What Is Gastroparesis?

Gastroparesis is a chronic gastrointestinal (GI) condition affecting the nerves and muscles that help your stomach empty itself. When the stomach can’t move well, food sits inside, resulting in delayed digestion.e60dc2a1-f33c-4a05-9b50-8e3e8e59762980cf51bc-36de-41d2-85ba-c385bbe6bf92 Slow gastric motility (emptying of the stomach) can make you feel fuller longer and decrease your appetite. It may also cause symptoms like nausea, bloating , heartburn, and abdominal pain.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bfd34e84-1261-48fe-b774-d5e113d62669 Although there’s no cure for gastroparesis, you can often manage the symptoms with medication, lifestyle changes, and other treatment options.e60dc2a1-f33c-4a05-9b50-8e3e8e59762907e5c777-8951-4ee5-9059-d2b86a42e8a5
Types of Gastroparesis Types Healthcare providers classify gastroparesis according to its cause. Some examples include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629d11c6349-ddf7-45a0-86e6-ad0a238e9ea4e60dc2a1-f33c-4a05-9b50-8e3e8e597629af6c3bc3-8e19-48d6-9eea-f3ceeb5bf366 Idiopathic: Unknown cause (about 50 percent of cases) Diabetes-related: Caused by diabetes mellitus Post-surgical: A side effect of surgery Infection-related: Caused by an infection Autoimmune: Caused by an autoimmune disease Rheumatological: Caused by a rheumatic condition Neurological: Caused by a neurological condition Medication-related: A side effect of certain medications
Signs and Symptoms of Gastroparesis Symptoms Symptoms of gastroparesis come from delayed or disordered emptying of the stomach, affecting the entire GI tract. Common symptoms include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629343129dc-d2c0-403c-a6e9-d936f3c033f6e60dc2a1-f33c-4a05-9b50-8e3e8e597629dbdec4ca-1856-4ec9-bdeb-f224e213f8ba Bloating Quickly feeling full as you eat Feeling full long after you finish eating Nausea and vomiting Regurgitating or spitting up undigested food Poor appetite Although these signs are common in gastroparesis, some with the disorder don’t notice any symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e597629470a797c-1438-40bb-8663-50fc1a5791e0
Causes and Risk Factors of Gastroparesis Causes As mentioned, about half of gastroparesis diagnoses are idiopathic, meaning they have an unknown cause. When providers can pinpoint a cause, the most common are:e60dc2a1-f33c-4a05-9b50-8e3e8e5976294f7b1433-6e0a-490e-875f-22e828231222e60dc2a1-f33c-4a05-9b50-8e3e8e597629370ef44c-0e02-4ee8-85f9-d219768491b1 Diabetes mellitus: Gastroparesis can happen in people with type 1 or type 2 diabetes. Post-surgical injury: A surgical procedure that damages the stomach nerves or changes stomach anatomy can result in gastroparesis. Viral infection: When it comes to infectious causes, gastroparesis is most commonly seen with Norwalk virus ( norovirus ), rotavirus, and Epstein-Barr virus . Rheumatological diseases: Examples include amyloid neuropathy and systemic sclerosis (scleroderma). Autoimmune disease: This occurs when the body mistakenly attacks its own organs and tissues . Neurological conditions: These include Parkinson’s disease and multiple sclerosis . Medications: These can include opioids, nicotine, marijuana , antipsychotics , glucagon-like peptide-1 (GLP-1) agonists , and medicines for allergies and high blood pressure. Many of the above causes can also be classified as risk factors. For example, if you have diabetes, you have a higher risk of gastroparesis.e60dc2a1-f33c-4a05-9b50-8e3e8e597629370ef44c-0e02-4ee8-85f9-d219768491b1 Other risk factors include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976294df307ce-6a2d-4c45-9d65-9e77122431a1 Female sex: People assigned female at birth are more prone to developing gastroparesis than people assigned male at birth. Hypothyroidism: Insufficient thyroid hormone production can lead to gastroparesis.
