Delayed gastric emptying results from a malfunction in the movements of the stomach.
In this case, the stomach muscle contracts too little or too irregularly. Thus, the chewed food stays in the stomach longer than usual because the stomach is not emptied regularly.
Delayed gastric emptying is also known as gastroparesis, and happens when food remains in your stomach for more than 3 hours. Usually, no visible abnormality will be found, and it’s thought to be due to interrupted communication between brain and gut. It may be exacerbated by psychological factors.
Continue reading to learn the causes and consequences of delayed gastric emptying and learn what you can do to minimize your symptoms!
Table of Contents
- 1 Delayed gastric emptying: Introduction
- 2 Causes of delayed gastric emptying
- 3 How do I recognize delayed gastric emptying?
- 4 How to diagnose delayed gastric emptying?
- 5 Treatment of delayed gastric emptying
- 6 What can I do to relieve the symptoms of delayed gastric emptying?
- 7 Delayed gastric emptying: Conclusion
Delayed gastric emptying: Introduction
In the stomach, your food is prepared for digestion. The stomach produces gastric juice that includes digestive enzymes. Food is kneaded in the stomach, finely ground, and mixed with that gastric juice.
Usually, food remains in the stomach for about 3 hours before it is delivered to the small intestine. A very high-fat meal takes a little longer than three hours.
But if you suffer from delayed gastric emptying, also known as gastroparesis, food often stays in your stomach much longer.
In some cases, food is delivered to the small intestine in too large chunks (not sufficiently finely ground). This is also called a lazy stomach.
Causes of delayed gastric emptying
In many people, the cause of delayed gastric emptying is unknown. Examination usually shows no abnormalities of the stomach.
In this case, delayed gastric emptying belongs to the so-called functional abdominal complaints or functional gastrointestinal complaints.
This means that the symptoms are caused by a disturbed stomach function, but no visible abnormality can be found. The cause of this is unknown, but probably stress and tension play a role.
This does not mean that nothing is wrong. It is clear that the stomach is not functioning correctly; hence, the “functional complaints.” Unfortunately, it is not possible to figure out what is wrong with today’s diagnostic methods.
There is growing evidence that these stomach problems are related to the cooperation between the brain and the stomach. Our brain and stomach are in constant communication and send signals to each other.
Think of signals about hunger or nausea and vomiting. This communication occurs through our nervous system, and more precisely the nerves in our stomach, intestines, and brain.
This whole is also called the brain-gut axis. These nerves we cannot control or influence ourselves.
It seems that too much, too little, or wrong signals are sent to the brain from the stomach and vice versa, and this may explain the stomach upset. However, it is still unclear exactly what causes this disturbance.
So it is not the case that these symptoms just in the brain as was often thought in the past.
Thus, delayed gastric emptying usually does not have a psychological cause. However, psychological factors (such as stress and anxiety) can exacerbate stomach symptoms.
Because the disrupted signals cannot be seen, undergoing a gastroscopy is also unnecessary as it then finds nothing abnormal.
A gastroscopy is a tedious examination with an (admittedly minimal) risk of damage to your stomach or esophagus. Thus, it is better not to perform such a gastroscopy when it is not really necessary.
If you have questions about this in your situation, it is best to discuss this with your treating physician yourself.
Demonstrable cause of delayed gastric movement
In certain other cases, a demonstrable cause or abnormality can be found for delayed gastric emptying:
The use of some medications
Sedatives and medications for high blood pressure or Parkinson’s disease can slow stomach movements.
In rare cases, a narrowing (stenosis) near the stomach outlet or at the beginning of the duodenum can cause severe gastric emptying symptoms.
This narrowing can be caused by an ulcer or a benign or malignant tumor.
How do I recognize delayed gastric emptying?
Signs and symptoms in delayed gastric emptying
Nausea and sometimes vomiting after meals are common symptoms of delayed gastric emptying.
In severely delayed gastric emptying, vomit is usually expelled with great force and in copious amounts.
