A morning routine of vomiting and severe abdominal discomfort marked the beginning of a prolonged medical ordeal for Chris Drew, a paralegal residing in Chicago. When staying home failed to alleviate the misery compounded by workplace stress, she sought help from her primary care physician after nearly three weeks. A referral to a gastroenterologist followed, initiating a battery of tests for conditions such as Crohn's disease, gallbladder issues, and cancer. Every preliminary screen yielded negative results.
To pinpoint the underlying issue, medical staff administered a specialized evaluation known as the egg test. Patients consume scrambled eggs prepared with a radiopharmaceutical—colloquially termed radioactive eggs—and spend four hours lying beneath a specialized camera. The egg whites act as a vehicle for the radioactive material, allowing clinicians to track the progression of food through the digestive tract. The procedure successfully identified the source of the distress, revealing precisely where gastric motility slowed or stopped. Five months of examinations and a 50-pound weight reduction culminated in a definitive diagnosis: gastroparesis.
An estimated five million individuals across the United States live with gastroparesis, a painful medical issue characterized by delayed gastric emptying. Ashley Vareedayah, a gastroenterologist at UI Health, notes that while the term translates literally to stomach paralysis, the physiological reality involves a sophisticated interplay among gastric nerves, muscles, and hormones. Affected individuals experience prolonged feelings of fullness after meals, frequently accompanied by bloating, abdominal discomfort, and vomiting. Consequently, patients often restrict their food intake, leading to nutritional deficiencies and weight loss. Although conditions such as acid reflux, heartburn, constipation, and diarrhea occur more frequently, Vareedayah emphasizes that the symptom severity of gastroparesis places a significant burden on patients.
Determining the exact trigger remains a challenge for medical professionals. Diabetes ranks as a primary suspect because the disease frequently damages nerves throughout the body, including those in the stomach. Nevertheless, many patients diagnosed with the condition do not have diabetes, pointing toward alternative explanations. Other hypotheses implicate viral infections as potential catalysts, reflecting a broader medical gap in fully comprehending the underlying disease process. Drew, who does not have diabetes, suspects that acute stress from a hostile living situation with roommates a decade earlier initiated her symptoms at age 36. Her medical team at Northwestern Medicine even recommended sessions with a hypnotist to manage anxiety, a process that highlighted how many individuals, particularly women, store stress within the gastrointestinal tract.
Statistical data indicates that gastroparesis occurs roughly four times more frequently in women than in men, registering at 32 cases per 100,000 women compared to 10 per 100,000 men in one American study. Kyle Staller, director of the Gastrointestinal Motility Laboratory at Massachusetts General Hospital and an associate professor at Harvard Medical School, warns against dismissing the female predominance as purely psychological. Staller, one of eight experts who formulated the American Gastroenterological Association guidelines published in October 2025, points out that these represent genuine physiological differences. Slower natural gastric emptying rates in healthy women or the influence of sex hormones like estrogen and progesterone on gastrointestinal motility may explain the discrepancy.
The broader visibility of the condition has grown in recent years alongside the rising popularity of GLP-1 weight loss medications, which have been available since 2005 but surged in use following the introduction of Ozempic in 2017. These drugs intentionally slow gastric emptying to induce satiety, creating side effects that mirror gastroparesis symptoms. In their updated guidelines, the American Gastroenterological Association explicitly advises clinicians to evaluate patients' medication histories. Staller notes that individuals who previously maintained normal digestion have developed symptoms after starting GLP-1 therapies, urging physicians to consider whether pharmaceuticals contribute to the presentation before treating it as a novel disease.
Managing the condition primarily relies on dietary adjustments, focusing on low-fat, low-fiber meals rich in lean proteins consumed in small, frequent portions. Dietitians frequently recommend grazing on portions sized between one and one-cup-and-a-half roughly six times per day to accommodate reduced motility. Vareedayah acknowledges the frustration this imposes on patients, noting that eating serves an important social function beyond mere nutrition. When lifestyle adjustments prove insufficient, medical interventions range from FDA-approved pharmaceuticals like metoclopramide—which requires careful monitoring due to potential side effects like tardive dyskinesia—to procedural solutions such as gastric peroral endoscopic myotomy or gastric electrical stimulation.
