Anorexia and gastroparesis

No items found.
No items found.

What is gastroparesis? Gastroparesis (literally meaning “stomach paralysis) is a condition that affects the movement and muscles involved in emptying the stomach and moving food onward down the digestive tract. In a normal digestive tract, strong muscular contractions push the food from the stomach to the intestines. 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)

Last updated on 
In this article

How does anorexia lead to gastroparesis?

People suffering from gastroparesis anorexia severely limit food intake, resulting in:

  • Increasing weight loss 
  • Effects on the skin, hair, and nails 
  • Muscle weakness 
  • Dizziness or fainting
  • Malnutrition. 

Just as the visible muscles lose strength and the body weakens, internal muscles are affected the same way. Because of the severely restricted food intake, the muscles in the digestive system are not used as often. 

These internal muscles begin to atrophy, or lose tone and strength. Just as someone’s legs would atrophy if they aren’t used, the stomach muscles do the same. Eventually, gastroparesis develops – the process of emptying the stomach slows or even stops altogether. (2)

How is gastroparesis diagnosed?

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

There are two types of gastric emptying tests, which determine how fast your stomach empties its contents. 

  1. Scintigraphy: This test involves eating a light meal that contains a small amount of radioactive substance. A scanner can detect how the radioactive material moves through the stomach, and at what rate. 
  2. Breath test: This test follows the same principle, although the food contains a substance that is detected on your breath as it absorbs. Breath samples are collected every few hours and the level detected is analyzed. This test detects how fast the stomach empties and absorbs nutrients.

Another type of test used for diagnosis is the upper gastrointestinal (GI) endoscopy, commonly called an “upper GI.” In this test, the patient is mildly sedated while a tube with a tiny camera is inserted through the mouth and down the esophagus, stomach, and sometimes small intestine. This test can rule out other conditions such as ulcers or pyloric stenosis (a narrowing of the stomach valve).

Ultrasound of the abdomen can also be used to rule out other conditions, such as gallbladder disease. This involves using a device over the stomach that produces a picture of the internal structures. (3)

You might be interested in

Physical effects of gastroparesis

Symptoms of decreased digestive movement from gastroparesis may include any of the following:

  • Early fullness, soon after beginning a meal
  • Feeling full too long after a meal
  • Nausea and vomiting
  • Bloating and belching
  • Upper abdominal pain
  • Acid reflux and heartburn
  • Poor appetite

These effects are concerning for the treatment of 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 normal response. This can cause problems in treatment due to feelings of over-fullness and a lack of desire to eat. 

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

  • 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)

What is the treatment for gastroparesis?

Treatment for gastroparesis is most effective when it is started early, however this is complicated further by restrictive eating behaviors and distorted body image in people with anorexia nervosa and other eating disorders. 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. For individuals undergoing treatment for their eating disorder, it is important that symptoms be recorded, and any changes thoroughly examined. 

The best treatment for gastroparesis is prevention and treatment of any underlying conditions or behaviors that may be contributing to it. 

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

  • 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 there is no “cure” 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.

Resources

  1. Mayo Foundation for Medical Education and Research. (2020, October 10). Gastroparesis. Mayo Clinic. Retrieved April 4, 2022, from https://www.mayoclinic.org/diseases-conditions/gastroparesis/symptoms-causes/syc-20355787 
  2. Abdominal Issues, G. I. A. (2020, March 17). Eating disorders and GI problems: GI Alliance: Gastroenterology. GI Alliance. Retrieved April 4, 2022, from https://gialliance.com/eating-disorders-and-gi-problems-understanding-the-connections/ 
  3. Mayo Foundation for Medical Education and Research. (2020, October 10). Gastroparesis. Mayo Clinic. Retrieved April 4, 2022, from https://www.mayoclinic.org/diseases-conditions/gastroparesis/diagnosis-treatment/drc-20355792 
  4. U.S. Department of Health and Human Services. (n.d.). Symptoms & causes of gastroparesis. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved April 4, 2022, from https://www.niddk.nih.gov/health-information/digestive-diseases/gastroparesis/symptoms-causes 

FAQs

Further reading

Thumbnail image of an article

Anorexia's effect on your organs

All organs are affected by anorexia nervosa (AN) and starvation, some...
Thumbnail image of an article

Why does anorexia bloating occur?

