Gastroparesis

What is gastroparesis?

Gastroparesis is a condition that affects the stomach’s ability to move food through the digestive system. Also known as delayed gastric emptying of the stomach, gastroparesis prevents stomach nerves and muscles from working properly, slowing the stomach’s ability to break down food and send it into the small intestine. As a result, food stays in your stomach longer than normal.

Doctors generally diagnose this relatively uncommon condition if your stomach has had trouble emptying food for at least three months, and you don’t have a blockage in your digestive system.

Gastroparesis can’t often be cured, but dietary changes, nonsurgical treatments and newer endoscopic procedures can help you manage symptoms.

Watch our webinar on common reasons for bloating, including gastroparesis

Types of gastroparesis

To classify what type of gastroparesis you have, doctors will look to its cause. Types of gastroparesis include:

Idiopathic gastroparesis: Most cases of gastroparesis, between 25% and 50%, are considered idiopathic, meaning doctors are unable to identify a specific cause.
Diabetic gastroparesis: With poorly managed diabetes, high blood sugar can damage the vagal nerves, which help control digestion. This is the most common single cause of gastroparesis.
Post-infectious gastroparesis: You can develop gastroparesis after infections with certain viruses, such as the Norwalk virus, rotavirus or Epstein-Barr virus.
Postsurgical gastroparesis: Gastroparesis may occur if surgery to your digestive system damages the vagal nerves, which tell the stomach muscles to contract.

Gastroparesis symptoms

When your stomach muscles work correctly, they contract to process food and move it along to its next stop in the digestive system, your small intestine. With gastroparesis, food lingers in your stomach. As a result, you may experience symptoms ranging from feeling full too soon to nausea, acid reflux and more.

Common symptoms of gastroparesis include:

Abdominal (belly) pain
Acid reflux
A distended (stretched) abdomen
Bloating
Dyspepsia (indigestion)
Excessive belching
Feeling full almost as soon as you start eating
Hypoglycemia (low blood sugar)
Nausea
Reduced appetite
Unexplained weight loss
Vomiting

When to see a doctor

See your primary care doctor if you experience digestive symptoms, especially if they last for weeks or months. They will perform an initial workup and may refer you to a gastroenterologist for a more detailed evaluation. If your gastroenterologist diagnoses gastroparesis, they will recommend the most appropriate treatment for you based on the cause and other factors.

Gastroparesis causes

Most often, gastroparesis occurs due to damage to the nerves that control the stomach muscles. These nerves convey messages from the brain that tell the muscles to contract. When injured, this system of communication doesn’t function properly. So, the muscles don’t work as well as they should.

In some cases, damage to the muscles rather than the nerves interferes with the stomach’s ability to empty.

Several factors can cause nerve or muscle damage and lead to gastroparesis. These factors include diabetes, digestive surgery and certain infectious diseases.

Gastroparesis risk factors

Diabetes, certain surgeries and some infections can cause gastroparesis or make it more likely to develop. Other factors, such as specific medications, treatments and medical conditions, can also raise your risk. Understanding these risk factors can help you and your doctor identify possible contributors and guide your treatment plan.

Risk factors for gastroparesis include:

Autoimmune diseases: Your body’s immune system may mistakenly attack your cells, which can damage nerves in your stomach in the process.
Certain medications: Some medicines, such as opioids and certain antidepressants, can slow down stomach emptying and contribute to gastroparesis.
Neurological diseases: Conditions that cause abnormal nervous system functioning, such as multiple sclerosis, can affect your stomach nerves.

Complications

Without treatment, gastroparesis can have an impact on your quality of life. Symptoms such as nausea and vomiting can lead to more serious problems, like dehydration and malnutrition. In addition, if you have diabetes, gastroparesis can make managing your blood sugar more difficult.

Complications that may develop from gastroparesis include:

Acid reflux: Gastroparesis-related acid reflux can become chronic, and chronic acid reflux can lead to esophagitis (inflammation) and gastroesophageal reflux disease.
Bezoar: Food in the stomach can solidify into a mass called a bezoar and block the outlet to the small intestine.
Blood sugar problems: Delayed stomach emptying can cause steep drops and spikes in blood sugar.
Dehydration: Persistent vomiting, a common symptom of gastroparesis, can lead to dehydration through loss of fluid.
Malnutrition: When your stomach muscles don’t move food through the digestive system normally, you may not absorb nutrients well.

How is gastroparesis diagnosed?

Your doctor will start by asking about your medical history to learn of any risk factors that could cause or contribute to gastroparesis. They will also conduct a physical exam to look for signs of the disorder.

Next, your doctor will likely order imaging tests or a procedure to rule out other causes of your symptoms, such as a blockage in your stomach. If you don’t have a blockage, your doctor will perform tests to determine how well food moves through your stomach.

Gastroparesis treatment

While gastroparesis usually can’t be cured, treatment focuses on managing symptoms and addressing underlying causes to help improve quality of life.

Your treatment plan will depend on several factors, including the type of gastroparesis you have and the severity of your symptoms. Treatment options include dietary and lifestyle changes, blood sugar control, medications and if necessary, surgery.

You may need to try several therapies before finding one that effectively controls your symptoms, but your doctor will work with you to identify the best approach for managing your condition.

Dietary and lifestyle changes

Modifying your diet can make digestion easier while ensuring you get the necessary nutrients and calories. A dietitian can help you make nutrition changes, which may include:

Avoiding alcohol and carbonated beverages
Avoiding lying down for two hours after eating
Chewing your food thoroughly
Choosing soft foods
Eating low-fat and low-fiber foods
Eating small, nutrient-rich meals frequently instead of three large meals per day
Drinking plenty of water
Taking a daily multivitamin
Taking a walk or engaging in another form of light exercise after meals

Find specialized care for gastroparesis near you

At Baylor Scott & White, we offer several locations for the treatment of diseases of the digestive system, including gastroparesis, at gastroenterology centers across North and Central Texas. Our experienced team is ready to provide personalized care to help improve your quality of life. Whether you're seeking diagnostic testing, treatment options or ongoing support, we are here to help you.