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Slow Stomach – Causes of Delayed Gastric Emptying

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A slow stomach is a common term that is used to describe delayed gastric emptying. This means that the contents of the stomach are not released into the duodenum at a normal rate. It may be related to a disorder with the :

  • stomach nerves and neurotransmitters
  • digestive hormones
  • smooth muscle of the stomach wall
  • mechanical obstruction

Gastroparesis is delayed gastric emptying with no mechanical obstruction to the flow of gastric contents. Gastric outlet obstruction on the other hand is when there is a mechanical obstruction to the flow of gastric contents out of the stomach.

Causes of Slow Gastric Emptying

It is important to understand the process of gastric emptying and that factors that promote and inhibit it.

  • Normal Gastric Emptying
    • What is gastric emptying?
    • How does gastric emptying work?
    • What promotes and inhibits gastric emptying?

Gastroparesis

Causes of gastroparesis include :

  • Diabetic neuropathy
  • Anorexia nervosa and bulimia (refer to Effects of Eating Disorders)
  • GERD (gastroesophageal reflux disease)
  • Hypothyroidism
  • Sclerodoma
  • Amyloidosis of the gastric musculature
  • Parkinson’s disease
  • Viral infections
  • Surgery affecting the vagus nerve
  • Chemotherapy
  • Drugs
    • Opiates
    • Calcium channel antagonists
    • Anticholinergics like tricyclic antidepressants  and phenothiazines

Gastric Outlet Obstruction

The mechanical obstruction may lie in the duodenum or within the pyloric channel (intrinsic). Any mass outside of the organs surrounding the stomach and duodenum may also cause an obstruction to the flow of chyme (extrinsic).

Causes of gastric outlet obstruction include :

  • Pyloric edema due to gastritis or peptic ulcer
  • Pyloric stenosis
    • Fibrotic stricture of duodenal ulcer
    • Adult hypertrophic pyloric stenosis
  • Gastric polyps
  • Cancer
    • pancreas
    • stomach
    • duodenum
    • bile ducts (cholangiocarcinoma)
  • Congenital duodenal webs
  • Pancreatic pseudocysts
  • Gallstone obstruction

Article reviewed by Dr. Greg. Last updated on July 31, 2010