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.
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. Although there’s no cure for gastroparesis, you can often manage the symptoms with medication, lifestyle changes, and other treatment options.
Healthcare providers classify gastroparesis according to its cause. Some examples include:
Idiopathic: Unknown cause (about 50 percent of cases)
Medication-related: A side effect of certain medications
Symptoms of gastroparesis come from delayed or disordered emptying of the stomach, affecting the entire GI tract. Common symptoms include:
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.
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:
Diabetes mellitus: Gastroparesis can happen in people with type 1 or type 2 diabetes.
Post-surgicalinjury: 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).
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.
Upper GIEndoscopy 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.
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.
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.
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.
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.
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.
No treatments can cure gastroparesis, but several options exist to ease symptoms, speed up gastric emptying, and ensure adequate nutrition and hydration.
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.
Prokinetic medications include:
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:
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.
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.
Gastric Venting This tube placed into the stomach allows trapped gas and fluids to escape, easing discomfort from slow gastric motility.
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.
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.
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.
Medications being studied for improved gastric motility and symptom control in gastroparesis include:
Granisetron (Kytril)
Aprepitant (Emend)
Metoclopramide (Reglan) nasal spray
Relamorelin
Prucalopride (Motegrity)
Velusetrag
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.
Alongside standard gastroparesis treatments, your provider may recommend the following lifestyle changes to help you manage your symptoms and feel better.
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.
Idiopathic gastroparesis, which accounts for half of cases, has no cure, but you can get relief from gastroparesis symptoms by following your treatment plan. 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.
When gastroparesis goes untreated, complications may arise, including the following.
Hypoglycemia or hyperglycemia (low or high blood sugar)
Retention of food in stomach
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.
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.
The symptoms of gastroparesis can mimic other disorders of the stomach and GI tract. These include:
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
The Association of Gastrointestinal Motility Disorders (AGMD) offers support groups, which can help you connect with others who have the same diagnosis as you.
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.
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.
