Gastroparesis, also called delayed gastric emptying, is a disorder of the digestive tract that causes food to remain in the stomach for a period of time that’s longer than average. It’s most frequently recognized disease-associated cause is diabetes.

Gastroparesis occurs because the nerves that move food through the digestive tract are damaged, so muscles don’t work properly. As a result, food sits in the stomach undigested.

Gastroparesis can develop and progress over time, especially in those with blood sugar levels that are not well managed.

Here, we’ll cover the basics of gastroparesis, including symptoms, prevention, and more.

The following are symptoms of gastroparesis:

Gastroparesis symptoms may be minor or severe, depending on the damage to the vagus nerve, a long cranial nerve that extends from the brainstem to the abdominal organs, including those of the digestive tract.

Symptoms can flare up any time, but they’re more common after eating high fiber or high fat foods, all of which take more time to digest.

People who have gastroparesis have damage to their vagus nerve. This impairs nerve function and digestion because the impulses needed to churn food are slowed or stopped. Gastroparesis is difficult to diagnose and thus often goes undiagnosed. However, delayed diagnosis is associated with significant mortality.

Gastroparesis is more common in people who have high, unmanaged blood glucose levels over a long period of time. Extended periods of high glucose blood levels cause nerve damage throughout the body.

Chronically high blood sugar levels also damage the blood vessels that supply the body’s nerves and organs with nutrition and oxygen. This includes the vagus nerve and digestive tract, both of which ultimately lead to gastroparesis.

Because gastroparesis is a progressive disease, and some of its symptoms like chronic heartburn or nausea seem common, you may not realize that you have the disorder.

Females with diabetes are more likely to develop gastroparesis. Other conditions can compound your risk of developing the disorder. These include previous abdominal surgeries or a history of eating disorders.

Diseases, conditions, and factors other than diabetes can cause gastroparesis, including:

  • viral infections
  • acid reflux disease
  • smooth muscle disorders
  • certain surgeries
  • certain medications

Sometimes no known cause can be found, even after extensive testing.

When food isn’t digested normally, it can remain inside the stomach, causing symptoms of fullness and bloating. Undigested food can also form solid masses called bezoars that can contribute to:

  • nausea
  • vomiting
  • obstruction of the small intestines

Gastroparesis presents significant problems for people with diabetes because delays in digestion make managing blood glucose difficult.

The disease makes the digestion process hard to track, so glucose readings can fluctuate. If you have atypical glucose readings, share them with your doctor, along with any other symptoms you’re experiencing.

Gastroparesis is a chronic condition, and having the disorder can feel overwhelming.

Going through the process of making dietary changes and trying to manage blood sugar levels while feeling sick and nauseated to the point of vomiting can be exhausting. Those with gastroparesis often feel frustrated and depressed.

Your doctor will consider a variety of factors before making a diabetic gastroparesis diagnosis. They’ll consider your medical history and symptoms, and perform a physical exam to check for signs of gastroparesis. Signs could include:

Your doctor may also order blood or urine tests to check for any complications of gastroparesis. Imaging tests may also be used to check for abdominal blockages.

Some other tests your doctor may perform include esophagogastroduodenoscopy (EGD) or gastric emptying scintigraphy.

An EGD test can rule out infections and detect the presence of any food left in the stomach. Gastric emptying scintigraphy is a tool used for assessing gastric emptying. It’s considered the gold standard in the diagnosis of gastroparesis.

Your doctor will also likely adjust your insulin regimen as needed. They may recommend the following:

  • taking insulin more often or changing the type of insulin you take
  • taking insulin after meals, instead of before
  • checking blood glucose levels frequently after eating and taking insulin, when necessary

The doctor will be able to give you more specific instructions on how and when to take your insulin.

Gastric electrical stimulation (GES) is a possible treatment for severe cases of gastroparesis. In this procedure, a device is surgically implanted into your abdomen. It delivers electrical pulses to the nerves and smooth muscles of the lower part of your stomach. This may reduce nausea and vomiting.

In severe cases, people with long-term gastroparesis may use feeding tubes and liquid food for nutrition.

Less studied treatments include:

  • venting gastrostomy, a procedure where a tube allows gas and fluids to drain from the stomach
  • partial gastrectomy (partial removal of the stomach)
  • pyloroplasty, the widening of the opening near the end of the stomach that allows food to flow into the duodenum, the first part of the small intestine
  • intrapyloric botulinum toxin injection (the injection of botulinum toxin into the muscle of the pylorus) which helps relax the muscle
  • the medication granisetron, a 5-HT3 antagonist administered as a patch on the skin to relieve nausea and vomiting

For those with gastroparesis, avoiding eating high fiber, high fat foods is important, as these foods take longer to digest. Examples include:

  • raw foods
  • higher fiber fruits and vegetables like broccoli
  • rich dairy products like whole milk and ice cream

Additionally, consider avoiding carbonated beverages, which can make symptoms worse.

Doctors also recommend eating smaller meals throughout the day and blended foods if needed. It’s important to keep yourself properly hydrated as well, especially if you have vomiting.

Additionally, acupuncture has been shown to possibly be an effective therapy for diabetic gastroparesis.

Other illnesses can cause symptoms that mimic gastroparesis, including:

There’s no cure for gastroparesis — it’s a chronic condition. But it can be successfully managed with dietary changes, medications, procedures, and proper management of blood glucose. Though making some changes is necessary, you can continue to lead a healthy and fulfilling life.