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Gastroparesis
K31.84 · Gastroparesis
Gastroparesis
Delayed stomach emptying without a blockage. A real motility disorder confirmed by gastric emptying study, not a DGBI.
~4%
of US adults have symptoms consistent with gastroparesis; confirmed diagnoses are fewer
Quick answer
Gastroparesis is a measurable motility problem: the stomach empties too slowly even though nothing is blocking it. Diagnosis requires a gastric emptying study, not a guess. The plan is gastroenterology-led: prokinetic medication, dietary structure, and a clear treatment ladder. Supplements support the same motility and nerve-energy circuits. They are not the main lever.
Gastroparesis (ICD-10 K31.84) is delayed gastric emptying in the absence of mechanical obstruction, formally diagnosed by gastric scintigraphy showing retained meal at 4 hours. Adult prevalence is approximately 1.8%, with the majority idiopathic. Symptoms — early satiety, postprandial fullness, nausea, and vomiting of undigested food — overlap heavily with functional dyspepsia, and the distinction matters because the management diverges.
Patterns and subtypes
🍽️
Idiopathic
No clear cause
Symptoms
- Early fullness with small meals
- Nausea after eating
- Bloating that lingers for hours
Triggers
- Larger meals
- High-fat or high-fiber foods
- Eating fast or while stressed
💉
Diabetic
Long-standing diabetes
Symptoms
- Erratic blood sugars after meals
- Nausea, fullness, vomiting
- Weight loss over months
Triggers
- High A1C over years
- Skipping insulin timing
- Large evening meals
🔬
Post-surgical
After GI or vagal surgery
Symptoms
- New nausea and fullness after a procedure
- Slow return to normal eating
- Reflux symptoms layered in
Triggers
- Bariatric, fundoplication, or esophageal surgery
- Vagal nerve injury
🦠
Post-viral
After a stomach bug
Symptoms
- Nausea and fullness that never fully resolved
- Pattern starts after a clear viral illness
- Often improves over 12-24 months
Triggers
- Post-infectious nerve injury
- Slow recovery, especially in younger adults
What your doctor might miss
Symptoms alone don't make the diagnosis.
Early fullness and nausea overlap with functional dyspepsia. A 4-hour gastric emptying scintigraphy is the standard test. Without it, you may be on the wrong plan for years.
Many medications slow gastric emptying.
GLP-1 agonists (semaglutide, tirzepatide), opioids, anticholinergics, and some antidepressants can mimic or worsen gastroparesis. A medication review is part of the workup, not an afterthought.
Gastroparesis and functional dyspepsia overlap.
Up to a third of patients with confirmed delayed emptying also meet criteria for functional dyspepsia, and the reverse is true. Naming both, when both are present, changes the plan.
Red flags
Urgent — ER now
- Vomiting blood or coffee-ground material
- Severe belly pain that is new or different
- Persistent vomiting with signs of dehydration
- No urination for 12+ hours
- Unintended weight loss over 10% in 6 months
Needs evaluation
- New symptoms after age 50
- Erratic blood sugars in diabetes
- Persistent nausea over 4 weeks
- Family history of stomach cancer
- Bezoar (a mass of undigested food) on imaging
Mimics
- Functional dyspepsia: normal gastric emptying study distinguishes.
- Gastric outlet obstruction: imaging or endoscopy.
- Cyclic vomiting syndrome: episodic, with full recovery between.
- Rumination syndrome: observation of effortless regurgitation pattern.
The treatment ladder
01 · Confirm
Confirm.
See a gastroenterologist. The diagnosis runs on a 4-hour gastric emptying study, not symptoms alone. Endoscopy rules out obstruction. Medication review is part of the workup.
Use Visit Prep →
02 · Medical plan
Medical plan.
Prokinetic medication (metoclopramide, erythromycin, or newer agents) is the standard of care. Diabetic patients need tighter glucose control. Stop or swap any medication that slows the stomach if possible.
03 · Diet structure
Diet structure.
Smaller, more frequent meals. Lower fat and lower insoluble fiber on rough days. A registered dietitian who knows gastroparesis is worth the visit. The boring rules earn the most ground.
04 · Support
Support.
MGB+ Cool layers in motility-supporting botanicals and lipid-soluble B1 alongside your gastroenterologist's plan. It supports the same motility and nerve-energy cofactors your medical team is targeting. It is a layer-on, not a replacement for prokinetic medication or specialist care.
See MGB+ Cool → →
Gastroparesis questions
Frequently asked
How is gastroparesis different from functional dyspepsia?
Gastroparesis is confirmed with a gastric emptying study showing the stomach holds onto food longer than it should. Functional dyspepsia has the same kinds of symptoms but a normal emptying study. They overlap heavily, but the test is what draws the line. The plan differs because prokinetic medications are first-line for confirmed gastroparesis.
Do I need a gastric emptying study?
Yes, if your doctor suspects gastroparesis. It is the standard test. A 4-hour scintigraphy with a low-fat meal is the most accurate version. Endoscopy is also usually part of the workup to rule out a blockage. Without these, you may be on the wrong plan.
Can a GLP-1 drug (semaglutide, tirzepatide) cause gastroparesis?
GLP-1 drugs slow gastric emptying as part of how they work. In some patients this looks identical to gastroparesis and resolves when the drug is stopped or paused. If you started a GLP-1 and developed nausea and fullness, talk to your prescriber before assuming you have a separate disease.
Will MGB+ Cool replace my prokinetic medication?
No. Cool is built to layer on top of your gastroenterologist's plan, not replace it. Prokinetic medications, glucose control in diabetes, and dietary structure are the proven first-line moves. The botanicals, ginger, and lipid-soluble B1 in Cool support the same motility and nerve-energy circuits. Talk to your prescriber before changing any medication.
How long until I notice a change?
Most people notice the ginger and botanical blend within the first 1 to 2 weeks. The cofactor support from lipid-soluble B1 and magnesium settles in over 4 to 8 weeks. Cool is meant to run alongside your medical plan for a steadier baseline. It is not a fast fix and is not a substitute for prokinetic medication.
Is gastroparesis permanent?
It depends on the cause. Post-viral cases often improve over 12 to 24 months. Diabetic gastroparesis can stabilize with tighter glucose control. Idiopathic cases vary. The realistic goal is a steadier baseline and fewer rough weeks, not a guaranteed cure.
Should I see a motility center?
Yes, if first-line care is not holding. Major academic centers run motility clinics with access to newer drugs, gastric electrical stimulation, and clinical trials. Ask your GI for a referral if you are still struggling after a real trial of medication and dietary changes.
MGB+ Cool
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