Digestive tract paralysis (DTP) is a group of gastric motility disorders.
Gastroparesis (GP) is precisely what it sounds like: Paralysis of the stomach.
GP can be challenging to diagnose, but there is testing available. A suspected patient may undergo many tests, like gastric emptying studies, manometry, endoscopies, colonoscopies, and electrogastrograms.
Another form of DTP is Chronic Intestinal Pseudo-Obstruction (CIP). CIP causes symptoms of intestinal blockage, even if a physical blockage is not actually present. Nerve or muscle problems lead to decreased intestinal motility.
CIP can mimic more common conditions, making it particularly difficult to diagnose. Abdominal x-rays and CT scans, intestinal manometry, barium follow-through testing, colonoscopies, and intestinal biopsies can aid in attaining a diagnosis of CIP.
Symptoms of GP and CIP can include severe abdominal pain, cyclic vomiting, loss of appetite, esophageal spasms, abdominal obstructions or blockages, excessive abdominal distention or bloating, malnutrition, weight loss or gain, dehydration, acid reflux, and erratic blood sugar levels.
There are many causes for DTP such as mitochondrial disease, diabetes, neurological disorders, viral infections, abdominal surgery, autoimmune diseases, and rheumatoid conditions. DTP can also be idiopathic, meaning that the cause is unknown.
There is no cure for DTP, but there are treatments that may provide symptomatic relief for some patients. For mild cases, sometimes dietary changes can be enough to manage symptoms. Some medications can be tried in an effort to speed motility. Anti-nausea medication can be helpful as well. Botox injections in the pyloric sphincter can be administered via endoscopy, which can help motility in some cases. Many patients, especially those with cyclic vomiting have found relief from the placement of a gastric pacer. In very severe cases, a gastrectomy (partial or complete removal of the stomach) or a multivisceral transplant (transplantation of the stomach, small bowel, duodenum, pancreas, and in some instances the liver) are performed.
For many DTP patients eating is very challenging or impossible, so supplementation is necessary to prevent malnutrition. Some patients are able to tolerate enteral feeding through a G-tube (a tube placed in the stomach) or a J-tube (a tube that is placed in the jejunum, bypassing the stomach). Still other patients require nutrition that bypasses the digestive tract completely, relying on total parenteral nutrition (TPN), which is nutrition administered through a vein.
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