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Diagnosing Gastroparesis

Source: Mayo Clinic, National Institute of Diabetes and Digestive and Kidney Diseases: National Institutes of Health, Cleveland Clinic, Stanford Health Care, National Center for Biotechnology Information: U.S. National Library of Medicine: National Institutes of Health

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What is gastroparesis?

Gastroparesis, also known as gastric stasis or delayed gastric emptying, is a condition in which the stomach takes longer than normal to empty its contents. Under normal circumstances, strong muscle contractions move food through the digestive tract. With gastroparesis, damaged nerves and muscles cause these contractions to slow and weaken. Large masses of food can form in the stomach, which can cause digestive symptoms and even prevent food from entering the small intestine.

How is gastroparesis diagnosed?

The diagnostic process typically involves a thorough medical history, physical exam, and various medical tests. During this process, the possibility of other medical conditions that may be causing symptoms, such as nausea, vomiting, and bloating, will be evaluated.

Medical history and physical exam

The first step in the diagnostic process typically involves a thorough medical history and a physical exam. A medical history involves questions about medication and supplement use, current and past health issues or surgeries, and ongoing symptoms. A physical exam entails a health care professional checking vital signs, looking for signs of dehydration or malnutrition, and examining the abdomen for pain or unusual sounds.

Blood tests

Blood tests can show effects of gastroparesis, such as dehydration, malnutrition, and abnormal blood sugar levels. Other potential causes of symptoms, such as infections, can also be identified through blood work.

Imaging tests

Imaging tests, such as X-rays or an ultrasound of the abdomen, can be used to identify blockages or obstructions within the digestive tract. They can also be used to rule out potential issues with the gallbladder or kidneys that could be causing an individual’s symptoms.

Upper gastrointestinal endoscopy

During an upper gastrointestinal (upper GI) endoscopy, a tiny camera on the end of a long tube is used to look at the esophagus, stomach, and beginning of the small intestine. An upper GI endoscopy can be used to rule out conditions such as peptic ulcer disease or pyloric stenosis.

Gastric or duodenal manometry

Manometry measures the strength and pattern of muscle contractions in the stomach or first part of the small intestine. The contractions are measured by a tube that is inserted through the nose and extended into the stomach. Abnormal contractions suggest a diagnosis of gastroparesis.

Gastric emptying tests

The tests most commonly used to diagnose gastroparesis involve examining how fast the stomach empties its contents. One or more gastric emptying tests may be conducted. Gastric emptying tests include gastric emptying scan (scintigraphy), gastric emptying breath test, and wireless motility capsule test.

Gastric emptying scan or scintigraphy — The individual eats a bland meal that contains a small amount of radioactive dye. A scanner is placed over the abdomen to track the rate at which the food leaves the stomach. This test usually takes about four hours.
Gastric emptying breath test — The individual eats a meal that contains a small amount of a substance that is absorbed by the intestines. As it is absorbed, the substance can be detected in the breath. The amount of the substance in the breath is measured over a specific time period to determine how quickly the stomach empties.
Wireless motility capsule test — The individual swallows a capsule that contains a small electronic device. The device transmits information to a recorder the individual wears throughout the test. Physicians use the recorded data to determine how quickly the stomach empties and how quickly food and liquids travel through the intestines. The capsule is eliminated from the body during a bowel movement.