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Learn more about the results we get at Within

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Anorexia and gastroparesis

Gastroparesis (literally meaning “stomach paralysis”) is a condition that affects the muscles that move food through the stomach and digestive tract. 

In a normal digestive tract, strong muscular contractions push the food from the stomach to the intestines. Gastroparesis slows or stops this movement entirely, causing pain, discomfort, and other issues.

Gastroparesis can be a complication of several diseases and conditions, and sometimes the cause is completely unknown. Diabetes, gastric surgery, medications, and eating disorders like anorexia nervosa (AN) can all lead to gastroparesis.1,2

Gastroparesis can be a complication of several diseases and conditions, and sometimes the cause is completely unknown. Diabetes, gastric surgery, medications, and eating disorders like anorexia nervosa (AN) can all lead to gastroparesis.1,2

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5
 minute read
Last updated on 
August 6, 2024
In this article

How does anorexia lead to gastroparesis?

People with anorexia nervosa have an extreme fear of gaining weight and will generally severely limit their food intake as a result. This can lead to many medical complications, including the atrophying (or wasting away) of muscles.

But just as the visible muscles lose strength, so too do the internal muscles. When food intake is limited so severely, the muscles in the digestive system are not used as often, causing them to also atrophy or lose tone and strength. 

This can eventually lead to the development of gastroparesis, causing the process of emptying the stomach to slow or even stop altogether.2

How is gastroparesis diagnosed?

Gastroparesis is diagnosed via several tests, depending on symptoms, or to rule out other similar conditions.3

Scintigraphy
Breath test
Upper gastrointestinal endoscopy
Ultrasound

Physical effects of gastroparesis

Symptoms of decreased digestive movement from gastroparesis may include any of the following:1,2,4

  • Early fullness, soon after beginning a meal
  • Feeling full too long after a meal (due to delayed gastric emptying)
  • Nausea and vomiting
  • Distended and bloated stomach
  • Upper abdominal pain
  • Acid reflux (gastroesophageal reflux disease) and heartburn
  • Poor appetite and early satiety

These effects are concerning for the treatment of gastroparesis anorexia. As a person suffering from this eating disorder is learning to regulate food intake and listen to body cues about hunger, gastroparesis can alter the typical response. This can cause problems in treatment due to feelings of over-fullness and a lack of desire to eat.  

Issues with medications

To complicate the matter even further, certain medications can make gastroparesis symptoms worse:4

  • Narcotic pain medications such as codeine, hydrocodone, morphine, oxycodone, and tapentadol
  • Antidepressants such as amitriptyline, nortriptyline, and venlafaxine
  • Some anticholinergics used to treat overactive bladder

It is important that a person dealing with anorexia (even if in recovery) and simultaneously diagnosed with gastroparesis seek professional treatment from someone familiar with both conditions.4

Treating eating disorders and gastroparesis

The most effective way to treat gastroparesis is to start early. However, this can be complicated by the restrictive eating behaviors in people with anorexia nervosa and other eating disorders. Many people struggling with these conditions are also in denial that a problem exists, which can stop them from seeking out help.

Typically, the first symptoms of gastroparesis are nausea, vomiting, and early fullness. All of these may be symptoms that people dealing with anorexia may combat on a daily basis, which can also make it hard to know when gastroparesis has developed.

The best treatment for gastroparesis is the prevention and treatment of any underlying conditions or behaviors that may be contributing to it—including eating disorders. For individuals undergoing treatment for their eating disorder, it is important that symptoms be recorded and any changes thoroughly examined. 

Personalized anorexia treatment at home
Partial hospitalization and intensive outpatient programs
Personalized meal delivery
Insurance options
Dedicated care team

Types of treatments used

After gastroparesis has progressed, there are a few treatment options that can help:3

  • Dietary modification: Eating several small meals daily to reduce symptoms of over-fullness and promote nutritional intake. Drinking fluids between meals and not with meals. Eat soft and easily digestible foods, chewing thoroughly. Avoid carbonated beverages. 
  • Medications: Metoclopramide is the most used, while some others are used off-label and are currently undergoing FDA evaluation. This drug promotes gastric movement and emptying. Other medications are those commonly used for nausea and vomiting.
  • Gastric electrical stimulation: Uses an implanted device to provide nerve stimulation and promote gastric emptying. 
  • Nutritional supplementation: Some patients with advanced gastroparesis find that supplementation through a feeding tube in the stomach or small intestine or total parenteral nutrition (TPN) is needed to maintain weight and hydration. This is typically a later-stage treatment after other plans have failed to work. 

Although no “cure” exists for gastroparesis, research is ongoing to develop more treatment options. Individuals with anorexia nervosa or a history of it should be aware of the symptoms and seek treatment from a qualified gastroenterologist. Early treatment is always the best. 

Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.

Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.

Resources

  1. Gastroparesis. (2020, October 10). Mayo Clinic. Retrieved April 4, 2022. 
  2. Eating disorders and GI problems: GI Alliance: Gastroenterology. (2020, March 17). GI Alliance. Retrieved April 4, 2022.
  3. Gastroparesis. (2020, October 10). Mayo Clinic. Retrieved April 4, 2022.
  4. Symptoms & causes of gastroparesis. (n.d.) National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved April 4, 2022.
  5. Parkman, H. P., Van Natta, M., Yamada, G., Grover, M., McCallum, R. W., Sarosiek, I., Farrugia, G., Koch, K. L., Abell, T. L., Kuo, B., Miriel, L., Tonascia, J., Hamilton, F., & Pasricha, P. J. (2021). Body weight in patients with idiopathic gastroparesis. Neurogastroenterology and Motility, 33(2), e13974.

FAQs

What does gastroparesis pain feel like?

Gastroparesis can feel very uncomfortable. Symptoms of the condition can include:4

  • Sudden, sharp stomach pain that doesn’t go away
  • Difficulty breathing
  • Severe abdominal cramping or pain
  • Feeling of extreme weakness or fainting
  • Vomiting for more than an hour
  • Constipation

Does anorexia cause gastroparesis?

Anorexia nervosa can contribute to the development of gastroparesis. When someone severely restricts their food intake, it can lead to the weakening of digestive muscles, which can ultimately lead to gastroparesis.

Can gastroparesis cause weight gain?

Possibly. Some studies have connected gastroparesis with weight gain in some patients, though it was difficult to separate gastroparesis from other possible factors that would contribute to weight gain.5

How long does gastroparesis last?

It depends. Gastroparesis can sometimes be caused by a virus; the issue usually goes away relatively quickly. But when caused by anorexia nervosa or other serious conditions, the symptoms can last much longer or even stay through early recovery.

Further reading

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