Gastroparesis, often referred to as delayed gastric emptying, is a chronic medical condition in which the movement of food from the stomach to the small intestine is slowed or stopped altogether. 

Normally when a person swallows food, contractions in the muscles of the stomach help break the food down into smaller pieces before pushing it into the small intestine where the body continues the process of digestion. In people with gastroparesis, these stomach contractions are weak or non-existent, causing food to remain in the stomach longer than normal. This delay in emptying can result in serious symptoms and complications. 

Diabetes is one of the most common causes of gastroparesis, particularly if blood sugar levels have been poorly controlled over a long time. Another common cause of gastroparesis is damage to the vagus nerve, which sends nerve impulses that control the stomach and the small intestine.

Gastroparesis is rare. For every 100,000 people in the U.S., about 10 men and 40 women have gastroparesis. The condition can lead to a range of serious health problems, including malnutrition due to poor absorption of nutrients from food, and can make blood sugar levels harder to control, which can be particularly dangerous for people with diabetes.

Why Hoag for Gastroparesis Evaluation & Treatment? 

Need treatment for gastroparesis in Orange County? Trust the Hoag Digestive Health Institute to help you heal. Hoag’s comprehensive, fully-integrated Foregut Program is the area’s recognized leader in the treatment of chronic conditions of the esophagus stomach and lower esophageal sphincter. Our program offers a patient-centered approach, drawing on the latest advancements in techniques and technology to help patients find lasting, life-changing treatment options they just can’t get anywhere else.  

Symptoms and Causes of Gastroparesis

The symptoms of gastroparesis are different for every patient and can range from mild to severe. Symptoms of gastroparesis may include:

  • A feeling of fullness after eating only a small amount of food
  • Recurring nausea
  • Vomiting undigested food, sometimes several hours after a meal
  • Vomiting-related dehydration
  • Abdominal bloating
  • Recurrent belching
  • Heartburn or gastroesophageal reflux. Learn more about GERD.
  • Changes in blood sugar levels
  • Loss of appetite
  • Unintentional weight loss and malnutrition


Take Hoag’s Free, 5-Minute Online Assessment to Evaluate Your Risk of Acid Reflux and GERD



Causes of Gastroparesis

While most cases of gastroparesis occur for no discernable reason (known as “idiopathic gastroparesis”), there are known factors that can contribute to contracting the condition. These may include:  

  • Diabetes, which is one of the most common causes of gastroparesis, particularly if blood sugar levels have been poorly controlled over a long time 
  • Damage to the vagus nerve during previous surgical procedures involving the esophagus, stomach or small intestine 
  • Certain autoimmune diseases, including scleroderma
  • Nervous system disorders, including Parkinson’s disease and multiple sclerosis
  • Previous cancer treatments that included radiation therapy to your chest or abdomen
  • Hypothyroidism

In addition, certain medications may cause symptoms that mimic those of gastroparesis, or make gastroparesis symptoms worse. These include: 

  • Some narcotic pain medications, including codeine, hydrocodone, morphine, oxycodone and tapentadol. 
  • Some types of antidepressants, including amitriptyline, nortriptyline and venlafaxine
  • Some types of anticholinergics, which block nerve impulses

Diagnosis & Tests for Gastroparesis

If you visit a doctor with symptoms that suggest you might have gastroparesis, he or she will likely ask you questions about your medical history and symptoms, followed by a thorough medical exam. 

Depending on the results of that exam, your doctor may ask you to complete further tests to confirm or rule out gastroparesis. These tests may include:    

  • Upper gastrointestinal (GI) endoscopy, in which a specialist puts a long, flexible tube with a light and a camera on the tip into your mouth, down the esophagus and into the stomach, both to look for problems and potentially collect tissue samples for examination in a lab. Explore Hoag’s Orange County endoscopy centers located near you
  • A gastric emptying test (A.K.A. “gastric emptying scintigraphy”), which measures how long it takes for food to pass through the stomach. As part of the test, you may be asked to eat a bland meal that contains a small amount of harmless radioactive tracer material. Once the material is swallowed, imaging devices outside the body scan your abdomen and track how fast the food moves through the digestive system. 
  • Ultrasound imaging of the stomach and other structures
  • SmartPill, an ingestible device the size of an ordinary pill that measures pressure, acidity and temperature as it moves through the gastrointestinal tract
Advanced Diagnosis of Conditions of the Esophagus & Stomach at Hoag

As Orange County’s recognized leader in the accurate diagnosis and treatment of conditions involving the stomach and esophagus, the Hoag Digestive Health Institute is here for those facing serious conditions involving these crucial digestive organs, including GERD, Barrett’s esophagus and esophageal cancer. 

At Hoag, advanced procedures used to diagnose or treat conditions involving the stomach and esophagus include: 

Management & Treatment of Gastroparesis

The management and treatment of gastroparesis aim to alleviate symptoms, ensure adequate nutrition, and address underlying causes like diabetes. Sometimes, treating the underlying cause of gastroparesis will lessen or eliminate the symptoms produced by the condition.
Management and treatment of gastroparesis can involve a combination of techniques, including dietary changes, medications, and other techniques. Treatments for gastroparesis may include: 

  • Lifestyle changes, including: 
    • Eating foods that are lower in fiber and fat
    • Eating smaller and more frequent meals
    • Chewing food slowly and thoroughly
    • Avoiding carbonated drinks
    • Avoiding lying down for at least 2 hours after a meal
    • Avoiding alcohol
    • Getting moderate physical activity following meals
  • Taking medications that help the muscles in your stomach work better, or help control nausea and vomiting
  • Tube or intravenous feeding in severe cases where the person can’t get enough nutrition through eating
  • Gastric electrical stimulation (GES), which involves the implantation of a device that delivers mild electrical pulses to stimulate stomach contractions. These impulses help food move through the stomach more easily, while reducing nausea and vomiting. GES is only used in severe cases where symptoms can’t be well controlled with medicine. 

Prevention of Gastroparesis

There’s no known way to definitely prevent yourself from developing gastroparesis, and many cases develop without a known cause. However, there are certain steps you can take to reduce your risk of developing gastroparesis. These may include: 

  • Eat a balanced, healthy diet 
  • Maintain a healthy weight
  • Manage your diabetes, taking your medication as directed, monitoring your blood sugar and eating a diet that keeps your blood glucose levels under control
  • Get regular exercise
  • Use medications known to slow gastric emptying only as directed


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