Bloating is something that can occur in the gastrointestinal (GI) tract and cause...
Thumbnail image of an article

Why anorexia causes bruising

Bruising in the body results from outside pressure to the skin and tissue, such as a...
Thumbnail image of an article

What happens to hair growth when you have anorexia?

Anorexia nervosa (AN) is a severe eating disorder characterized by an extreme fear of...
Thumbnail image of an article

What are the effects of anorexia on teeth and oral health?

Anorexia nervosa (AN) is a mental health disorder that can lead to...
Thumbnail image of an article

What are common anorexia nervosa complications?

Individuals struggling with anorexia nervosa (AN) are in danger of developing a...
Thumbnail image of an article

Understanding yellow skin in anorexia nervosa

Anorexia nervosa (AN) is a serious medical condition that can cause damage to the...
Thumbnail image of an article

The connection between anorexia and edema

Edema anorexia is common in patients with both subtypes of anorexia, with...
Thumbnail image of an article

Refeeding syndrome and anorexia

Refeeding syndrome is a constellation of symptoms that can occur when an individual...
Thumbnail image of an article

How does anorexia affect the brain?

Anorexia nervosa (AN) is a disorder of undereating, and results in profound...
Thumbnail image of an article

How does anorexia affect eyesight?

The eyes, like any other organ, need proper nutrients to function. People living...
Thumbnail image of an article

How anorexia nervosa can affect heart rates

Those who struggle with anorexia nervosa (AN) severely restrict what they eat due...
Thumbnail image of an article

How anorexia nervosa affects your hands

You may not realize that anorexia nervosa (AN) can literally affect every part of the...
Thumbnail image of an article

Does anorexia cause mood swings?

Anorexia nervosa (AN) is a serious eating disorder that involves caloric restriction...
Thumbnail image of an article

Can eating disorders cause anemia?

Anemia is a condition that occurs when there aren’t enough healthy red blood cells in the...
Thumbnail image of an article

Anorexia’s effect on hair growth

One body system, among others, that anorexia nervosa (AN) impacts is the...
Thumbnail image of an article

Anorexia nervosa and brain fog: What is it?

Brain fog is considered to be a temporary mild cognitive impairment and sometimes...
Thumbnail image of an article

Anorexia nervosa ketoacidosis symptoms

Ketoacidosis, or ketosis, is a metabolic state where the body has high con...
Thumbnail image of an article

Anorexia and your digestive system

Anorexia nervosa (AN) can definitely affect your digestive system. One of the most...
Thumbnail image of an article

Anorexia and the kidneys

Those who struggle with anorexia nervosa (AN) and bulimia nervosa (BN) often develop...
Thumbnail image of an article

Anorexia, bone pain, joint pain, and body aches

Anorexia nervosa (AN) is a serious eating disorder that affects both the...
Thumbnail image of an article

Anorexia and irritable bowel syndrome

Research highlights the increased prevalence of irritable bowel syndrome...
Thumbnail image of an article

Anorexia and hypermetabolism

Hypermetabolism is when the metabolic system is hyperactive so much that the...
Thumbnail image of an article

Anorexia and lower back pain

Individuals with anorexia nervosa (AN) live with an intense fear of gaining...
Thumbnail image of an article

Anorexia and gastroparesis

Gastroparesis (literally meaning “stomach paralysis) is a condition that affects the...
Thumbnail image of an article

Anorexia and cachexia

Cachexia is a very serious, complex condition that occurs with anorexia...
Thumbnail image of an article

Anorexia and constipation

Most people experience constipation at some point. This can happen for many reasons...