How Is Gastroparesis Diagnosed? Diagnosis Providers diagnose gastroparesis through a physical exam, medical history, and diagnostic tests. To start, your healthcare provider will ask about your symptoms and examine your abdomen. Testing for Gastroparesis If your provider suspects gastroparesis, they may order the following tests to confirm a diagnosis. Gastric Emptying Scintigraphy This is the most common test and the current gold standard used to diagnose gastroparesis. During this 4-hour procedure, you’ll eat a light meal including a small, safe amount of radioactive material. While you eat, a scanner tracks that material’s movement through your GI system and measures how quickly food leaves your stomach.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e2ad92e1-2ead-4b18-b097-112f3d061ff3 Upper GI Endoscopy While you’re sedated, a provider inserts a tiny camera on the end of a long flexible tube into your throat. They will pass it through your esophagus, stomach, and into the small intestine to check for conditions that cause similar symptoms to gastroparesis, like peptic ulcers or pyloric stenosis.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e2ad92e1-2ead-4b18-b097-112f3d061ff3 Other less commonly performed tests that may be ordered include: Upper Gastrointestinal Barium Contrast Radiography For this X-ray study, you’ll swallow a solution called barium, which will coat your esophagus, stomach, and GI tract. Then, your provider will take an X-ray of your abdomen to see the emptying of the stomach and movement of the contrast through the small bowel.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296de78c46-913d-43d6-95c4-48aea7e98c8a Gastric Motility Breath Test (GEBT) For this test, you’ll consume a meal containing a substance (carbon-13) that your body will absorb. As your stomach digests this meal, the substance can be identified in your breath. Your provider then tests samples of your breath to measure how fast your stomach empties.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a2cd3c04-bf10-4e7c-b2a3-398954096073e60dc2a1-f33c-4a05-9b50-8e3e8e5976294c8f290f-080d-4553-a8f1-ca5b22cf56e5 Antroduodenal Manometry In this specialized procedure, your provider will insert a thin catheter through your mouth and esophagus and into your stomach. Over six hours, they’ll measure electric and muscle activity in your stomach and first part of the small bowel (the duodenum) before, during, and after a meal. You’ll fast for the first few hours, and then later you’ll eat a solid meal. Your provider will record measurements during both periods.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296de78c46-913d-43d6-95c4-48aea7e98c8a Ultrasound Using high-frequency sound waves, this test shows images of organs and tissues within your abdomen. An ultrasound can help your provider rule out other potential causes of your symptoms.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e2ad92e1-2ead-4b18-b097-112f3d061ff3 Your provider may also order imaging studies like a computed tomography (CT) scan or magnetic resonance imaging (MRI) to determine whether your causes are caused by an obstruction (blockage). They may also order blood tests to see if you may have an autoimmune disease that’s causing your symptoms. Overall, your diagnostic process will depend on your health history, symptoms, and provider.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294c8f290f-080d-4553-a8f1-ca5b22cf56e5
Treatment and Medication Options for Gastroparesis Treatment No treatments can cure gastroparesis, but several options exist to ease symptoms, speed up gastric emptying, and ensure adequate nutrition and hydration.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295afaad68-5fbd-406f-9dd2-9b4c5d93f536 Medication Options Some gastroparesis medications treat delayed stomach emptying, while others treat various causes and symptoms. For example, medications called prokinetics stimulate gastric motility, while other types treat symptoms like nausea and vomiting.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295afaad68-5fbd-406f-9dd2-9b4c5d93f536 Prokinetic medications include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976295afaad68-5fbd-406f-9dd2-9b4c5d93f536 Metoclopramide (Reglan) The only FDA-approved medication for gastroparesis Motilin Agonists These include erythromycin and azithromycin Serotonin Agonists These include prucalopride Medications for nausea and vomiting include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629ab29124e-d398-4d4a-b711-7fb067134b37 Diphenhydramine (Benadryl) This drug can help ease nausea and vomiting. Ondansetron This drug can help ease nausea and vomiting Prochlorperazine (Compazine) This can be prescribed if other medications for nausea and vomiting aren’t effective. Your healthcare provider may also recommend other medications for specific symptoms, like proton pump inhibitors for acid reflux, pain medication for severe stomach discomfort, or diabetes medication to manage blood sugar.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295afaad68-5fbd-406f-9dd2-9b4c5d93f536
