There are a number of things that may contribute to or cause gastroparesis. In the majority of people with gastroparesis, the cause is unknown and is termed “idiopathic.” Some people with idiopathic gastroparesis report symptoms following a virus infection (post-infectious or post-viral gastroparesis).

Other possible causes include:

  • Diabetes
  • Surgeries
  • Medications
  • Other illnesses
  • Cellular changes

Diabetes
Gastroparesis may occur as a complication of other conditions. Long-standing diabetes is the most common known cause of gastroparesis, although only a small percentage of people with diabetes develop gastroparesis. The cause of symptoms is probably due to damage to nerves that supply the stomach.

The vagus nerve transmits impulses to the stomach and intestines. Injury to the vagus nerve can impair gastric emptying.

Surgeries
Gastroparesis can also result as a complication from some surgical procedures. Most often these include nerve damage following esophageal or upper abdominal surgeries.

Medications
Less frequently, gastroparesis is seen to occur after the use of certain medications. Some medications can impair motility. Examples include:

  • narcotic pain relievers,
  • anticholinergic/antispasmodic agents,
  • calcium channel blockers,
  • some antidepressants, and
  • some medications for diabetes.

Other Illnesses
Sometimes gastroparesis is seen in association with other illnesses. Systemic illnesses, neurologic diseases, or connective disorders, such as multiple sclerosis, Parkinson’s disease, cerebral palsy, systemic lupus, and scleroderma are associated with gastroparesis. The cause and effect is unclear.

In a small number of people, gastroparesis symptoms appear to develop after onset of an apparent viral infection (post-infectious or postviral gastroparesis). The symptoms usually resolve or improve over time.

Potential Causes for Gastroparesis Reported by Patients

Respondents (1,423 adults) in the 2016 Gastroparesis in the Community Research Survey were asked, did the doctor who diagnosed you indicate a potential cause of your gastroparesis. Idiopathic gastroparesis (unknown cause) was most frequently suggested:

  • 44% Cause not known (idiopathic)
  • 15% Not told potential cause
  • 12% Diabetes 
  •   5% Vagal nerve injury
  •   3% Virus
  •   3% Surgery
  •   2% Autoimmune disorders (e.g., lupus, scleroderma)
  •   1% Medication-induced

Cellular Changes
Much remains to be learned about what causes gastroparesis. In both idiopathic and diabetic gastroparesis a great deal of interest is being paid to changes in the cells which help control muscular contractions (motility) in the stomach. These are known as the interstitial cells of Cajal (ICCs). These cells probably represent the essential pacemakers of the entire gastrointestinal (GI) tract. In addition to ICCs, scientists are looking at changes in the structure and the number of nerve cells and immune cells as possible contributors to the disease process in gastroparesis.

Adapted from IFFGD Publication: Gastroparesis (Delayed Gastric Emptying) by J. Patrick Waring, MD, Digestive Healthcare of Georgia, Atlanta, GA; and William F. Norton, Communications Director, International Foundation for Functional Gastrointestinal Disorders, Milwaukee, WI.

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