Rarely, the impaired nerve supply of the lower oesophagus can affect the stomach, leading to delayed emptying of the stomach or gastroparesis. This may cause a sensation of being very full and bloated after eating. Delayed gastric emptying worsens reflux symptoms. Although this is rarely a major problem, mild forms probably occur in up to 30% of patients. If suspected, this is a secondary care/tertiary care diagnosis and management issue.
Grade 1 (most TOFs). Mild symptoms only, weight and nutrition unaffected.
Grade 2 – Moderate. Manageable by medication.
Grade 3 – Severe. Not managed by medication. Weight and nutrition not managed by oral intake. Frequent hospitalisations.