What is gastroparesis?
Gastroparesis is a condition where the stomach empties more slowly than normal into the small intestine. Normally, the stomach muscles contract to break down food and move it forward through the digestive tract. In gastroparesis, these contractions do not work properly, which can lead to delayed digestion and a variety of symptoms.

In some cases, gastroparesis may also affect how other parts of the digestive system function.

What causes gastroparesis?
In many cases, the exact cause is unknown (idiopathic gastroparesis). Known causes and risk factors may include:

  • Diabetes
  • Prior gastrointestinal or stomach surgery
  • Viral or bacterial infections
  • Thyroid disorders
  • Neurologic conditions such as Parkinson’s disease or multiple sclerosis
  • Certain medications, including opioid pain medications and some diabetes or weight-loss medications
  • Connective tissue disorders such as scleroderma
  • History of eating disorders
  • Alcohol, tobacco, or marijuana use in some cases

Symptoms of gastroparesis
Symptoms can range from mild to severe and may include:

  • Nausea
  • Vomiting, sometimes of undigested food eaten hours earlier
  • Feeling full quickly after starting a meal (early satiety)
  • Bloating in the upper abdomen
  • Upper abdominal pain, often after eating
  • Heartburn or acid reflux
  • Poor appetite
  • Unintentional weight loss

Diagnosing gastroparesis
Your provider will review your symptoms and medical history and may recommend testing to confirm the diagnosis and rule out other conditions.

Testing may include:

  • Blood tests to check blood sugar, thyroid function, electrolytes, and nutritional status
  • Upper endoscopy (EGD) to rule out blockage or other structural causes
  • Gastric emptying study, the primary test used to measure how quickly the stomach empties
  • Upper GI X-ray (barium study)
  • Breath testing in selected cases
  • SmartPill (wireless motility capsule) in some patients

These tests help confirm delayed stomach emptying and guide treatment decisions.

Treatment for gastroparesis
Treatment focuses on improving symptoms, supporting nutrition, and helping the stomach empty more effectively.

Dietary changes (first step)

  • Eat smaller, more frequent meals (4–6 per day)
  • Choose soft, well-cooked foods that are easy to chew
  • Limit high-fat and high-fiber foods
  • Avoid spicy, fatty, acidic, or difficult-to-digest foods
  • Include soups and liquid-based nutrition when needed
  • Use nutritional supplements if recommended
  • Stay well hydrated

Medications
Treatment may include:

  • Anti-nausea medications
  • Prokinetic medications to help the stomach empty more effectively
  • Short-term use of medications such as erythromycin in selected cases

Your provider will determine the best combination based on your symptoms.

Nutritional support (if needed)
If nutrition is not adequate with oral intake, additional support may include:

  • Feeding tubes are placed into the small intestine
  • IV nutrition (parenteral nutrition) in rare, severe cases

Advanced therapies
For patients with persistent symptoms despite standard treatment, additional options may include:

  • Gastric electrical stimulation (Enterra therapy) is a device similar to a pacemaker that helps reduce nausea and vomiting
  • Gastric per-oral endoscopic myotomy (G-POEM) is an endoscopic procedure that helps improve stomach emptying 

Enterra therapy gastric electrical stimulation device may be considered in select patients with severe, refractory symptoms.

Complications of gastroparesis
Gastroparesis can affect nutrition and hydration. Some patients may develop deficiencies in iron, vitamin B12, vitamin D, calcium, potassium, or magnesium.

This condition can also affect emotional well-being, and some patients may experience stress, anxiety, or depression related to chronic symptoms.

Follow-up and ongoing care
Follow-up care depends on symptom severity and treatment response. Most patients are seen within 4–8 weeks after starting treatment, with additional visits scheduled as needed.

Ongoing care may include:

  • Regular follow-up visits
  • Nutrition monitoring
  • Medication adjustments
  • Dietitian support
  • Symptom tracking

When to seek care
Contact your healthcare provider if you experience:

  • Persistent or worsening nausea or vomiting
  • Inability to maintain nutrition or hydration
  • Significant or unintentional weight loss
  • Worsening abdominal pain
  • Symptoms that do not improve with treatment

Contact us
If you have questions about gastroparesis or treatment options, please contact our office at 612-871-1145.

 

Resources

Websites:

Books:

  • Eating for Gastroparesis: Guidelines, Tips, & Recipes by Crystal Zaborowski-Saltrelli
  • Living (Well!) with Gastroparesis: Answers, Advice, Tips & Recipes for a Happier, Healthier Life