(Delayed Gastric Emptying)
Gastroparesis is a disorder of the stomach. After you eat food, the stomach breaks down food. The stomach muscles then squeeze and push food down to the small intestine. Gastroparesis is a delay with the emptying of the stomach. Food either moves too slowly or does not move at all.
The delayed food can harden. This can lead to blockages, nausea, and vomiting. Bacteria can also start to grow and make you ill. Gastroparesis can be a serious condition. You will need care from your doctor.
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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 needed.
The main risk factor for gastroparesis is diabetes. Diabetes can damage nerves.
High blood glucose can also damage blood vessels. It may prevent blood flow to the vagus nerve. The nerve cannot work well without blood flow. Other risk factors include:
- Gastroesophageal reflux disease (GERD)
- Surgery that involves the stomach or vagus nerve
- Taking certain medications, such as anticholinergics or opioids
- Infection from a virus
- 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
- Alcohol use
Gastroparesis may cause:
- Feeling full early during a meal
- No appetite
- Nausea and vomiting
- Abdominal or esophageal pain
- Weight loss
The following may worsen symptoms:
- High-fiber foods, like raw vegetables and fruits
- Fatty foods
- Carbonated drinks
Your doctor will ask about your symptoms and health history. A physical exam will also be done. The doctor may do:
- Blood tests
Tests to measure any of the following:
- Stomach volume before and after a meal
- The rate at which the stomach empties
- The ability of the muscles in the stomach and small intestine to contract and relax
- Imaging tests can assess the stomach and surrounding structures:
- 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
Talk with your doctor about the best treatment plan for you. Treatment options include:
What you eat can affect your symptoms. Work with your doctor or a registered dietitian to create a meal plan that is right for you. Some habits may include:
- Eating small meals several times throughout the day
- Following a liquid diet
- Limiting high-fat and high-fiber foods
You may need to work around the stomach if the gastroparesis is severe. Nutrients can be delivered directly into the:
- Intestines—a tube is passed through nose, down throat and into intestine. Long term use may require a tube passed through the stomach wall into the intestine.
- Bloodstream—through an IV
You may be given medicine to treat the symptoms. It can also help the stomach empty. The medicine can stimulate the stomach muscles. Examples include:
Other medicine may be given to reduce nausea.
In severe cases, your doctor may consider surgery. This may include removing part of the stomach.
Steps that may reduce the risk of gastroparesis include:
- If you have diabetes, follow your treatment plan.
- Be aware of medicine that may delay gastric emptying. These include opioids, calcium channel blockers, and some antidepressants. Talk to your doctor about benefits and risk of your medicine to find what works best for you.
American College of Gastroenterology
American Gastroenterological Association
Canadian Association of Gastroenterology
Canadian Digestive Health Foundation
Complicatoins 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. Updated February 2017. Accessed April 4, 2018.
Gastroparesis. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T113805/Gastroparesis. Updated December 21, 2015. Accessed April 4, 2018.
Gastroparesis. American College of Gastroenterology website. Available at: http://patients.gi.org/topics/gastroparesis. Updated December 2012. Accessed April 4, 2018.
Gastroparesis. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/gastroparesis. Accessed April 4, 2018.
Shakil A, Church RJ, Rao SS. Gastrointestinal complications of diabetes. Am Fam Physician. 2008;77(12):1697-1702.
Last reviewed March 2018 by EBSCO Medical Review Board Daus Mahnke, MD Last Updated: 7/19/2018