications are retinopathy, nephropathy, and peripheral neuropathy.

Postsurgical Gastroparesis

Postsurgical gastroparesis develops most often because of peptic ulcer surgery, vagotomy, fundoplication, and bariatric surgery. Approximately, 5% of patients who are undergoing vagotomy with antral resection, and gastrojejunostomy can develop severe postsurgical gastroparesis.

Idiopathic Gastroparesis

Idiopathic gastroparesis refers to symptomatic gastroparesis with no primary underlying cause or abnormality. This is the most common form of gastroparesis; most of the idiopathic gastroparesis patients are women of young or middle-aged individuals.