GI Motility Disorders Unit

Treatment of gastroparesis includes diet, medication, and devise or procedures that facilitate emptying of the stomach. While gastroparesis cannot be cured, the goals of treatment are to relieve symptoms, control the underlying conditions that may be aggravating gastroparesis, or stimulate muscle activity in the stomach so that food is properly emptied from the stomach.

Dietary modifications

Dietary changes are one of the primary treatments for gastroparesis. To facilitate faster stomach emptying, smaller, more frequent portions of food are recommended. Foods high in fat or fiber (for example, raw fruit and vegetables) empty slower in the stomach and should be avoided.

To help with digestion food should be chewed well since the grinding action of the stomach is reduced. Generally, soft foods and liquids can be digested more easily as in gastroparesis the emptying of liquids often is less severely affected than the emptying of solids. To aid digestion, most meals should be taken early in the day and avoid lying down for a few hours afterwards, since when lying the assistance of gravity on gastric emptying is lost.

Jessica Peters is a dietitian based at the Royal Melbourne Hospital. She specialises in patient care associated with gastrointestinal and metabolic disorders. Her personal interest lies in gastroparesis; having not only conducted extensive research into dietary therapy for patients with gastroparesis,
but also through her private dietetic practice where she works with patients at all stages of gastroparesis. Jessica presents a broad all-encompassing talk on the management of nutritional needs in gastroparesis patients.

High-Definition 1080p Duration 32 minutes

Diabetes

In people who have diabetic gastroparesis, controlling the underlying condition is an important part of their treatment. High levels of blood glucose have been associated with delayed gastric emptying. Therefore, it is important to lower blood glucose levels in patients with diabetes to near normal levels with diet and medications.

Medications

Antimetics and prokinetics are the two main types of medications that can reduce the symptoms of gastroparesis. Antiemetics are drugs used to relieve symptoms such as nausea and vomiting. Some gastroparesis sufferers may benefit from prokinetic agents, which enhance the muscular contractions of the stomach and help move food along.

The administration of oral drugs should be done before a meal, since the goal of treatment is to stimulate muscular contractions during and immediately after a meal. Most drugs must be emptied from the stomach and absorbed in the small intestine. This can be a problem in patients with delayed emptying of solids foods as well as pills and capsules. Therefore, liquid medications are often more effective than pills or capsules as the majority of gastroparesis patients have less of a problem emptying liquids.

A/Professor Hebbard serves as the Director of Gastroenterology and Hepatology at The Royal Melbourne Hospital. He delivers a presentation that explores the challenges and solutions of managing gastroparesis, both from a doctor and a patient perspective.

High-Definition 1080p Duration 54 minutes

Gastric electrical stimulation

Gastric electrical stimulation is a newer method for treating severe gastroparesis. This approach involving electric stimulation of the stomach is analogous to cardiac pacing for the treatment of an abnormally slow heartbeat and involves the placement of a pacemaker. The pacemaker is surgically inserted beneath the abdominal skin and wire electrodes are attached to the muscle of the stomach. The battery-operated pacemaker generates electrical impulses that are transmitted to the stomach and the the muscles contract in response to the impulses. Gastric electrical stimulation has proven to be effective in patients with severe gastroparesis, but the treatment is expensive and the number of patients been treated relatively small.

A/Professor Gregory O’Grady specialises in gastrointestinal surgery at the Auckland City Hospital, New Zealand, and directs the Surgical Engineering Laboratory at the University of Auckland. His talk covers the consequences for electrical pacemaking in the stomach, as well as the emergence of diagnostic techniques such as "high-resolution electrical mapping”. A/Prof. O’Grady evaluates the current role of gastric electrical stimulation and evolving ‘gastric pacing’ techniques.

High-Definition 1080p Duration 44 minutes