What are the causes of gastroparesis (delayed gastric emptying) besides diabetes mellitus?

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From the Guidelines

Gastroparesis can be caused by several conditions besides diabetes, including post-surgical complications, medications, post-viral gastroparesis, and idiopathic causes, as outlined in a recent study published in 2023 1. The causes of gastroparesis can be categorized into several groups, including:

  • Post-surgical causes, such as partial or complete vagotomy, which may be intended or unintended, and can occur after surgeries like esophagectomy, Billroth II gastrectomy, and fundoplication or hernia repair 1
  • Medications, such as anticholinergics, glucagon-like peptide-1 receptor agonists, and opioids, which can delay gastric emptying by constraining the middle and distal stomach 1
  • Post-viral gastroparesis, which can occur after viral infections that affect the stomach nerves 1
  • Idiopathic causes, which account for a significant proportion of gastroparesis cases, with no clear cause identified despite thorough investigation 1 It is essential to note that understanding the underlying cause of gastroparesis is crucial for proper treatment, as addressing the primary condition may help improve gastroparesis symptoms. The most recent and highest quality study, published in 2023 in the journal Gastroenterology, provides a comprehensive overview of the potential causes of gastroparesis, highlighting the importance of considering these factors in the diagnosis and treatment of the condition 1.

From the Research

Causes of Gastroparesis

The causes of gastroparesis, besides diabetes mellitus, include:

  • Idiopathic gastroparesis, which is the largest category of gastroparesis patients where no definitive cause can be identified 2, 3
  • Post-surgical complications, which can lead to gastroparesis due to damage to the stomach or its nerves 2, 3
  • Post-viral infections, which can cause gastroparesis by damaging the stomach muscles or nerves 2, 4
  • Connective tissue disorders, such as scleroderma, which can affect the stomach muscles and cause gastroparesis 2, 3
  • Medication-induced gastroparesis, which can occur due to the use of certain medications that slow down stomach emptying 4
  • Prior infection, which can cause gastroparesis by damaging the stomach muscles or nerves 2
  • Mesenteric ischemia, which can cause gastroparesis by reducing blood flow to the stomach 2
  • Iatrogenic causes, which can include medical procedures or treatments that damage the stomach or its nerves 5

Etiologies of Gastroparesis

The etiologies of gastroparesis are diverse and can be classified into different categories, including:

  • Diabetic gastroparesis, which occurs in people with diabetes mellitus 5, 2, 3, 6
  • Idiopathic gastroparesis, which is the most common type of gastroparesis where no definitive cause can be identified 2, 3
  • Post-surgical gastroparesis, which occurs after surgical procedures that damage the stomach or its nerves 2, 3
  • Post-viral gastroparesis, which occurs after viral infections that damage the stomach muscles or nerves 2, 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Gastroparesis: Medical and Therapeutic Advances.

Digestive diseases and sciences, 2017

Research

Gastroparesis: A Review of Current Diagnosis and Treatment Options.

Journal of clinical gastroenterology, 2015

Research

2023 update on the clinical management of gastroparesis.

Expert review of gastroenterology & hepatology, 2023

Research

Gastroparesis.

Nature reviews. Disease primers, 2018

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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