Delayed gastric emptying refers to the stomach's inability to properly grind and break down food before it reaches the intestines. In almost all cases, the condition results from damage to the nerve that controls stomach muscles called the vagus nerve. Stomach muscles are left partially or fully paralyzed when the vagus nerve is inactive, which severely impacts digestion. This condition can be difficult to treat, but maintaining a specialized diet and taking prescription medications can relieve bloating, cramping, nausea, and other symptoms.
When food is ingested, muscles in the stomach churn the contents and grind solids into small, soft morsels. The contents are then released into the intestines to extract nutrients and process waste. If the vagus nerve is damaged or severed, the muscles cannot aid in breaking down solids. Food is very slowly eroded by stomach acids, leading to delayed gastric emptying.
Doctors have identified several potential risk factors for developing delayed gastric emptying. Long-term diabetes is the most common cause, as the disease slowly deteriorates the vagus nerve and other nerves in the body. Some people start having gastric emptying problems following surgery on the stomach or esophagus due to unintentional vagus nerve damage. Patients who take nervous system-suppressing medications for other disorders are at risk. Rarely, a severe bacterial or viral infection of the stomach can permanently debilitate stomach muscles.
The most common symptoms of delayed gastric emptying are frequent bouts of bloating, abdominal cramps, nausea, and vomiting that begin after eating and can last for several hours. Since solids cannot be immediately processed, people often feel full after ingesting very small portions of food. If the condition is not treated, a person can experience significant weight loss and malnutrition.
A doctor can diagnose this condition by performing a series of specialized tests. A common test called a gastric emptying study involves ingesting a radioactive marker that can be traced as it passes through the gastrointestinal tract. An endoscopy can also be helpful to check for undigested solids in the stomach. A doctor usually performs an abdominal x-ray as well to rule out other possible causes, such as a cancerous tumor or a congenital defect.
Treatment for delayed gastric emptying depends on the severity of digestive problems and the accompanying symptoms. Most patients are referred to clinical nutritionists to develop custom diet plans. Soft foods, nutritional supplements, vitamins, and plenty of liquids are usually recommended to prevent malnutrition and promote easy digestion. If diabetes is found to be an underlying factor, a patient may need to start or adjust insulin treatment measures. In addition, physicians usually prescribe medications to help combat nausea and vomiting. Surgery to widen the stomach opening is considered a final option if conservative treatments are ineffective.