What Causes Gastroparesis?
Experts are not sure what causes gastroparesis. The condition may be caused by:
- Nerves located in the wall of the stomach that don’t work properly
- “Pacemaker cells” in the wall of the stomach that don’t work properly
- Some kind of dysfunction of the wall of the stomach itself
Doctors do not yet understand why some children develop this condition and others do not. Risk factors include:
- Conditions such as an infection, diabetes, hypothyroidism, neurologic disorders and metabolic disorders
- Certain types of gastrointestinal surgeries. This includes surgery that helps control reflux in patients with gastroesophageal reflux disease (GERD).
- Certain medications and chemotherapy drugs
- Birth defects that affect the stomach or abdomen
What Are the Signs and Symptoms of Gastroparesis?
The most common symptoms of gastroparesis include:
- Upper abdominal discomfort or pain
- Feeling full after only a few bites of food
- Excessive burping or belching
Some children with gastroparesis avoid eating because this can make them feel worse. This can lead to weight loss, malnutrition and dehydration. Some children with gastroparesis find that eating small amounts of food throughout the day lessens their symptoms.
How Is Gastroparesis Diagnosed?
A pediatric gastroenterologist can diagnose and treat children who have symptoms of gastroparesis.
The pediatric gastroenterologist will take a careful medical history and examine your child during your child’s first appointment. Many conditions cause symptoms similar to those of gastroparesis. The doctor may order other tests to determine what is causing your child’s symptoms.
The “gold standard” test for diagnosing gastroparesis is a nuclear medicine test called gastric emptying scintigraphy. Your child eats food mixed with a small and safe amount of a radioactive substance. Then a technician uses a scanner to track how the substance moves through the digestive system. This test takes about four hours. The results show how quickly food is leaving your child’s stomach.
Other tests can help the care team understand the cause of your child’s gastroparesis. These may include:
- Endoscopy. A small, flexible tube (catheter) is placed through the mouth into the stomach to see whether anything is blocking the opening from the stomach to the small intestine (pylorus). A blockage in this area can cause gastroparesis. This test is done in a special procedure room using anesthesia. Your child will be asleep for the test.
- An X-ray study. This test is another way to see if anything is blocking the pylorus.
- Antroduodenal manometry. A catheter is placed through the nose into your child's stomach and small intestine to measure pressure. This can help the care team understand if the cause of your child’s condition is related to a problem with nerve signals.
What Are the Treatment Options for Gastroparesis?
The care team will develop a treatment plan for your child. Many children need a few different therapies. Your doctor will work with you to find the best treatment for your child.
Treatment options include:
- Treating any condition that is causing the gastroparesis
- A special diet that includes:
- Avoiding high fat foods and high fiber foods
- Eating several, small meals a day
- Adding more liquids to your child’s diet. Liquids leave the stomach faster than solids
- Medicines to control nausea, improve stomach emptying and relieve pain
- Procedures such as Botox injections and balloon dilation. These can help if the area from the stomach to the small intestine is too narrow.
- A feeding tube that delivers food directly into the small intestine. This is used when gastroparesis is so severe that the child cannot keep any food or liquids down.
- Gastric electrical stimulation. This treatment involves surgically implanting a device that stimulates the stomach with mild electrical pulses. This allows food to move through the stomach more normally. It can relieve the symptoms of gastroparesis. Learn more about gastric stimulation.
What Is the Long-Term Outlook for Children with Gastroparesis?
Most children with gastroparesis get relief from their symptoms with careful treatment. The symptoms eventually go away in many cases. Gastroparesis is a chronic, long-term condition for some children. Your child’s care team will help you and your child manage the symptoms of gastroparesis and experience the best health possible.
For information about the specialized care Cincinnati Children’s offers to children with gastroparesis, contact the intake coordinator for the Neurogastroenterology and Motility Disorders Center at 513-803-0776 or send an email to Motility2@cchmc.org.