Reaction to "The Facts About Gastroparesis"

This is an interesting article on gastroparesis (Click on gastroparesis to follow the link to John Casson's work). A major problems with this diagnosis is that a lot of the risk factors, symptoms, and treatments overlap with gastric dumping syndrome, and it even shares some with chronic mesenteric ischemia.

Here are some overlapping risk factors:

diabetes- all 3

gastric surgery - gastroparesis and gastric dumping more so than mesenteric ischemia

Here are some overlapping symptoms:

These include:

Stomach pain-all 3

Abdominal bloating-all 3

Reduced appetite-all 3

Premature feeling of fullness-all 3

Nausea/dry heaving-all 3

Acid reflux-all 3

Heartburn-all 3

Vomiting undigested food- more so gastroparesis

malnutrition-all 3

underweight- all 3

Here are some overlapping treatments:

eating smaller more frequent meals

I wonder what percentage of those diagnosed with gastroparesis actually have a gastric dumping syndrome or a chronic mesenteric ischemia?

One of the things that can help doctors determine which is what is taking a look at the blood sugars of a diabetes post-meal. Dumping syndromes especially early dumping syndromes tend to cause a hyperglycemic spike followed by a hypoglycemic reactions as the small intestines secrete large amounts of hormones to counter all the glucose hitting the small intestines. Gastroparesis on the other hand tends to have their blood sugar bottom out followed by a spike because the sugar is not reaching their blood stream in tandem with the insulin made by the body. It seems that in chronic mesenteric ischemia patients there is not a lot of information on post meal blood sugars but I am guessing based on the small meal sizes that the blood sugars will rise but probably not by much. Their fasting blood sugar will probably be on the low secondary to weight loss from food aversion and poor glycemic control due to diabetes which is a common risk factor of this condition.

The patient with gastric dumping will tend to favor higher fat and protein meals while gastroparesis patients tend to avoid those meals. People with CMI are often prescribed a low fat diet as too much dietary fat is believed to be the cause of atherosclerosis but patients who have developed a protein losing enteropathy as a result of CMI it is recommended that they have a high protein and fat diet. Whether or not they crave and naturally gravitate towards this diet I was not able to find out.

Bowel movements seem to be a very helpful sign in determining gastroparesis vs gastric dumping. In gastric dumping patients tend to have diarrhea while in gastroparesis patients tend to have constipation. In chronic mesenteric ischemia you can have both but if you have GI bleeding it tends to be a sign that you have chronic mesenteric ischemia.

Other systemic signs can help distinguish between the three conditions. Palpitations are more common in gastric dumping syndrome and chronic mesenteric ischemia (risk factors) but can occur in gastroparesis. Peripheral edema maybe present in both gastric dumping and in gastroparesis but this is unlikely to be related to the condition. In CMI peripheral edema is more to occur because the same atherosclerotic processing that is causing issues in their gut is showing up in the heart arteries as well.

If you have any other topics that you are interested in me researching please let me know and I will research them as soon as I can. Also please feel free to leave your questions comments and concerns.