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Gastric Sleeve and Gastric Bypass for Gastroparesis

Gastric Sleeve and Gastric Bypass for Gastroparesis

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      Gastric sleeve and gastric bypass surgery for gastroparesis are effective treatment options in severely overweight people. Gastroparesis, or delayed stomach emptying, is a condition caused by partial paralysis of the stomach. This condition affects 50 out of 100,000 people. Gastroparesis symptoms are debilitating and can lead t severe complications if left untreated. Although getting diagnosed with gastroparesis is relatively rare, 1 out of 4 people will experience symptoms similar to gastroparesis.

      What Is Gastroparesis?

      Gastroparesis is a disorder of the digestive tract where there is little to no movement of food from the stomach to the small intestine. When the gastrointestinal tract is regularly working, muscles move food throughout your digestive system. Firstly, food is transferred from your mouth to your esophagus by swallowing. Muscle movement in your esophagus propels food into your stomach, where muscles churn and grind food into small, more absorbable pieces. Food then moves from the stomach throughout the small and large intestines.

      Cartoon diagram picture of the gastrointestinal tract in people.
      Gastroparesis slows digestion and can lead to nutrient deficiencies.

      In gastroparesis, the stomach muscles do not work correctly. Frequently, nerve damage in the stomach causes muscles not to work correctly. Therefore, food does not get broken down, and the stomach takes too long to empty, which delays digestion. The slowing of stomach digestion can lead to various unpleasant symptoms and complications. Gastric bypass or gastric sleeve surgery can help eliminate the struggles of this condition and help the individual improve their quality of life.

      What Causes Gastroparesis?

      The number one cause of gastroparesis is diabetes. Type 2 Diabetes causes nerve damage in the stomach over time, which can lead to dysfunction in the stomach muscles and even paralysis. Gastroparesis can also be idiopathic, meaning that there is no clear cause or reason as to why a person may have gastroparesis.

      Certain factors put some individuals at greater risk for gastroparesis. Risk factors include:

      • Diabetes
      • Obesity
      • Abdominal or esophageal surgery
      • Damage to the vagus nerve
      • Viral infection
      • Medications that slow gastric emptying such as narcotics
      • Scleroderma
      • Hypothyroidism
      • Diseases of the nervous system such as Parkinson’s disease
      • Radiation therapy for cancers in the chest and abdomen

      Furthermore, women are four more times likely than men to develop gastroparesis. Studies have suggested that women with Type 2 diabetes are more likely to have gastroparesis because they have a greater Body Mass Index (BMI) and a higher Hemoglobin A1c compared to men with Type 2 diabetes.

      Three women walking and laughing together.
      Women are four more times likely than men to be diagnosed with gastroparesis.

      What Are the Symptoms of Gastroparesis?

      Some people do not have symptoms even though they have gastroparesis. However, many people with this condition experience some, or all, of the following symptoms:

      • Nausea
      • Vomiting (People may vomit undigested food ingested a few hours earlier)
      • Abdominal cramping and pain
      • Feeling full after only a few bites of a meal
      • Acid reflux
      • Bloating
      • Changes in blood sugar
      • Lack of appetite
      • Malnutrition
      • Unintended weight loss

      What Are Complications of Gastroparesis?

      Complications of gastroparesis may be mild to severe. Some complications may be life-threatening. Gastroparesis complications include:

      • Dehydration due to repeated vomiting
      • Malnutrition
      • Low-calorie intake
      • Unstable blood sugar
      • Unintended weight loss
      • Bezoars
      • Lower quality of life

      How To Diagnose Gastroparesis

      There are several tests your doctor may perform if you are concerned that you have gastroparesis.

      • Gastric Emptying Study - This test is an essential tool in diagnosing gastroparesis. In this test, you will eat a light meal that contains a small amount of radioactive material. This radioactive material helps a scanner detect food moving throughout your digestive system. While you digest, a scanner is placed over your abdomen to monitor how long it takes for food to leave your stomach.
      • Upper Gastrointestinal (GI) Endoscopy - Sometimes called an Upper GI, this procedure is performed by a gastroenterologist who uses a thin scope with a tiny camera on the tip to look down your esophagus, stomach, and into the first part of your small intestine. Your doctor can diagnose a variety of GI conditions, including peptic ulcer disease and pyloric stenosis with endoscopy.
      • Ultrasound - Your doctor will be able to look at your digestive organs using high-frequency sound waves to produce images on a screen.
      • Barium Swallow Study - Your doctor may order a series of x-rays to be taken while you digest barium, which is a white, chalk-like liquid that coats your digestive system. Barium can be picked up by an x-ray and can identify anything that may be abnormal.
      Depiction of what a nerve ending looks like in the human body.
      Gastroparesis is usually caused by damage to nerves in the stomach.

