Reflux and Gastroparesis – The Chicken or The Egg?
Reflux is a very common disease and what’s interesting about reflux is it actually can be caused by, or cause other diseases that go unrecognized.
In particular, the stomach emptying is very important as a normal way that your body functions that creates the gastric pressure that impacts the development of the reflux. If the stomach is emptying slowly, which we would call gastroparesis, the gastric yield pressure is elevated which may either cause reflux, and in many cases it can be caused by reflux.
We know that up to 45% of patients who have reflux will have gastroparesis. Interestingly, of that group, maybe 25% percent of them it’s actually the gastroparesis that causes the reflux. What about the other 75% where it’s actually the reflux causing the gastroparesis?
This occurs because the stomach cannot contract normally and push the food out through the bottom of the stomach because the lower esophageal sphincter valve is so loose, that gastric contents constantly move up into the esophagus, and pressure cannot develop in the stomach to allow emptying.
The positive thing is when we make that connection that it’s actually the reflux causing the gastroparesis, by correcting the reflux either by Nissen fundoplication or a Stretta procedure, we know that either these two procedures will also correct the gastroparesis at the same time.