Gastroparesis

Clinic

• Also called delayed gastric emptying, is an entity belonged to category of GI motility disorders
• Weak peristalsis of stomach, resulting in prolonged food and liquid remaining in stomach
• This can result in irregular absorption of nutrients, inadequate nutrition, and poor glycemic control.
• Probable mechanism is autonomic neuropathy (Vagus nerve)
• Uncontrolled diabetes mellitus is its major causation.
• Other causes include post-infectious and trauma to the vagus nerve.
• Idiopathic gastroparesis (33% of all chronic cases); Due to an autoimmune response triggered by an acute viral infection:
  1. Gastroenteritis
  2. Mononucleosis

Signs / Symptoms

• Symptoms include Nausea (Esp Morning), Vomiting, Abdominal pain, Early satiety, Abdominal bloating and Heartburn.

• Other symptoms:
  • Myalgia
  • Erratic blood glucose levels
  • Lack of appetite
  • Muscle weakness
  • Night sweats
  • Palpitations
  • Spasms of the stomach wall
  • Constipation or infrequent bowel movements
  • Weight loss, malnutrition
  • Dysphagia

Miasms

PLV

Fantastically, many accompanied Sign / Symptoms of Gasteroparesis are similar to PLV such as muscular weakness, Dyspahgia

Related entities

• GERD
• Ileus
• Achalasia
• Gastritis

Related Disease

• Connective tissue diseases such as scleroderma
• Ehlers–Danlos syndrome
• Parkinson's disease
• Multiple system atrophy. It may occur as part of a mitochondrial disease.
• Opioids and anticholinergic medications can cause medication-induced gastroparesis.
• Damage to the vagus nerve, such as abdominal surgery
• Heavy cigarette smoking

Mechanism

• On the molecular level, it is thought that gastroparesis can be caused by the loss of neuronal nitric oxide expression
• Other important components of the stomach are the interstitial cells of Cajal (ICC) which act as a pacemaker since they transduce signals from motor neurons to produce an electrical rhythm

Pathogenesis of symptoms in diabetic gastroparesis include:

• Loss of gastric neurons containing nitric oxide synthase (NOS) is responsible for defective accommodation reflex, which leads to early satiety and postprandial fullness.
• Impaired electromechanical activity in the myenteric plexus is responsible for delayed gastric emptying, resulting in nausea and vomiting.
• Sensory neuropathy in the gastric wall may be responsible for epigastric pain.
• Abnormal pacemaker activity (tachybradyarrhythmia) may generate a noxious signal transmitted to the CNS to evoke nausea and vomiting.

Gastroparesis black box

Entities	Miasms	Remedies
Gastric Dilation	PLV	GELS PLB, LACH, BELL Caust, Sil Op, Hell, Cocc, Alum, Sulph, Phos, Merc, Agar

Remedies

Abdominal Bloating	Lyc	Lycopodium Clavatum is an effective homeopathic medicine for gastroparesis with marked abdominal bloating. The bloating is noted even after eating a little bit of food. There may be constrictive pains in the stomach that are relieved by rubbing the stomach. There may be a gnawing and gripping sensation in the stomach, and clothes around the stomach may cause uneasiness. Some other complaints that indicate the need for this remedy include loss of appetite, coldness in the stomach, and violent hiccoughs.
Vomiting of Food	Hydr	Hydrastis Canadensis is a well-indicated homeopathic medicine for gastroparesis where there is vomiting of food. The main symptoms include a sensation of a lump in the stomach followed by regurgitation that causes vomiting of the food eaten. Some people also experience distressing and cutting pain in the stomach along with weakness and weight loss.
Stomach Pain after Eating	Puls	Pulsatilla Nigricans is an effective homeopathic remedy for gastroparesis with stomach pain after eating. The pain usually begins an hour after eating. The patient may feel chilly, and a tightness in the stomach may also appear. The stomach is sensitive to the least pressure. Belching that tastes like food may be present, and all these symptoms tend to get work after eating fatty food and fruits. Other characteristic features include dry mouth, bitter taste in the mouth and a lack of thirst.
Sensation of Weight in the Stomach	Chin	China Officinalis is a natural homeopathic medicine for gastroparesis when there is a sensation of weight in the stomach after eating. The digestion becomes very weak and slow. Belching of bitter taste is present, and the food may be regurgitated. There is a rumbling and pulsating sensation at the pit of the stomach.
Sensation of Hard Knot in the Stomach	Nux-v	Nux Vomica offers a natural cure for gastroparesis when the person feels as if the food is sitting in the stomach in a hard knot. The stomach area is sensitive to touch, and there may be nausea or vomiting, and retching. The vomit contains undigested food or greenish matter. Vomiting relieves nausea. Another important feature is a sour taste in the mouth.
Fetid Belchings	Bism	Bismuth is a natural medicine for stomach paralysis where the person experiences intense, fetid belchings. The food lies in the stomach for several days due to weak digestion. There is pressure and the sensation of a load in the stomach after eating. This is followed by vomiting of that food. There may be stomach pain which is relieved by bending backward in most cases.
Heartburn/Acid Reflux	Carb-v	Homeopathic Medicine Carbo Veg offers a natural cure for gastroparesis that is attended with heartburn or acid reflux. There are sour belchings and water brash after eating attended with fullness and a tensed sensation in the stomach. The epigastric region is also sensitive and tender to touch. Contractive pain in stomach extending to the chest is another characteristic feature. The above features are noted even from eating the simplest kind of food.