Gastroparesis or gastric paralysis

The often unrecognised disease!

Gastroparesis is a disorder in which the stomach’s normal movement is significantly slowed or stopped altogether. Rather than food being processed and propelled into the small intestine in a timely manner, it remains in the stomach for longer than it should. This delay is not caused by a physical blockage, but by impaired nerve or muscle function within the stomach wall itself.

Uncomfortable Symptoms

Many people with gastroparesis experience uncomfortable symptoms: a feeling of fullness soon after starting to eat, bloating, nausea or even vomiting. Some lose weight because they cannot finish meals or because the food simply lingers and is poorly processed. The underlying mechanisms vary: diabetes-related nerve damage, surgery of the stomach, infections or idiopathic (unknown cause) cases all play a role. Because the symptoms mimic those of indigestion, reflux or functional dyspepsia, gastroparesis often goes unrecognised.

woman on a bed
The impact on life quality

The impact on life quality can be large: daily eating becomes stressful, social situations around food difficult, and nutritional deficiencies risk. Early recognition, specialist referral and tailored management can change the trajectory: by improving symptoms, reducing complications and restoring a sense of control. Our Partners emphasise a multidisciplinary approach — gastroenterologist, dietitian, nurse specialist — and a personalised plan that addresses both symptom control and lifestyle adaptation. If you find yourself eating less because you feel full too quickly, or you suffer persistent nausea without obvious cause, ask about delayed gastric emptying. Your stomach should be your friend — not a hindered station where food stalls. Our Partners can help you understand, diagnose and manage gastroparesis so you can reclaim your relationship with food and regain comfort in daily life.

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What is the Enterra Therapy?

Minimal invasive implanted device

The Enterra Therapy is a minimal invasive, device-driven treatment designed for patients whose gastroparesis symptoms persist despite dietary adjustments, medications and lifestyle changes. At its heart lies a small implantable stimulator, placed under the skin in the abdomen and connected to leads positioned on the stomach wall. This device delivers gentle electrical impulses that modulate the stomach’s neuromuscular activity, improving motility and reducing symptoms such as nausea and vomiting.

Nerves controlling the stomach

The concept was developed after recognition that when nerves controlling the stomach (in particular the vagus nerve) are damaged or underperforming, muscle contractions of the stomach become weak and uncoordinated. By providing targeted stimulation, the Enterra system seeks to restore more normal gastric emptying, relieve discomfort and improve nutritional absorption.

Complemented by detailed assessment

The therapy is complemented by detailed assessment, bespoke programming of the device, close follow-up and patient education. Before the implant, comprehensive diagnostic work-up is conducted — including gastric emptying studies, symptom scoring and nutritional status. Specialists evaluate whether the patient is a suitable candidate, often after less invasive therapies have been tried. The aim is not just symptom relief, but enhancing quality of life: reducing hospital admissions, improving meal tolerance, enabling a more normal eating pattern and supporting long-term nutrition. Although the system does not cure gastroparesis, it represents a key option in the management of moderate to severe cases. At the clinic the therapy is tailored to your individual needs, adjusting stimulation parameters, combining it with dietitian support and close monitoring of your progress. If you have been living with persistent symptoms and are searching for an advanced option, the Enterra Therapy may be the next step on your journey to better digestive health.

Who is the Enterra Therapy suitable for?

Criteria for suitability

The Enterra Therapy is particularly suitable for individuals who fulfil several criteria. Firstly, patients must have a confirmed diagnosis of gastroparesis (delayed gastric emptying), typically documented by a gastric emptying scintigraphy or equivalent motility study. Secondly, they should have persistent symptoms — for example nausea, vomiting, bloating, early satiety or pain — that have not responded adequately to standard treatment: dietary modifications (small, low-fat meals), pro-motility or anti-nausea medications, and lifestyle interventions. Thirdly, the individual must be medically stable and able to undergo a minor surgical procedure under local or general anaesthetic. The therapy is often considered when symptoms significantly impact quality of life — frequent hospitalisations, poor nutrition, weight loss or dependence on enteral feeding. In Europe, Enterra Therapy is indicated for the treatment of chronic, medication-resistant nausea and vomiting associated with gastroparesis in patients aged 18 to 70 years.

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Comprehensive multidisciplinary assessment

Before implantation, the patient undergoes a comprehensive multidisciplinary assessment: gastroenterologist, surgeon, dietitian, sometimes psychologist. During this assessment it is evaluated if there are potential contraindications (for example certain electrical devices, severe cardiac conditions or infection risk). It is also discussed realistic goals: this therapy is not a cure but a tool to manage symptoms and enable improved daily living. Ideal candidates often include those with diabetic gastroparesis where nerve damage has been documented, post-surgical gastroparesis after stomach or vagus nerve surgery, and even idiopathic gastroparesis when symptoms are refractory. The therapy is less suited to those with mechanical obstruction masquerading as gastroparesis (which must be excluded) or those too frail to tolerate the procedure. Our Partners emphasise informed decision-making: you will meet their specialist team, review device options, discuss risks and benefits, and only proceed if you feel comfortable and supported. If you have been told that nothing more can be done — ask them. The Enterra Therapy may offer a path to better symptom control, fewer dietary dread moments and more confidence in everyday eating.

woman on a bed

How does the Enterra Therapy work?

