Symptoms, Causes, and Treatment Options

Gastroparesis is a condition that occurs when your stomach doesn’t empty as quickly as it should after eating. Scientists estimate that up to 2% of the U.S. population may suffer from gastroparesis, which tends to be more common in women than men.

Not everyone with gastroparesis has the same symptoms. However, some of the main symptoms of gastroparesis may include:

• Nausea or vomiting
• Feeling full after starting a meal
• Excessive belching
• Bloating
• Stomach discomfort or pain
• Decreased appetite, which may lead to weight loss or malnutrition over time

People with mild gastroparesis may experience stomach upset from time to time, while those with moderate to severe gastroparesis may experience nausea and difficulty finishing meals.

Normally, your stomach empties the food you eat into the small intestine a few hours or so after eating. This requires complex coordination between the nerves, stomach muscles and intestinal muscles of the digestive system.

Researchers don’t know exactly what goes wrong in all cases of gastroparesis, but they suspect that a problem with the emptying process occurs when you have this condition.

Diabetes

People with type 1 diabetes appear to be at higher risk of developing this disease than people with type 2 diabetes.

Gastroparesis due to diabetes can be caused by damage to the nerves that send and receive signals from the stomach. These autonomic nerves can become damaged due to high blood sugar caused by diabetes. As a result, nerve damage can change the way the nerves and muscles in the stomach process digestion.

Other causes

Although diabetes is the most likely reason you may have gastroparesis, other potential causes of the condition include:

Many different medications can also cause or temporarily worsen gastroparesis in some people. Some of these medications include:

• Opioids like Oxycontin (oxycodone)
• Acid reflux medications, such as Prilosec (omeprazole)
• Medicines for high blood pressure, such as Norvasc (amlodipine)
• Medicines classified as “anticholinergics,” such as Clozaril (clozapine) and Benadryl (diphenhydramine)
• Marijuana and alcohol

However, gastroparesis is most often idiopathic, meaning your doctor doesn’t always know the underlying cause of the condition.

If you suspect you have gastroparesis or have symptoms of the condition, it is advisable to consult your doctor for appropriate tests. During your appointment, your provider will take a detailed medical history and perform a physical exam to learn more about your symptoms.

Keep in mind: The symptoms of many different medical conditions can resemble those of gastroparesis, so your doctor should rule out other potential causes. Depending on the situation, your provider may also test you for the following conditions before making a diagnosis:

To test you for gastroparesis and the conditions above, your provider may order one or more of the following tests:

• Blood tests: Can check your complete blood count (CBC), hemoglobin A1C and glucose (blood sugar).
• Esophagogastroduodenoscopy (EGD): A surgical procedure that allows your provider or surgeon to check your esophagus and stomach for obstructions or physical blockages (for example, a tumor)
• Gastric emptying scintigraphy (GES): Test how long it takes for your food to empty from your stomach
• Gastric emptying breath test: A less expensive alternative to the GES test, but often less accurate for diagnosing gastroparesis
• Wireless Motility Capsule Test: Checks your stomach muscles for dysfunction

Unfortunately, many people with gastroparesis do not receive a diagnosis because the symptoms often mimic those of other health conditions. Researchers hope that as they learn more about the disease, health care providers will have the tools needed to accurately diagnose and treat gastroparesis.

Currently, there is no cure for gastroparesis. However, treatment can help reduce your symptoms. Your exact treatment plan will depend on your symptoms and the severity of your condition. Treatment options may include changes to your diet, medications, and certain procedures.

Nutrition

Dietary changes are the gold standard for managing gastroparesis. Your healthcare professional can work with a nutritionist or dietitian to give you the following advice:

• Eat smaller but more frequent meals (for example, three small meals with two snacks)
• Avoid foods high in fat
• Limit foods high in fiber

It is also good to eat foods that are easy to mash with a fork (for example, soft potatoes) while avoiding foods with more solid components (with peels, shells, seeds, etc.). Soups are often a good option because they make it easier to empty the stomach without any dysfunction.

Drugs

You may need to use medications to reduce nausea and vomiting and help your stomach empty. Your provider can work with you to prescribe the medication that is best for you. Examples of medications they may consider include:

• Reglan (metoclopramide)
• Motilium (domperidone)
• E-Mycin (erythromycin)
• Neoprad (levosulpiride)
• Zofran (ondansetron)
• Pamelor (nortriptyline)
• Emend (aprepitant)

Procedures

Some people with severe gastroparesis may also benefit from certain medical procedures. Your treatment plan may include:

• Repeated botulinum injection (Botox) into the pylorus, the opening at the end of the stomach
• Pyloroplasty, or surgery to widen the opening of the pylorus
• Pyloromyotomy, or surgery to cut the wall of the pylorus
• Surgery that involves implanting an electrical stimulation device into your stomach to help it empty

Studies have shown that people with diabetes whose blood sugar (blood sugar) levels are not well controlled are at higher risk of eventually developing gastroparesis. If you’re living with diabetes, it’s best to keep your blood sugar levels in a healthier range to help prevent gastroparesis, as well as other complications.

Because the cause of gastroparesis is not yet well understood, health care providers do not have many other prevention strategies to stop or delay the onset of gastroparesis. That said, your provider may recommend eating a nutritious diet that’s right for you, exercising, and drinking plenty of water to keep your digestive system working as efficiently as possible.

Certain medical conditions are more common in people with gastroparesis. These conditions include:

If you are diagnosed with gastroparesis, it’s a good idea to talk to your doctor about what you can do to reduce the risk of experiencing symptoms of the conditions above.

Unfortunately, nausea and chronic pain related to gastroparesis can significantly affect your quality of life. Existing treatments, although useful, do not always eliminate symptoms. Researchers are still actively looking for new drugs and procedures that may be useful in the future to help treat this disease.

Food is often a decision of personal preference and lifestyle, and it can be frustrating not to eat the way you’d like when your provider recommends a particular diet. However, it’s important to be realistic and avoid foods that may make your symptoms worse. If necessary, consult a nutritionist or registered dietitian for help.

If you think your symptoms are affecting your emotional well-being, consider attending a support group or meeting with a mental health professional.