Surgery If other treatments don’t work for you, additional procedures can be an option. The types of surgery used for gastroparesis include: Feeding Tube Placement For severe gastroparesis that makes you unable to eat or drink, your provider may offer to place a feeding tube in your small intestine. This tube allows you to feed nutritional formula straight into your small intestine.e60dc2a1-f33c-4a05-9b50-8e3e8e597629460f4092-d8a9-445d-ab05-cb78a51fd8fa Gastric Venting This tube placed into the stomach allows trapped gas and fluids to escape, easing discomfort from slow gastric motility.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299d3fd4d7-83ca-406a-891a-e7009f7ce523 Pyloroplasty This surgical procedure relaxes the pylorus muscle, a small muscle that sits between your stomach and small intestine. The pylorus typically helps your stomach hold food in, but a pyloroplasty allows food to move out of the stomach sooner. A newer version of this surgery, called G-POEM, can be done with endoscopy (a tube through your throat) so that no skin incisions are necessary.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a91f3d35-7b5f-4301-8517-05e99cb805a4e60dc2a1-f33c-4a05-9b50-8e3e8e5976299d3fd4d7-83ca-406a-891a-e7009f7ce523 Gastric Bypass This procedure, a type of bariatric surgery , removes part or all of your stomach and creates a new outlet from your stomach to your small intestine. Typically used as a weight loss solution, your provider may recommend this surgery for severe diabetes-related gastroparesis.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299d3fd4d7-83ca-406a-891a-e7009f7ce523 Investigational Therapies Experts continue to search for new therapies for gastroparesis, and several are currently being studied. One investigational treatment currently being studied is called gastric electrical stimulation. This involves a surgically inserted device that stimulates your stomach muscles to move food to the small intestine.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e2f92221-db1d-4bbe-9220-6f74a03e1e88e60dc2a1-f33c-4a05-9b50-8e3e8e597629460f4092-d8a9-445d-ab05-cb78a51fd8fae60dc2a1-f33c-4a05-9b50-8e3e8e597629abb5ecfc-ab4a-4773-b940-8171d56c8670 Medications being studied for improved gastric motility and symptom control in gastroparesis include:e60dc2a1-f33c-4a05-9b50-8e3e8e597629e2f92221-db1d-4bbe-9220-6f74a03e1e88 Granisetron (Kytril) Aprepitant (Emend) Metoclopramide (Reglan) nasal spray Relamoreline60dc2a1-f33c-4a05-9b50-8e3e8e5976298e03c014-6c46-485b-8fb0-90930b1616b4 Prucalopride (Motegrity)e60dc2a1-f33c-4a05-9b50-8e3e8e5976297220409c-71b7-41c4-90f3-44e5960c9863 Velusetrage60dc2a1-f33c-4a05-9b50-8e3e8e5976296cc922b6-cf6b-4cb3-a7da-9b553cb3ab3b
Prevention of Gastroparesis Prevention Idiopathic gastroparesis can’t be prevented, but some other types like diabetic gastroparesis can. Talk to your healthcare provider if you’re at high risk for gastroparesis so they can help you address your risk factors.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296368501d-d39c-4d29-8464-1625e5dcda44e60dc2a1-f33c-4a05-9b50-8e3e8e597629bafe65aa-50c4-4863-985f-ed613acb325d
Lifestyle Changes for Gastroparesis Lifestyle Changes Alongside standard gastroparesis treatments, your provider may recommend the following lifestyle changes to help you manage your symptoms and feel better.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297fbf6611-ca9b-494a-966d-99d89b9a38f0e60dc2a1-f33c-4a05-9b50-8e3e8e59762902809b67-a445-40a4-9f3d-2fe48859df1a Eat smaller, more frequent meals rather than three large meals. Chew your food thoroughly. Opt for cooked fruits and vegetables over raw ones. Follow a low-fat diet. Blend your food or ensure your food is in small pieces. Drink 1 to 1.5 liters of water daily. Do gentle exercise after eating, such as taking a walk. Avoid carbonated drinks and alcohol. Don’t smoke (or if you do, quit smoking). Sit upright for two hours after a meal. Take a daily multivitamin. Don’t eat and drink at the same time — try to space them out by an hour. Also, consider meeting with a registered dietitian nutritionist (RDN) who can help you fine-tune your diet based on your needs.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fee0abae-d409-46b5-bacf-a9296d750688
