Gastroparesis

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Gastroparesis

Gastroparesis, meaning "stomach paralysis," is a chronic disorder in which the stomach empties its contents into the small intestine too slowly, despite no mechanical obstruction. This delayed gastric emptying can wreak havoc on the digestive system, and for those of us battling acid-related conditions, it often adds insult to injury.

In a healthy digestive system, the vagus nerve helps coordinate the muscular contractions (peristalsis) that move food through the stomach and into the duodenum. When the vagus nerve is damaged or not functioning properly—as may happen with long-term diabetes, certain surgeries, or even viral infections—these contractions weaken or become erratic. The result: food lingers in the stomach far longer than it should.

This sluggish motility can cause a range of symptoms, including:

• Nausea and vomiting

• Bloating

• Early satiety (feeling full quickly)

• Upper abdominal pain

• Erratic blood sugar levels

• And of course—reflux.

With food and gastric contents sitting in the stomach longer, there's a greater chance for acid to backflow into the oesophagus. Gastroparesis can exacerbate reflux, leading to increased episodes of heartburn, regurgitation, and inflammation of the oesophagus (oesophagitis). In some cases, undigested food may be vomited back up hours after eating, sometimes with a disturbing resemblance to what was eaten earlier—an unsettling sign of delayed gastric emptying.

Diagnosis & Treatment

Gastroparesis is typically diagnosed through a gastric emptying study, where a radioactive meal is tracked as it moves through the stomach. Other tests might include upper endoscopy or electrogastrography.

Treatment can be tricky. Dietary changes are often first-line: small, low-fat, low-fibre meals that are easier to digest. Some patients benefit from prokinetic medications like metoclopramide or domperidone, which stimulate stomach contractions—but these come with risks and side effects. In severe cases, feeding tubes or gastric electrical stimulation may be considered.

For those already managing acid reflux or related conditions, gastroparesis can feel like a cruel companion—turning a manageable trickle of acid into a more persistent flood. Understanding the overlap between these conditions is key to managing both effectively.

Page updated 18 May 2025