Dr. Matthew Smith explains what gastroparesis is and how it can be treated.

What is gastroparesis?

Gastroparesis is where the stomach doesn't necessarily function as well as it should. It doesn't grind up food and push it through into the small bowel as quickly as it should. Patients a lot of times will complain of bloating, nausea, vomiting, and abdominal pain.

How do you treat gastroparesis?

Depending on the type of gastroparesis you're dealing with (diabetic, idiopathic, narcotic) determines the way we treat it.

Diabetic gastroparesis

There are a couple of procedures that can be offered.

  1. Pyloroplasty - We cut the muscle between the stomach and the first part of the small bowel called the duodenum. That can either be done endoscopically (no incisions on the belly but a scope down the throat) where we cut that muscle. That's called a POEM or pylorum endoscopic pyloromyotomy. The other one can be done laparoscopically with tiny incisions through laparoscopic ports with long instruments and a long camera with a lighted tube on the end of it.
  2. Gastric stimulator - Sometimes we actually skip the pyloromyotomy in diabetic gastroparesis, and we put in what we call a gastric stimulator. That's this implantable device that helps to stimulate the stomach function and squeezing in order for it to help empty.

Idiopathic gastroparesis

With idiopathic, we usually start with a pyloromyotomy or pyloroplasty, just like we talked about for diabetic gastroparesis, using either an endoscopic or laparoscopic approach. We can move on to other techniques after that.

It really takes the right patient and expectations to know exactly where to head with gastroparesis.