What Is Gastroparesis? Understanding Symptoms & Causes

September 23, 2025

Gastroparesis is a digestive condition many people have never heard of, yet it affects an estimated 5 million people in the United States. It is a chronic condition that can impact daily life in very different ways. For some, symptoms may be mild and mistaken for routine stomach upset. For others, gastroparesis can significantly disrupt daily life and nutrition.

“Gastroparesis is a disorder where the stomach takes longer than normal to empty its contents into the small intestine,” said Franciscan Health gastroenterologist Mohammad Arfeen, DO. “That delay can cause uncomfortable symptoms, from nausea to bloating to difficulty finishing meals. It’s a lot like the mechanism by which the injectable weight loss medications work.”

Understanding the signs, causes and treatment options can help patients get relief and regain quality of life.

Key Takeaways: Gastroparesis Symptoms & Causes

Gastroparesis can be marked by a constant feeling of fullness, vomiting, nausea, abdominal pain, heartburn, poor appetite, bloating or unintentional weight loss.
Causes of gastroparesis include surgery, diabetes, GERD and certain medications. For some cases, there is no known cause.
Many people can manage gastroparesis symptoms with the right care. Personalized treatment for gastroparesis can include lifestyle changes, medications, or advanced treatments.

What Are Symptoms Of Gastroparesis?

Gastroparesis affects people in very different ways. For some, nausea never lets up, vomiting happens multiple times a day or a constant sense of fullness makes it difficult to eat. Others experience symptoms only after certain meals or foods, with episodes that come and go.

In addition to nausea and vomiting, many patients also deal with:

Abdominal pain
Bloating
Changes in blood sugar control for people with diabetes
Feeling full quickly, even after eating small amounts
Heartburn or acid reflux
Poor appetite or unintentional weight loss

Symptoms may flare when you feel stress or with poorly controlled blood sugar, which can make day-to-day management more challenging.

“Many of my patients describe a constant sense of fullness,” Dr. Arfeen said. “It’s not just inconvenient. It affects how much they can eat and their ability to get nutrients. Sometimes it even makes blood sugar harder to control.”

What Causes Gastroparesis?

Gastroparesis doesn’t have a single cause. In fact, doctors have identified several different factors that may play a role. In some cases, the cause isn’t clear at all.

Diabetes

“Diabetes is the most common known cause of gastroparesis,” Dr. Arfeen said.

High blood sugar over time can damage the vagus nerve, which controls stomach emptying.

Dr. Arfeen explained that by far the most common cause is diabetic gastroparesis, which links to neuropathy.

“Just like people get numbness and tingling in their hands and feet when elevated blood sugars attack the nerves over time, those same sugars can damage the nerves that control the motility of the stomach,” he said. “That nerve damage leads to decreased motility, poor emptying and sometimes spasm of the pylorus — the ring at the exit of the stomach.”

If your gastroparesis is related to diabetes, learn more about how diabetes affects you in our blog on diabetic gastroparesis.

Gastroesophageal reflux disease (GERD)

In some patients, long-term (GERD) may overlap with or worsen symptoms of gastroparesis. Chronic reflux can disrupt normal stomach function and make emptying even slower.

Medications

Certain drugs, especially narcotic pain medications, GLP-1s and some antidepressants, can slow the natural muscle contractions of the stomach.

For patients who already have slower movement of food through the digestive tract, these medications can make gastroparesis symptoms worse.

Surgery

Operations on the stomach, esophagus or upper small intestine can sometimes unintentionally injure the vagus nerve. This nerve plays a key role in controlling how quickly food moves through the digestive system. When it’s damaged, food may stay in the stomach longer than it should.

Idiopathic (unknown) gastroparesis

In many patients, we can’t identify a clear cause for their gastroparesis. This is called idiopathic gastroparesis. While frustrating, it’s important to know that the condition is still real and treatable even if doctors can’t pinpoint the exact reason why it developed.

How Is Gastroparesis Diagnosed?

Diagnosis often begins with a medical history and physical exam. Providers may use additional tests to confirm delayed stomach emptying, including:

Gastric emptying study: This is the most common test. Patients eat a meal with a safe tracer and imaging measures how quickly food leaves the stomach.
Upper gastrointestinal endoscopy: This procedure can rule out blockages or other structural issues.
SmartPill® motility capsule: A wireless device swallowed like a pill that transmits information about how food moves through the GI tract
Imaging scans: A CT scan, MRI and X-rays taken after you have a chalky drink may show a blockage in the stomach or intestines.

“Diagnosis is an important step because symptoms of gastroparesis can overlap with other digestive conditions,” Dr. Arfeen said.

Living With Gastroparesis

Many people can manage symptoms with the right care. Personalized treatment for gastroparesis may include:

Dietary changes, such as eating smaller and more frequent meals
Medications to stimulate stomach emptying or control nausea
Blood sugar management, which is especially important for people living with diabetes
Referral to specialists in gastroenterology for advanced treatment options

We may recommend advanced therapies for patients with severe or persistent symptoms. One option is gastric peroral endoscopic myotomy (G-POEM), a minimally invasive procedure that improves stomach emptying by cutting tight stomach muscles that slow digestion. In certain cases, we may consider other treatments, such as gastric electrical stimulation or surgery.

“Gastroparesis doesn’t have a one-size-fits-all solution,” Dr. Arfeen said. “But with a personalized approach, we can help most patients feel better and protect their nutrition.”