The working mechanism

The working mechanism of the Enterra Therapy involves electrical modulation of stomach activity. Once the device is implanted, leads are positioned on the gastric wall and the stimulator beneath the abdominal skin delivers programmed impulses at specific frequencies, durations and amplitudes. These impulses engage neural circuits and smooth muscle within the stomach, improving coordination of contractions and accelerating emptying of gastric contents. In practical terms when the stomach empties more effectively, symptoms such as persistent nausea, vomiting and early fullness often become milder, allowing improved meal consumption and better nutritional intake. At the same time the therapy can reduce the distension and discomfort caused by retained gastric food. The treatment does not rely solely on the device: it is integrated into a comprehensive care plan. After implantation, patients attend regular follow-up to adjust stimulation parameters, review symptom diaries and work with dietitians to optimise meal patterns.

Success requires adherence

Success requires adherence: smaller meals, low-fat and low-fibre diets, avoidance of foods that delay gastric emptying, and modest physical activity after meals (such as gentle walking) all support the therapy’s effectiveness. While the therapy has shown beneficial outcomes in many patients, it is important to set realistic expectations. Some people experience rapid improvement in symptoms, others gradually over months. A small proportion may require additional interventions (e.g., pyloroplasty or other surgical options) if stomach emptying remains severely impaired. For patients with diabetic gastroparesis, controlling blood glucose remains crucial, as poor glycaemic control undermines gastric motility. In essence the Enterra Therapy is a sophisticated assistive technology: it supports your stomach’s natural function, complements medical and dietary care, and gives you a chance for more confident eating, fewer hospital visits, fewer disturbances around food and improved quality of life.

Frequently Asked Questions

Gastroparesis is a condition in which the stomach takes longer than normal to empty its contents into the small intestine, despite there being no mechanical blockage.

There are a number of causes including diabetes-related nerve damage, previous stomach or vagus nerve surgery, certain medications, infections and in many cases no identifiable cause (idiopathic gastroparesis).

Common symptoms include early satiety (feeling full quickly), nausea, vomiting, bloating, abdominal pain, reduced appetite and weight loss.

Diagnosis is made after excluding mechanical obstruction and includes tests such as gastric emptying scintigraphy, breath tests, wireless motility capsule and evaluation by a gastroenterologist.

In most cases gastroparesis is not fully curable but it is certainly manageable with lifestyle changes, diet, medications and in some cases device therapy or surgery.

In many patients the condition stabilises or improves with treatment; however some may experience worsening and need more intensive interventions.

A diet in gastroparesis should emphasise small, frequent meals, low in fat and fibre, well-cooked or liquid foods, avoidance of carbonated drinks and lying down soon after eating.

Avoid high-fat foods, raw vegetables, whole grains, seeds and skins of fruit, carbonated beverages, large meals and lying down immediately after eating.

Yes. Certain medications such as narcotics, anticholinergics, calcium channel blockers and some diabetes drugs can slow gastric emptying and contribute to gastroparesis.

In diabetic patients good glycaemic control is vital, because high blood sugar impairs gastric motility and can worsen gastroparesis symptoms.

If you have persistent nausea, vomiting, early fullness, weight loss, or poor nutritional intake despite initial treatment, you should be referred to a gastroenterologist or motility specialist.

Treatment may include dietary and lifestyle changes, pro-motility medications, anti-nausea drugs, endoscopic or surgical options such as pyloroplasty or gastric electrical stimulation.

Gastric electrical stimulation is a device-based treatment that delivers electrical impulses to the stomach muscle to enhance gastric emptying and reduce symptoms in refractory gastroparesis.

Gastroparesis itself does not typically reduce life expectancy, but complications such as malnutrition, dehydration or diabetic ketoacidosis may increase risks if unmanaged.

Yes. Because food remains in the stomach for longer than normal and may not be fully processed, patients can have reduced nutrient absorption, weight loss and deficiencies.

Yes; gentle post-meal physical activity such as walking or mild yoga can help stimulate digestion, but strenuous exercise immediately after a meal may worsen symptoms.

Most cases are not hereditary. However some underlying conditions that lead to gastroparesis (for example connective tissue disorders) may have genetic links.

In some cases where gastroparesis follows a transient trigger (such as a viral infection or certain medications) it may improve or resolve, but many require long-term management.

Bezoars are hardened masses of undigested food that can form in the stomach when emptying is delayed; they can lead to blockage, pain, nausea and require medical or surgical removal.

Yes. Slow gastric emptying and impaired gut motility may allow bacterial overgrowth in the small intestine, contributing to bloating, pain and malabsorption.

A dietitian experienced in motility disorders helps tailor meal plans, monitors nutrient intake, advises on safe foods and supports adaptation of lifestyle to reduce symptoms and maintain nutrition.

Improvement timing varies: some patients notice changes within weeks of diet and medication changes, whilst those undergoing device therapy may require several months of adjustment and follow-up to optimise outcomes.

Not everyone: only patients with confirmed gastroparesis, persistent symptoms despite standard treatments, and medically suitable for implantation are eligible; thorough assessment is required.

Meal size reduction, frequent small meals, avoiding high-fat/high-fibre foods, staying upright 2 hours after eating, gentle post-meal activity and good hydration all support symptom control.

Prepare by tracking symptoms (when they occur, what you ate, what worsens/improves them), listing all medications, noting weight changes or nutritional issues, and writing down questions to ask your specialist.

Note: The information provided on this website is for general educational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Always talk to your doctor about the best treatment options for your individual situation.