Normal Stomach Function:
The normal muscle function in the stomach involves both somewhat disordered muscle activity that aids in the breakdown of food and its mixing and the more controlled sequential contractions that push food out of the stomach. The emptying of the stomach is meant to be a relatively gradual and controlled process. At the end of the controlled emptying, strong contractions will sweep all remnant particles out of the stomach and into the small intestine for further digestion and absorption.
Delayed Gastric Emptying (Gastroparesis):
The symptoms of delayed emptying include nausea, vomiting, feeling full, early satiety, and even bloating and pain. Of course, these symptoms may be caused by a variety of problems unrelated to gastroparesis or delayed emptying.
Evaluation often begins with simple laboratory tests followed by an endoscopy test to assess for conditions such as ulcers or severe gastritis or even tumors, which can cause significant symptoms and even actual delayed emptying. Abdominal CT scans may be necessary, depending upon the whole picture. If necessary, the gastric emptying process may be measured via a gastric emptying study involving the patient eating a labeled meal whose progress through the stomach and small intestine may be monitored.
Occasionally patients will suffer not from delayed emptying but from too rapid emptying of the stomach. This condition usually occurs when the person has had surgery and is diagnosed primarily by eliminating other causes of symptoms and by the patient’s history, but gastric emptying studies can sometimes be useful.
A related symptom, sometimes called functional dyspepsia, involves pain or discomfort in the center of the abdomen. Other common symptoms include bloating, mild nausea, fullness and malaise. The possible etiologies are numerous but studies have shown that a mild delay in gastric emptying or improper expansion of the stomach may occur in at least one third of patients. Work-up depends greatly upon the individual patient’s circumstances but may include laboratory tests, endoscopies, CT scans and gastric emptying studies.
Appropriate evaluation of a variety of conditions including dysphagia, reflux, pain and nausea may require manometry, pH and emptying studies to understand completely and to most effectively plan a treatment program.