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Gastroparesis
Overview
- What is gastroparesis?
Gastroparesis is a condition where the stomach empties too slowly.
As we eat, the normal stomach relaxes to accommodate this food. It then processes the food into a pulverized consistency and finally pushes it into the small intestines for digestion. In gastroparesis, all these movements are weaker and slower. This is not because of a blockage. Instead, it happens when nerves that control the stomach do not work well.
Gastroparesis can be challenging, but there are many ways to manage it. With the right diet, medications and support from your care team, many people are able to feel better and improve their quality of life.
Symptoms
- What are the symptoms of gastroparesis?
Common symptoms include:
- Feeling full quickly when eating
- Nausea
- Vomiting
- Belly pain
- Bloating (feeling as though your stomach is full of air)
- Burping or hiccups
- Weight loss
- Excessive heartburn
Certain foods can make these symptoms worse, such as:
- Fatty foods
- High-fiber foods
- Carbonated drinks
Causes
- What causes gastroparesis?
There are many causes of gastroparesis including:
- Diabetes (most common known cause)
- Infections (viral or bacterial)
- Certain medications (narcotic pain medications, some of the newer weight loss drugs)
- Prior surgeries involving the stomach, esophagus or chest
- Conditions such as Parkinson’s Disease or scleroderma
- Marijuana
- Eating disorders
- Rarely from cancer
In most people, the cause is never identified. This can be frustrating.
Diagnosis
- How is gastroparesis diagnosed?
Gastroparesis is diagnosed with a gastric emptying test.
During the test, you eat a small meal (often eggs) that contains a tiny, safe amount of material that can be tracked on imaging. Radiologists then check how quickly the food leaves your stomach over a 4-hour time period. If most of the food is still in the stomach after four hours, it may mean you have gastroparesis.
Your workup may include an upper endoscopy to make sure you do not have a physical obstruction in your stomach – a procedure where your doctor uses a flexible tube with a camera, to look into your stomach.
Treatment
- Why is nutrition important in gastroparesis treatment?
Diet is the first step in treatment. Many people can feel better by changing the way they eat:
- Small and frequent meals, almost like snacking
- Choosing low-fat and low-fiber foods
- Eating softer or liquid foods like soups, smoothies and purees
If you have diabetes, keeping blood sugars under good control is very important. This can be challenging, so working closely with your medical team can help.
- What medications can help?
Some medications help the stomach empty faster (called prokinetics) while others help with symptoms of nausea (anti-emetics).
- Metoclopramide: Helps the stomach empty more quickly. This is the only FDA-approved drug for gastroparesis. Your doctor will review the risks and benefits of this drug with you.
- Erythromycin: An antibiotic that can also help the stomach empty. It may stop working over time, hence is usually only used for small intervals.
- Domperidone: Helps with nausea and stomach emptying. This drug is not FDA-approved in the USA and is no longer available in the USA due to its side-effects.
- Anti-emetics: Ondansetron, promethazine, prochlorperazine or aprepitant. These medications do not increase the stomach emptying, but do help with symptoms of nausea and vomiting.
- Prucalopride: May help some patients, especially those with constipation
Your doctor will help you pick the option that is best for you.
- What procedures are available?
If symptoms are severe, certain procedures may help:
- Gastric Electrical Stimulation (GES): A device is placed on the stomach to help reduce symptoms, specifically symptoms of nausea and vomiting.
- Gastric peroral endoscopic myotomy (G-POEM): A minimally invasive procedure done endoscopically that makes a cut in the muscle at the end of the stomach to help the stomach empty more quickly.
These options are usually considered when other treatments have not worked.
Author(s) and Publication Date(s)
Jean Fox, MD and Amy Foxx-Orenstein, DO, FACG, Mayo Clinic, Rochester, MN, and Scottsdale, AZ – Published August 2004, Updated November 2008, Updated December 2012.
Peter S. Buch,, MD, FACG, Frank H Netter, MD School of Medicine, North Haven, CT – Updated June 2021.
Nimrod Deiss-Yehiely, MD, University of Chicago Medicine, Chicago, IL and Saad Javed, MD, Drexel University College of Medicine, Pittsburgh, PA - Updated April 2026.
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