Gastroparesis is when the stomach cannot break down food and move it to the small intestine. With this problem, food either moves too slowly or not at all. This can cause food to harden and lead to blockages. Early treatment can improve outcomes.

The Stomach and Intestines

Causes

The vagus nerve controls movement of the stomach. The nerve may be damaged because of injury or illness. The muscles of the stomach will then not be able to work as they should.

Risk Factors

This problem is more common in women.

The main risk factor for gastroparesis is diabetes, which can damage nerves. Other things that may raise the risk are:

Gastroesophageal reflux disease (GERD)
Surgery that involves the stomach or vagus nerve
Taking certain medicines, such as anticholinergics or opioids
Viral infection
Diseases affecting the nerves, muscles, or hormones
Diseases affecting metabolism (body’s ability to make and use energy)
Anorexia or bulimia
Radiation therapy or chemotherapy
Smoking
Alcohol use

Symptoms

Problems may be:

Feeling full early during a meal
Lack of hunger
Nausea and vomiting
Weight loss
Bloating
Heartburn
Belly or chest pain

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done.

Your blood and urine may be tested to look for problems.

Images may be taken of the stomach and surrounding structures. This can be done with:

Ultrasound
Barium x-ray or CT scan
Gastric emptying study— may also be done by MRI scan

Other procedures may be:

Upper GI endoscopy —a thin, lighted tube inserted down the throat to examine the esophagus, stomach, and small intestine
SmartPill—a pill-sized device that is swallowed to take images of the entire digestive system

Treatment

Any underlying causes will need to be treated. The goal will be to ease symptoms. Options are:

Dietary Changes

Dietary changes may need to be made to ease symptoms. This may mean:

Eating small meals several times throughout the day
Following a liquid diet
Limiting high-fat and high-fiber foods

Alternative Nutrition

People with severe symptoms may need to have nutrients delivered directly into the:

Intestines—a tube is passed through nose, down the throat, and into the intestine. Long term use may require a tube passed through the stomach wall into the intestine.
Bloodstream—through an IV

Medicine

Medicine may be given to ease symptoms, such as nausea. Other medicines may be given to help the stomach empty. Examples are:

Metoclopramide
Erythromycin

Surgery

People with severe symptoms and those who are not helped by other methods may need surgery. This may include removing part of the stomach.

Prevention

People with diabetes can lower the risk of this problem by following their care plan.

RESOURCES:

American College of Gastroenterology
http://patients.gi.org

American Gastroenterological Association
http://www.gastro.org

CANADIAN RESOURCES

Canadian Association of Gastroenterology
https://www.cag-acg.org

Canadian Digestive Health Foundation
http://www.cdhf.ca

References:

Complications of diabetes mellitus. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/complications-of-diabetes-mellitus. Accessed August 18, 2021.

Gastroparesis. American College of Gastroenterology website. Available at: https://gi.org/topics/gastroparesis. Accessed August 18, 2021.

Gastroparesis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/gastroparesis. Accessed August 18, 2021.

Gastroparesis. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/gastroparesis. Accessed August 18, 2021.

Last reviewed July 2021 by EBSCO Medical Review Board James Cornell, MD
Last Updated: 8/18/2021

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