Gastroparesis living

Overview

Gastroparesis is a condition where the stomach takes too long to empty its contents into the small intestine. The stomach muscles are weak or damaged, so food moves through more slowly than normal.

Gastroparesis is not very common, but it affects many people around the world. It is one of the most frequently diagnosed stomach motility disorders.

It can affect anyone, but it is more common in women and in people with diabetes. It may also affect people after certain stomach surgeries or with certain nervous system conditions.

Symptoms

Common symptoms

• Feeling full after only a few bites
• Nausea or vomiting (sometimes hours after eating)
• Bloating and abdominal discomfort
• Stomach pain that comes and goes
• Poor appetite and unintentional weight loss
• Changes in blood sugar levels (if you have diabetes)

Symptoms in children

• Infants and children may vomit frequently and have a swollen belly.
• They may eat very little and not gain weight as expected.
• They may seem fussy or uncomfortable after meals.

Symptoms in older adults

• Older adults may have vague symptoms like loss of appetite, fatigue, or confusion.
• They may develop dehydration and weight loss more quickly.
• Symptoms can sometimes be mistaken for normal ageing, so medical review is important.

Causes

Main causes

• Damage to the vagus nerve, especially in people with diabetes and high blood sugar
• Idiopathic causes (when no specific cause can be found)
• Surgery on the stomach or oesophagus that affects the vagus nerve
• Some nervous system disorders, such as Parkinson's disease
• Certain medications (talk to your doctor about possible effects)

Risk factors

• Having type 1 or type 2 diabetes, especially with long-term poor blood sugar control
• Previous abdominal surgery, such as bariatric or ulcer surgery
• Autoimmune conditions, such as scleroderma
• Infections that affect the stomach, though this is less common

When to see a doctor

See a doctor urgently if:

• If you have severe abdominal pain, repeated vomiting, or signs of dehydration
• If you are diabetic and your blood sugar levels are not responding to your usual care

Book a routine appointment if:

• If you have nausea, vomiting, or feeling full after small meals that lasts for weeks
• If you are losing weight unintentionally
• If symptoms are interfering with your daily life or ability to eat enough

Diagnosis

A doctor will start by asking about your symptoms and medical history, then examine you. They will often refer you to a digestive specialist (gastroenterologist) for tests that look at how well your stomach empties.

Tests that may be done

• Gastric emptying study: you eat or drink a mildly radioactive meal and it is tracked on a scanner to see how long it takes to leave your stomach.
• Upper endoscopy: a thin, flexible tube with a camera is passed through your mouth to look at your stomach and rule out blockages.
• Abdominal ultrasound: this uses sound waves to check the gallbladder, kidneys, and other organs for other causes.
• Blood tests: these check for anaemia, electrolyte problems, low thyroid, or diabetes.

What to expect at your appointment

The tests are usually done as an outpatient, meaning you can go home the same day. It may take a few weeks to get a clear diagnosis. Your doctor will explain the results and help you map out a plan.

Treatment

There is no single cure for gastroparesis, but treatment can help you feel better and avoid complications. The plan depends on what is causing it and how severe your symptoms are.

Self-care at home

• Eat smaller, more frequent meals (for example, six small meals a day instead of three large ones).
• Choose well-cooked, soft, low-fibre foods, and chew thoroughly.
• Drink fluids between meals rather than large amounts during meals.
• Take a gentle walk after eating to help your stomach work.
• Track your blood sugar closely if you have diabetes, and talk to your diabetes team.

Medical treatments

There are medications that can help the stomach muscles contract and empty more effectively, as well as medicines to control nausea and pain. Your healthcare team will discuss options that are right for you and adjust them over time.

When is surgery considered?

In rare, severe cases when symptoms cannot be controlled with other treatments, procedures may be considered, such as placing a feeding tube or using a device that supplies mild electrical stimulation to the stomach. These options are only discussed after thorough evaluation by a specialist.

Living with this condition

Living with gastroparesis means planning meals and listening to your body. You may need to adjust your eating schedule, carry snacks, and have an emergency plan for bad days. It helps to keep a diary of what you eat and how you feel.

Lifestyle tips

• Make mealtimes calm and relaxed, without rushing.
• Sit upright for at least an hour after eating.
• Avoid tight clothing around your waist.
• Ask your doctor about quitting smoking and limiting alcohol, as they can make symptoms worse.
• Find gentle ways to manage stress, like breathing exercises, meditation, or talking to a friend.

Diet and exercise

Most people do best with small, low-fat, low-fibre meals that are soft and easy to digest. Cooking vegetables until soft and blending foods can help. Gentle exercise like walking after meals can support digestion, but avoid vigorous exercise right after eating. Work with a dietitian to make sure you still get enough nutrients.

Mental health and emotional wellbeing

Living with a chronic condition can be stressful and can lead to anxiety or depression. It is completely normal to feel frustrated or worried. Please speak to your doctor about your feelings, and if you are in crisis, contact your local mental health crisis line or call your local emergency number.

Prevention

In many cases, gastroparesis cannot be prevented, especially if it is caused by a medical condition or surgery. However, keeping diabetes under good control may reduce the risk of nerve damage that leads to it.

Complications

If left untreated

• Dehydration from frequent vomiting
• Poor absorption of nutrients and unintentional weight loss
• Severe blood sugar swings if you have diabetes
• Formation of bezoars (hard food masses) in the stomach, which can block the outlet
• Reduced quality of life because of pain and nausea

Long-term outlook

Gastroparesis can be challenging, but with the right treatment, lifestyle adjustments, and support, many people manage it well and enjoy a good quality of life. It is important to work closely with your healthcare team and keep them updated on any changes.

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