胃轻瘫

迹象 & 症状

胃轻瘫的症状从轻微到严重不等，通常包括:

• 恶心想吐
• 呕吐
• An early feeling of fullness when eating
• 减肥
• 腹部肿胀
• Abdominal discomfort

诊断

A diagnosis of gastroparesis begins with X-rays and an endoscopy. If your doctor does not detect another problem, 建议进行下列检查以作出明确诊断.

• 内窥镜检查. During this procedure, 用柔性内窥镜观察胃肠道上半部分. The areas examined include the esophagus, or the swallowing tube leading to the stomach, the stomach and the beginning of the small intestine, called the duodenum.

The procedure is performed using an endoscope, 这是一个很长的, 薄而柔韧的管子，末端有一个微型摄像机和灯. By adjusting the various controls on the endoscope, 胃肠病学家可以安全地操作仪器，仔细检查上消化系统的内壁. 内窥镜包含一个通道，允许仪器通过以获取组织样本, remove polyps and provide other therapy. 来自内窥镜的高质量图像显示在电视显示器上. 在许多情况下，上消化道内窥镜检查比x线检查更精确.

• Gastric emptying scan. 对于这个测试, 你会吃食物, 典型的蛋, that contain a very safe radioisotope, a slightly radioactive substance that will show up on the scan. 放射性同位素的辐射剂量很小，没有危险. 吃完, 你将躺在一台机器下面，它会显示食物在胃里的图像，以及食物离开胃的速度. 如果60 ~ 90分钟后胃中仍有一半以上的食物，则可诊断为胃轻瘫. 然而，有时需要多次胃排空扫描来检测胃轻瘫.
• 测压法. A test that measures the strength of your stomach contractions.
• Electrogastrogram. 这项测试适用于出现不明原因的恶心和呕吐的患者. During the one-hour procedure, electrodes are placed on your stomach, which record the electrical activity of your stomach. 这必须在空腹的情况下进行，然后再吃流食.

治疗

Dietary requirements

胃轻瘫的治疗需要遵循一定的饮食要求, 比如每天少吃多餐，避免吃难以消化的食物. These include fatty foods, legumes, lentils and citrus fruits. If you have gastroparesis as a complication of diabetes, you may need to increase your insulin therapy.

药物

药物 also are used to treat gastroparesis. One of the most effective is metoclopramide, which helps the stomach to empty by stimulating stomach activity. It also may relieve nausea and vomiting. Common side effects include drowsiness and fatigue. 除了, some people may experience 抑郁症, 运动障碍, anxiety and breast tenderness or discharge. 甲氧氯普胺不推荐用于帕金森病患者.

The antibiotic erythromycin also improves stomach emptying, but its side effects of nausea, vomiting and abdominal cramps limit its usefulness. 另外一种叫做多潘立酮的药物在美国没有被批准使用. 多潘立酮通过刺激胃运动来促进胃排空, relieves nausea and has few side effects. Additional new methods are being evaluated in studies, and it is recommended that you speak to your doctor about these.

If drugs do not work for you, your doctor may recommend a jejunostomy tube, which allows food to bypass your stomach. 液体营养, 在严重的胃轻瘫发作时，液体和药物通过管子直接输送到小肠. In extreme cases of gastroparesis, 患者可能需要半永久性静脉注射(IV)，将营养物质和液体直接输送到血液中.

其他的治疗方法

Gastric electrical stimulation uses a device, surgically implanted in the abdomen, 向胃下部的神经和平滑肌传送轻微的电脉冲. 这种刺激可以减轻由糖尿病或不明原因引起的胃轻瘫患者的慢性恶心和呕吐.

If gastroparesis is related to an injury of the vagus nerve, patients may benefit from a procedure called pyloroplasty. 这个过程扩大和放松将胃与小肠上部分开的瓣膜, called the pyloric valve. This allows the stomach to empty more quickly. 在某些情况下, before deciding to perform the procedure, 将肉毒杆菌毒素(Botox)注射到幽门瓣膜处，使其暂时麻痹和放松. 这有助于我们确定患者是否能从幽门成形术中获益.