Gastroparesis Prognosis Prognosis and Outlook Idiopathic gastroparesis, which accounts for half of cases, has no cure, but you can get relief from gastroparesis symptoms by following your treatment plan.e60dc2a1-f33c-4a05-9b50-8e3e8e597629335735ef-da2a-42f5-bced-2e910b4b73c3 Everyone’s GI tract works a little differently, so finding the right treatment for you may involve some trial and error. Gastroparesis typically isn’t life-threatening, and your provider can help you recognize complications early to keep those health risks low.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b1398de6-7053-46a2-8617-dbbd0be2fb8c
Complications of Gastroparesis Complications When gastroparesis goes untreated, complications may arise, including the following.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e5990b69-0641-4bed-8f8b-747b79cb9e53e60dc2a1-f33c-4a05-9b50-8e3e8e597629301b22c4-ceb7-4f97-9122-c3a6149043b3 Weight loss Malnutrition and dehydration Abdominal distention (stretching) Hypoglycemia or hyperglycemia (low or high blood sugar) Retention of food in stomach
Research and Statistics: Who Has Gastroparesis? Research and Statistics Research shows idiopathic gastroparesis occurs four times as often in women than in men. It’s also more common in white people than other racial or ethnic groups, and its prevalence increases with age.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294c6c687e-7808-46cb-99ae-ddcef7e2fa8f One study analyzed 4.3 million medical records and found that every 16 per 10,000 people had gastroparesis. Of participants with type 1 diabetes, about 5 percent had gastroparesis compared with just over 1 percent of people with type 2 diabetes.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298d8b98cc-65c0-4442-b894-7e8b8646486d
Related Conditions Related Conditions The symptoms of gastroparesis can mimic other disorders of the stomach and GI tract. These include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976296b449bd4-4579-41e0-adda-c2b32af4c389e60dc2a1-f33c-4a05-9b50-8e3e8e597629f68c1daa-c4d7-4426-8077-2e9dc3f8be82 Functional Dyspepsia A condition causing chronic indigestion Gastric Outlet Obstruction A condition similar to gastroparesis, but symptoms are caused by a mechanical obstruction (physical blockage) Cyclical Vomiting Syndrome A chronic functional condition with vomiting episodes that last hours to days Rumination Syndrome A behavioral disorder with daily, effortless regurgitation of undigested food with no nausea or vomiting involved Cannabinoid Hyperemesis Syndrome A condition with episodes of vomiting coupled with a frequent desire for hot showers for symptom relief, often linked to high-dose or long-term cannabis use
Support for Gastroparesis Support Association of Gastrointestinal Motility Disorders The Association of Gastrointestinal Motility Disorders (AGMD) offers support groups , which can help you connect with others who have the same diagnosis as you. Northwestern University Gastroparesis Support Group Northwestern University offers a gastroparesis support group, hosted by the Digestive Health Center’s Behavioral Medicine Program. Inspire Community Inspire, the world’s largest health community, offers an online, forum-style community for support and group discussion on issues related to gastrointestinal motility disorders like gastroparesis.
The Takeaway Gastroparesis is a chronic disorder that impedes your stomach from moving food well, leading to symptoms like nausea, feeling full after a few bites, poor appetite, and potentially weight loss, among other symptoms. The cause of gastroparesis may not always be clear, but possible causes can include diabetes, surgery, or neurological disorders like Parkinson’s disease. Gastroparesis has no cure, but your provider may recommend treatment with medications, lifestyle changes, diet, and sometimes surgery.
Resources We Trust Mayo Clinic: Gastroparesis: Symptoms and CausesCleveland Clinic: GastroparesisAmerican College of Gastroenterology: Gastroparesis OverviewInternational Foundation for Gastrointestinal Disorders: Prevention & Management TipsJohns Hopkins University: Gastroparesis



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