      What Treatment Options Are Available For Gastroparesis?

      If you have been diagnosed with gastroparesis, several treatment options may be available to you. Firstly, if you have diabetes, you will want to work with your doctor to control your blood sugar and treat your diabetes. Managing your diabetes can help alleviate symptoms associated with gastroparesis. Dietary changes can also help treat gastroparesis. Maintaining proper nutrition is an important goal for people with gastroparesis. Your doctor may recommend you work with a dietician to ensure you get enough calories and nutrients. You may need to add supplements to your diet to ensure you are getting essential nutrients. Furthermore, your doctor may prescribe medication that aims to either stimulate the stomach muscles or reduce unpleasant symptoms such as nausea and vomiting.

      Surgical treatment may be recommended by your doctor when the above treatments are not successful in controlling symptoms. Surgical options include:

      • Gastric Pacemaker - Similar to a pacemaker in the heart, a gastric pacemaker sends electrical signals to the stomach muscles to restore the normal functioning of muscles.
      • Gastric Sleeve for Gastroparesis - A surgeon may perform gastric sleeve for gastroparesis to remove stomach tissue that is not functioning. Gastric sleeve for gastroparesis may reduce nausea and vomiting, which are very uncomfortable symptoms of gastroparesis.
      • Gastric Bypass for Gastroparesis - A surgeon may recommend gastric bypass surgery for gastroparesis if there is damaged stomach tissue. Gastric bypass for gastroparesis is an effective treatment option for people who are overweight and suffering from gastroparesis.
      Picture of an operating room in a hospital.
      Your doctor may recommend surgery if other forms of treatment have failed.

      Gastric Bypass for Gastroparesis As A Treatment Option

      Traditionally, gastric bypass surgery is a procedure that aims to treat morbid obesity and diseases related to obesity. Studies have identified that gastric bypass surgery may also improve gastroparesis in overweight patients. Indeed, one study found that people who were taking medication to help with gastroparesis were able to stop the medication after gastric bypass surgery.

      Gastric bypass surgery is a bariatric procedure where a surgeon modifies the anatomy of the digestive tract to help with weight loss in severely overweight people. Gastric bypass surgery also called a Roux-en-Y procedure, is a two-part procedure. Firstly, the surgeon cuts the stomach into a smaller pouch that limits how much food a person can eat at one time. Secondly, part of the stomach and small intestine are bypassed to limit nutrient absorption.

      Although studies are limited that address gastric bypass for gastroparesis, gastric bypass is a safe operation with a low risk of complications. However, as with any surgical procedure, there are complications with gastric bypass surgery. Complications from surgery should be weighed against the long term complications of living with gastroparesis and severe obesity. Furthermore, gastric bypass surgery can help treat Type 2 diabetes, which is one of the leading causes of gastroparesis. Indeed, 30% of gastroparesis cases are due to diabetes.

      Is Gastric Bypass For Gastroparesis For Me?

      If you qualify for bariatric surgery and have gastroparesis, gastric bypass surgery may be an option for you. However, you and your doctor will want to work together to try different treatment options before going through surgery. These treatment options may include controlling your diabetes, managing your symptoms, medication, undergoing a nutritional assessment, increasing physical activity, and dietary modification. It is important to note that each person has different experiences and results with surgery. Talk with your doctor about what is best for you in treating your gastroparesis.

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        Julia Rae Walker, RN, BSN, BA

        Author

        Julia is an experienced critical care nurse with a background in pediatric and adult patient populations. Her passion is helping patients maximize their quality of life.

        Gintas Antanavicius, MD, FACS, FASMBS

        Medical Reviewer

        Dr. G is a co-founder of BariBuilder. A US-based expert surgeon with over 10 years of bariatric experience, he regularly publishes research in medical journals like SOARD, Obesity Surgery, etc.