Symptoms & Causes of Gastroparesis

What are the symptoms of gastroparesis?

The symptoms of gastroparesis may include

• feeling full soon after starting a meal
• feeling full long after eating a meal
• nausea
• vomiting
• too much bloating
• too much belching
• pain in your upper abdomen
• heartburn
• poor appetite

Certain medicines may delay gastric emptying or affect motility, resulting in symptoms that are similar to those of gastroparesis. If you have been diagnosed with gastroparesis, these medicines may make your symptoms worse. Medicines that may delay gastric emptying or make symptoms worse include the following:

• narcotic pain medicines, such as codeine , hydrocodone , morphine , oxycodone , and tapentadol 
• some antidepressants , such as amitriptyline , nortriptyline , and venlafaxine 
• some anticholinergics —medicines that block certain nerve signals
• some medicines used to treat overactive bladder 
• pramlintide

These medicines do not cause gastroparesis.

When should I seek a doctor’s help?

You should seek a doctor’s help right away if you have any of the following signs or symptoms:

• severe pain or cramping in your abdomen
• blood glucose levels that are too high or too low
• red blood in your vomit, or vomit that looks like coffee grounds
• sudden, sharp stomach pain that doesn’t go away
• vomiting for more than an hour
• feeling extremely weak or fainting
• difficulty breathing
• fever

You should seek a doctor’s help if you have any signs or symptoms of dehydration, which may include

• extreme thirst and dry mouth
• urinating less than usual
• feeling tired
• dark-colored urine 
• decreased skin turgor, meaning that when your skin is pinched and released, the skin does not flatten back to normal right away
• sunken eyes or cheeks
• light-headedness or fainting

You should seek a doctor’s help if you have any signs or symptoms of malnutrition, which may include

• feeling tired or weak all the time
• losing weight without trying
• feeling dizzy
• loss of appetite
• abnormal paleness of the skin

What causes gastroparesis?

In most cases, doctors aren’t able to find the underlying cause of gastroparesis, even with medical tests. Gastroparesis without a known cause is called idiopathic gastroparesis.

Diabetes is the most common known underlying cause of gastroparesis. Diabetes can damage nerves, such as the vagus nerve and nerves and special cells, called pacemaker cells, in the wall of the stomach. The vagus nerve controls the muscles of the stomach and small intestine. If the vagus nerve is damaged or stops working, the muscles of the stomach and small intestine do not work normally. The movement of food through the digestive tract is then slowed or stopped. Similarly, if nerves or pacemaker cells in the wall of the stomach are damaged or do not work normally, the stomach does not empty.

In addition to diabetes, other known causes of gastroparesis include

• injury to the vagus nerve due to surgery on your esophagus, stomach, or small intestine
• hypothyroidism 
• certain autoimmune diseases, such as scleroderma
• certain nervous system  disorders, such as Parkinson’s disease  and multiple sclerosis 
• viral infections of your stomach