Gastroparesis is a condition in which the muscles in your stomach don't function normally.

Ordinarily, strong muscular contractions propel food through your digestive tract. But in gastroparesis, the muscles in the wall of your stomach work poorly or not at all. This prevents your stomach from emptying properly. Gastroparesis can interfere with digestion, cause nausea and vomiting, and cause problems with blood sugar levels and nutrition.

There is no cure for gastroparesis. Making changes to your diet may help you cope with gastroparesis signs and symptoms, but that's not always enough. Gastroparesis medications may offer some relief, but some can cause serious side effects.

Signs and symptoms of gastroparesis include:

  • Vomiting
  • Nausea
  • A feeling of fullness after eating just a few bites
  • Abdominal bloating
  • Heartburn or gastroesophageal reflux
  • Changes in blood sugar levels
  • Lack of appetite
  • Weight loss and malnutrition

When to see a doctor

Make an appointment with your doctor if you have any signs or symptoms that worry you.

It's not always clear what leads to gastroparesis. But in many cases, gastroparesis is believed to be caused by damage to a nerve that controls the stomach muscles (vagus nerve).

The vagus nerve helps manage the complex processes in your digestive tract, including signaling the muscles in your stomach to contract and push food into the small intestine. A damaged vagus nerve can't send signals to your stomach muscles. This may cause food to remain in your stomach longer, rather than move normally into your small intestine to be digested.

The vagus nerve can be damaged by diseases, such as diabetes, or by surgery to the stomach or small intestine.

Factors that can make it difficult for your stomach to empty properly include:

  • Diabetes
  • Abdominal surgery
  • Infection
  • Certain medications that slow the rate of stomach emptying, such as narcotic pain medications and antidepressants
  • Certain cancer treatments
  • Anorexia
  • Bulimia
  • Scleroderma
  • Parkinson's disease
  • Hypothyroidism

Gastroparesis can cause several complications, such as:

  • Bacteria overgrowth in the stomach. Food that stays in the stomach can begin to ferment and disrupt the balance of good and bad bacteria. This can allow harmful microorganisms to grow out of control.
  • Undigested food that hardens and remains in your stomach. Undigested food in your stomach can harden into a solid mass called a bezoar. Bezoars can cause nausea and vomiting and may be life-threatening if they prevent food from passing into your small intestine.
  • Blood sugar fluctuations. Although gastroparesis doesn't cause diabetes, inconsistent food absorption can cause erratic changes in blood sugar levels, which make diabetes worse. In turn, poor control of blood sugar levels makes gastroparesis worse.

You're likely to start by first seeing your family doctor or a general practitioner if you have signs and symptoms of gastroparesis. If your doctor suspects you may have gastroparesis, you may be referred to a doctor who specializes in digestive diseases (gastroenterologist). You may also be referred to a dietitian who can help you choose foods that are easier to digest.

What you can do

Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared. To prepare, try to:

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Write down key personal information, including any major stresses or recent life changes.
  • Make a list of all medications, vitamins or supplements that you're taking.
  • Consider taking a family member or friend along. Sometimes it can be difficult to absorb all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Write down questions to ask your doctor.

Questions to ask

Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For gastroparesis, some basic questions to ask your doctor include:

  • What is likely causing my gastroparesis?
  • Could any of my medications be causing my signs and symptoms?
  • What kinds of tests do I need?
  • Is my gastroparesis likely temporary or chronic?
  • Do I need treatment for my gastroparesis?
  • What are my treatment options?
  • What are the potential side effects of each treatment option?
  • Are there certain foods I can eat that are easier to digest?
  • I have these other health conditions. How can I best manage them together?
  • Are there any restrictions that I need to follow?
  • Should I see a dietitian?
  • Should I see a specialist? What will that cost, and will my insurance cover it?
  • Are there brochures or other printed material that I can take with me? What websites do you recommend?
  • What will determine whether I should plan for a follow-up visit?

In addition to the questions that you've prepared, don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may allow more time later to cover other points you want to address. Your doctor may ask:

  • When did you first begin experiencing symptoms?
  • Have your symptoms been continuous, or occasional?
  • How severe are your symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?

Doctors use several tests to help diagnose gastroparesis and rule out conditions that may cause similar symptoms. Tests may include:

  • Measuring the time it takes for your stomach to empty. A gastric-emptying study measures how long it takes for food to move through your stomach. There are several ways to measure stomach emptying. In the most common test, you eat food that contains a small amount of radioactive material. A scanner that detects the movement of the radioactive material is placed over your abdomen to monitor the rate at which food leaves your stomach.
  • Using a scope to see inside your stomach. An upper endoscopy may help rule out other conditions that can cause delayed gastric emptying. During an endoscopy, your doctor passes a thin tube equipped with a camera down your throat and into your stomach and small intestine. The camera transmits images your doctor uses to evaluate your digestive system for abnormalities.

Treating gastroparesis begins with identifying and treating the underlying condition. For instance, if diabetes is causing your gastroparesis, your doctor can work with you to help you control your diabetes. Beyond this, other gastroparesis treatments may include:

Changes to your diet

Your doctor may refer you to a dietitian who can work with you to find foods that are easier for you to digest, so that you're more likely to get enough calories and nutrients from the food you eat. A dietitian might suggest that you try to:

  • Eat smaller meals more frequently.
  • Eat low-fiber forms of high-fiber foods, such as well-cooked fruits and vegetables rather than raw fruits and vegetables.
  • Choose mostly low-fat foods, but if you can tolerate them, add small servings of fatty foods to your diet.
  • Avoid fibrous fruits and vegetables, such as oranges and broccoli, that may cause bezoars.
  • If liquids are easier for you to ingest, try soups and pureed foods.
  • Drink water throughout each meal.
  • Try gentle exercise after you eat, such as going for a walk.

