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Gastroparesis is a disorder that occurs when the stomach takes too long to empty food. This disorder, also known as delayed gastric emptying, is a result of abnormal movement of the muscles in the stomach. This can be due to either nerve damage or muscular disease. There’s no known cure for gastroparesis, but medical treatment can help you manage your symptoms.
The exact cause of gastroparesis isn’t known, but it’s thought to have something to do with disrupted nerve signals in the stomach. It’s believed that the vagus nerve, which controls the movement of food through the digestive tract, becomes damaged and causes food to be digested slowly or not at all.
A common cause of damage to the vagus nerve is diabetes, specifically diabetes that isn’t well controlled. High levels of blood sugar can change the way the vagus nerve gets its nutrients.
Surgeries that involve the stomach or other digestive organs can also damage the vagus nerve. Infections, medications, and muscle diseases are other causes of gastroparesis. But in many cases, the cause is labeled as idiopathic, which means the reason isn’t known.
Certain health conditions can make it harder for your stomach to empty, increasing your chances of developing gastroparesis. The risk factors include:
The symptoms of gastroparesis can range from mild to severe. They occur more often in some people than others. The symptoms of gastroparesis can include:
Your doctor will perform a physical exam and ask you questions about your medical history. In order to rule out other possible causes of your symptoms, your doctor will probably want to run some tests. These might include:
Once your doctor has ruled out other possible causes of your symptoms, they’ll order tests that will confirm that you have gastroparesis. These tests can include:
If your gastroparesis is caused by a condition like diabetes, the first step is to improve control of that underlying condition. After that, your doctor may recommend medication, diet changes, and even surgery in some cases.
Your doctor may prescribe one or more medications to treat your gastroparesis. Medicines like prochlorperazine (Compro) and diphenhydramine (Benadryl) are often given to control nausea and vomiting caused by gastroparesis.
Medicines like metoclopramide (Reglan), erythromycin (EES), domperidone (Motilin), and cisapride (Prepulsid, Propulsid) stimulate the stomach muscles and help with digestion. But these drugs can cause side effects. Talk with your doctor to decide which medication is right for you.
If your malnutrition or vomiting remains an issue even with the use of medicine, your doctor may decide that surgery on your stomach is necessary. The goal of surgery for gastroparesis is to help your stomach empty more effectively. Surgery could entail stomach stapling or a stomach bypass procedure.
Seeing a dietitian (an expert on food and nutrition) is a common part of treatment for gastroparesis. A dietitian can suggest foods that your body can digest more easily, allowing your body to absorb more nutrients. Your dietitian might make suggestions like:
If you have a severe case of gastroparesis, you might not be able to eat solid foods and drink liquids. In this case, you may need a feeding tube until your condition improves.
In a few treatment centers across the United States, doctors are testing a device called a gastric neurostimulator, or Enterra Therapy System. The device releases electrical signals that help control nausea and vomiting. This treatment is mainly used on those with gastroparesis secondary to diabetes or an idiopathic cause, who have nausea and vomiting, and who have not responded to medication.
Botulinum toxin type A is a toxin that reduces muscle activity. It has been shown to relax the pyloric sphincter muscle, which is the muscle that controls the flow of food from the stomach to the small intestine. Using botulinum toxin type A on the pyloric sphincter muscle allows the stomach to pass more food into the small intestine.
The symptoms associated with gastroparesis, such as vomiting and decreased appetite, can cause dehydration and malnutrition. Dehydration and malnutrition can cause numerous problems, including:
Gastroparesis causes food to stay in the stomach for too long, which can cause an overgrowth of bacteria. The food can also harden into masses called bezoars that cause nausea, vomiting, and obstruction in the stomach.
Managing blood glucose levels is essential for people with diabetes. Gastroparesis can make it harder to manage those levels.
If you suspect you have gastroparesis, talk to your doctor. They’ll do a thorough exam before diagnosing the condition. If you do have gastroparesis, there are treatment options that can help ease your symptoms.
Written by: Carmella Wint and Winnie Yu
Medically reviewed on: Aug 23, 2017: Michele Cho-Dorado, MD
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