In addition, you may suffer from the following symptoms:
- Feeling full quickly (quick satiety)
- Bloating and/or belching
- An annoying bloated feeling
- Strongly dilated stomach
- A pressing feeling on the stomach
- Heartburn: As stomach contents flow back into the esophagus, you may experience belching and a painful or burning sensation near the sternum.
How to diagnose delayed gastric emptying?
Diagnosis of delayed gastric emptying
Delayed gastric emptying is usually diagnosed with one of the following tests:
Gastric emptying study
Disturbed stomach movement can be determined by a gastric emptying test.
Before the examination, you will eat a test meal containing a small amount of radioactive material.
Then you have to sit in front of a camera for one to two hours for the path taken by the test meal to be followed.
This examination is also called a gastric emptying scintigraphy, thus indicating the use of radioactivity.
Pressure measurement of the stomach
In some hospitals, a pressure measurement of the stomach can be performed.
The doctor measures whether the stomach wall expands sufficiently after a meal. This examination is called a gastric barostat.
The pressure measurement is done by inflating a tiny balloon several times in the stomach.
The doctor inserts this balloon into the stomach with a flexible tube (endoscope) through the mouth and esophagus.
Occasionally, the diagnosis is made during a keyhole examination of the stomach (gastroscopy).
The doctor uses a flexible tube with a camera to look into the stomach through the mouth and esophagus during this examination.
If the doctor can find food residues from previous days here, you are suffering from delayed gastric emptying.
Good to know: This examination is usually done to detect other conditions.
Sometimes during this examination, the diagnosis of delayed gastric emptying is made by accident.
A gastroscopy is an examination that can be perceived as unpleasant. Therefore, it is always good to consider whether or not a gastroscopy is really necessary.
If there is delayed gastric emptying, it is usually not helpful to undergo a gastroscopy because no abnormalities can be seen in the stomach itself.
Treatment of delayed gastric emptying
Delayed gastric emptying can be treated with medications that stimulate the action of the muscles in the stomach.
These muscles must ensure that food is appropriately kneaded and ground before being delivered to the duodenum (the first part of the small intestine).
In addition, the muscles in the stomach wall must properly mix the gastric juice with the food. This mixing is essential for proper digestion.
Such drugs that stimulate the muscles of the gastrointestinal tract are called prokinetics. These medications cause the muscles in the stomach wall to contract more regularly.
These medications also reduce nausea. However, tube feeding may be a solution when nutritional advice and medication do not help sufficiently for very severe symptoms.
Only in very rare cases is surgical intervention necessary.
What can I do to relieve the symptoms of delayed gastric emptying?
Tips and advice for delayed gastric emptying
Food is kneaded too slowly with a lazy stomach, not mixed enough with gastric juice, and not appropriately propelled toward the duodenum.
In addition, it is known that the stomach needs more time to “process” fatty meals.
Therefore, to reduce symptoms, it is crucial in any case to avoid fatty foods as much as possible.
Other tips to avoid delayed stomach movements include the following:
- Try to eat regularly and healthily even if you are less hungry.
- Avoid very fatty foods.
- Instead, use several small meals rather than three large meals a day.
- Eat slowly and chew your food very well.
- Avoid large amounts of gas-forming foods, such as cabbage, peppers, onion, garlic, leeks, nuts, and raw vegetables.
- Avoid drinking carbonated soft drinks and beer.
- Distribute your meals throughout the day.
Tip: A dietitian can help you put together a healthy diet, but you can also check our other post to already get a good idea: Gastroparesis dietary guidelines: Foods to eat and foods to avoid
Delayed gastric emptying: Conclusion
Also known as gastroparesis, delayed gastric emptying is when food remains in your stomach for more than 3 hours.
Scientists are constantly increasing their knowledge about the relationship between the brain and the gut, which is making treatment more and more effective.
If you feel any of the above listed symptoms, go to your physician without delay.