Some people with gastroparesis may be unable to tolerate any food or liquids. In these situations, doctors may recommend a feeding tube (jejunostomy tube) be placed in the small intestine.

Feeding tubes can be passed through your nose or mouth or directly into your small intestine through your skin. The tube is usually temporary and is only used when gastroparesis is severe or when blood sugar levels can't be controlled by any other method.

Medications

Medications to treat gastroparesis may include:

  • Medications to control nausea and vomiting. Anti-emetic medications include prochlorperazine (Compro), diphenhydramine (Benadryl, Unisom) and lorazepam (Ativan).
  • Medications to stimulate the stomach muscles. These medications include metoclopramide (Reglan) and erythromycin. There is a risk of serious side effects with these medications, so discuss the benefits and risks with your doctor.

Surgery

If treatment doesn't help control your nausea, vomiting or malnutrition, you may consider gastroparesis surgery. During surgery, the lower part of the stomach may be stapled or bypassed to help improve stomach emptying.

Experimental treatments

Researchers are working on new ways of treating gastroparesis, such as:

  • Injecting a nerve toxin to allow the stomach to release food. Botulinum toxin type A (Botox) is a nerve toxin most commonly known for its use in treating skin wrinkles. Researchers have found that Botox injections relax the pyloric muscle in some people, thereby allowing the stomach to release more food into the small intestine. The benefits are temporary, however, and more studies are needed to determine the overall usefulness of this treatment.
  • Implanting an electrical device to control the stomach muscles. Electrical gastric stimulation uses an electric current to cause stomach contractions. Working much like a heart pacemaker, this stomach pacemaker, consisting of a tiny generator and two electrodes, is placed in a pocket that surgeons create on the stomach's outer edge. Stomach pacemakers have been shown to improve stomach emptying and reduce nausea and vomiting in some people with gastroparesis, but more studies are needed.
  • Latest technology. Mayo Clinic has tests to help identify gastroparesis that are available in only a few medical centers.
  • Experience. Each year, Mayo Clinic doctors diagnose and treat thousands of people with gastroparesis.
  • Expertise. Mayo Clinic has doctors who specialize in disorders involving the movement of food through the digestive system (motility disorders). If needed, your treatment team may include specialists in diabetes, nutrition, the nervous system and behavior therapy.
  • Research leader. Mayo Clinic has long been at the forefront of gastroparesis research. You may have access to experimental treatments being studied.

Mayo Clinic in Rochester, Minn., ranks No. 1 for digestive disorders in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Scottsdale, Ariz., and Mayo Clinic in Jacksonville, Fla., are ranked high performing for digestive disorders by U.S. News & World Report.

At Mayo Clinic, we assemble a team of specialists who take the time to listen and thoroughly understand your health issues and concerns. We tailor the care you receive to your personal health care needs. You can trust our specialists to collaborate and offer you the best possible outcomes, safety and service.

Mayo Clinic is a not-for-profit medical institution that reinvests all earnings into improving medical practice, research and education. We're constantly involved in innovation and medical research, finding solutions to improve your care and quality of life. Your doctor or someone on your medical team is likely involved in research related to your condition.

Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care — and trusted answers — like they've never experienced.

Why Choose Mayo Clinic

What Sets Mayo Clinic Apart

At Mayo Clinic, tests for gastroparesis involve the entire digestive tract. It's important to pinpoint your problem so that you can get the right treatment.

Mayo's specialized tests include:

  • Detailed GI transit assessment. Measures how food moves through your digestive tract. Mayo Clinic specialists use a four-hour study to obtain the most precise results.
  • Gastric accommodation test. Measures how much the stomach expands after a meal. This test was developed by Mayo Clinic researchers.
  • Gastroduodenal manometry. Tests the muscles involved in digestion. At Mayo Clinic you rest in place throughout the test, which lasts five to six hours, to obtain the most-accurate results.
  • Autonomic nervous system testing. Analyzes a range of nerve functions involved in digestion. These tests were developed in conjunction with Mayo autonomic neurologists — doctors who specialize in the autonomic nervous system.
  • Paraneoplastic serological testing. Screens blood samples for antibodies associated with rare nervous system disorders that can cause severe gastroparesis. Mayo is one of the few medical centers to offer this blood test.

Gastroparesis is complicated to treat, especially for people who have diabetes or take pain medications that slow stomach emptying. At Mayo Clinic, a team of specialists works closely with you to find treatments that help control symptoms and improve your overall health and well-being.

For severe gastroparesis, Mayo Clinic doctors may recommend nutritional support using a tube placed directly into the small intestine (enteral nutrition) or a catheter inserted into a vein (parenteral nutrition).

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Specialists in gastroenterology usually manage care for adults who have gastroparesis. Specialists in motility disorders, endocrinology, neurology, psychology and nutrition are often involved in care.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

Specialists in gastroenterology usually manage care for adults who have gastroparesis. Specialists in motility disorders, endocrinology, neurology, psychology and nutrition are often involved in care.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

Specialists in gastroenterology care for adults who have gastroparesis. Specialists in the Motility Interest Group, endocrinology and nutrition are often involved in caring for people with gastroparesis.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Mayo Clinic doctors are conducting clinical trials of new ways to diagnose and treat gastroparesis. Researchers in the Enteric Neuroscience Program are studying the underlying mechanics of the digestive system, including nerve reflexes between the stomach and brain, as well as new methods of gastric biopsy to better understand the underlying causes of gastroparesis. Mayo researchers are also studying new therapies for diabetic gastroparesis.

Publications

See a list of publications by Mayo Clinic doctors on gastroparesis on PubMed, a service of the National Library of Medicine.

Jan. 04, 2012