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Gastroparesia

Definición

Es una enfermedad que reduce la capacidad del estómago para vaciar sus contenidos y no implica un bloqueo (obstrucción).

Causas

Se desconoce la causa exacta de la gastroparesia. Puede ser provocada por una interrupción de las señales nerviosas al estómago. Esta afección es una complicación común de la diabetes y también puede darse después de algunas cirugías.

Los factores de riesgo para la gastroparesia abarcan:

• Diabetes
• Gastrectomía (cirugía para extirpar parte del estómago)
• Esclerosis sistémica
• Uso de medicamentos que bloquean ciertas señales nerviosas (medicamentos anticolinérgicos)

Síntomas

Los síntomas pueden incluir:

• Distensión abdominal
• Dolor abdominal
• Hipoglucemia (en personas con diabetes)
• Náuseas
• Llenura abdominal prematura después de las comidas
• Pérdida de peso sin intentarlo
• Vómitos

Pruebas y exámenes

Las pruebas que usted puede necesitar incluyen:

• Esofagogastroduodenoscopia (EGD)
• Estudio del vaciado gástrico (utilizando el etiquetado isotópico de los alimentos)
• Tránsito esofagogastroduodenal

Tratamiento

Las personas con diabetes siempre deben controlar el nivel de azúcar en la sangre. El mejor control de estos niveles puede mejorar sus síntomas de gastroparesia. Comer alimentos en cantidades pequeñas y más frecuentes, además de alimentos blandos también puede ayudar a aliviar algunos síntomas.

Los medicamentos que pueden ayudar abarcan:

• Fármacos colinérgicos, que actúan sobre los receptores nerviosos de acetilcolina
• Eritromicina
• Metoclopramida, un medicamento que ayuda a vaciar el estómago
• Fármacos antiserotonínicos, que actúan sobre los receptores de serotonina

Otros tratamientos pueden abarcar:

• Toxina botulínica ("Botox") inyectada en la salida del estómago (píloro)
• Estimulación eléctrica del estómago
  
• Procedimiento quirúrgico que crea una abertura entre el estómago y el intestino delgado que permite movilizar más fácilmente el alimento a través del tubo digestivo (gastroenterostomía)

Expectativas (pronóstico)

Muchos tratamientos parecen brindar solamente beneficio temporal.

Posibles complicaciones

Las náuseas y los vómitos persistentes pueden causar:

• Deshidratación
• Desequilibrios de electrólitos
• Desnutrición

Las personas diabéticas pueden tener complicaciones serias a raíz del control deficiente del azúcar en la sangre.

Cuándo contactar a un profesional médico

Los cambios en su alimentación pueden ayudar a controlar los síntomas. Contacte a su proveedor de atención médica si los síntomas continúan o si aparecen nuevos síntomas.

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