SystmOnline Services Apps
Gastroparesis is a long-term (chronic) condition where the stomach can't empty itself in the normal way. Food passes through the stomach more slowly than usual.
It's thought to be the result of a problem with the nerves and muscles controlling the emptying of the stomach.
If these nerves are damaged, the muscles of your stomach may not work properly and the movement of food can slow down.
This page covers:
Symptoms of gastroparesis may include:
These symptoms can be mild or severe, and tend to come and go.
See your GP if you're experiencing symptoms of gastroparesis, as it can lead to some potentially serious complications.
In many cases of gastroparesis, there's no obvious cause. This is known as idiopathic gastroparesis.
Known causes of gastroparesis include:
Other possible causes include:
To diagnose gastroparesis, your GP will ask about your symptoms and medical history, and may arrange some blood tests.
You may be referred to hospital for some of the following tests:
Gastroparesis can't usually be cured, but dietary changes and medical treatment can help you control the condition.
You may find these tips helpful:
It may also help to avoid certain foods that are hard to digest – such as apples with their skin on, or high-fibre foods like oranges and broccoli – as well as foods high in fat, which can also slow down digestion.
The following medications may be prescribed to help improve your symptoms:
However, the evidence that these medications relieve the symptoms of gastroparesis is relatively limited and they can cause a number of side effects. Your doctor should discuss the potential risks and benefits with you.
Domperidone should only be taken at the lowest effective dose for the shortest possible duration because of the small risk of potentially serious heart-related side effects.
If dietary changes and medication don't improve your symptoms, a relatively new treatment called gastroelectrical stimulation may be tried. However, this is currently not routinely funded by many local NHS authorities.
Gastroelectrical stimulation involves surgically implanting a battery-operated device under the skin of your tummy.
Two leads attached to this device are fixed to the muscles of your lower stomach. They deliver electrical impulses to help stimulate the muscles involved in controlling the passage of food through your stomach. The device is turned on using a handheld external control.
The effectiveness of this treatment can vary considerably. Not everyone will respond to it, and for many of those who do the effect will largely wear off within 12 months. This means electrical stimulation isn't suitable for everyone with the condition.
There's also a small chance of this procedure leading to complications that would require removing the device, such as:
Speak to your surgeon about the possible risks. You can also read the National Institute for Health and Care Excellence (NICE) guidelines on gastroelectrical stimulation for gastroparesis.
More severe cases of gastroparesis may occasionally be treated by injecting botulinum toxin into the valve between your stomach and small intestine.
This relaxes the valve and keeps it open for a longer period of time so food can pass through.
The injection is given through an endoscope, which is passed down your throat and into your stomach.
This is a fairly new treatment and some studies have found it may not be very effective, so it's not recommended by all doctors.
If you have extremely severe gastroparesis that isn't improved with dietary changes and medication, you may benefit from a feeding tube.
Many different types of temporary and permanent feeding tube are available.
A temporary feeding tube called a nasojejunal tube may be offered to you first, which is inserted through your nose to pass nutrients directly into your small intestine.
A feeding tube can also be inserted into your bowel surgically through a cut (incision) made in your tummy. This is known as a jejunostomy.
Liquid food containing nutrients can be fed through the tube, which goes straight to your bowel to be absorbed, bypassing your stomach.
Speak to your doctor about the risks and benefits of each type of feeding tube.
An alternative feeding method for severe gastroparesis is intravenous (parenteral) nutrition, where liquid nutrients are passed straight into your bloodstream through a catheter fed into a large vein.
Some people may benefit from having an operation to insert a tube into the stomach through the tummy. This tube can be periodically opened to release gas and relieve bloating.
A surgical procedure may be recommended as a last resort to either:
These procedures may reduce your symptoms by allowing food to move through your stomach more easily.
Your doctor can explain whether any procedures are suitable for you, and can discuss the possible risks involved.
Having gastroparesis means your food is being absorbed slowly and at unpredictable times. If you also have diabetes, this can lead to wide swings in blood sugar levels.
The nerves to the stomach can be damaged by high levels of blood glucose, so it's important to keep your blood glucose levels under control if you have diabetes.
Your doctor can advise you about any changes you may need to make to your diet or medication.
If you're taking insulin, you may need to divide your dose before and after meals and inject into areas where absorption is typically slower, such as the thigh.
You'll also need to check your blood glucose levels frequently after you eat.
Read about living with diabetes.