Gastroparesis is not just a stomach that empties slowly. For many patients, it is a chronic condition that can impact nearly every aspect of daily life - from eating and maintaining nutrition to working, socializing, sleeping, and planning even basic activities.
As a surgeon who has cared for many people with hard-to-treat gastroparesis, I have seen how deeply this condition can affect patients and their families. I have also seen the frustration that arises when dietary changes, medications, and lifestyle adjustments provide little or only temporary relief. For some patients with severe, medically resistant gastroparesis, more advanced treatment options, including gastric electrical stimulation with an Enterra gastric stimulator, have been considered as part of a broader treatment plan.
August is Gastroparesis Awareness Month, and the 2026 awareness theme, #MoreThanInvisible, is especially significant. Gastroparesis may not be obvious to someone looking at a patient, but its effects can be very real. The International Foundation for Gastrointestinal Disorders (IFFGD) points out that people living with gastroparesis may have persistent nausea, vomiting, abdominal pain, bloating, early fullness, reflux, regurgitation, unintended weight loss, and malnutrition. These symptoms can also impact employment, emotional well-being, relationships, and overall quality of life.
What Is Gastroparesis?
Gastroparesis is a disorder in which the stomach takes too long to empty its contents, without any mechanical blockage preventing food from leaving. This condition can cause a wide range of upper gastrointestinal symptoms, especially around or after meals.
Patients often report feeling full after only a few bites. Others deal with significant nausea, vomiting, bloating, abdominal discomfort, reflux, or regurgitation. Some patients struggle to maintain their weight because eating becomes difficult or unpredictable.
It’s important to distinguish between gastroparesis symptoms and the underlying delay in gastric emptying. A person's symptoms and gastric emptying results do not always match perfectly. This is one reason treatment for gastroparesis often requires a personalized approach instead of a one-size-fits-all solution.
Living With Gastroparesis Can Be a Constant Balancing Act
One of the toughest parts of gastroparesis is that patients often have to plan their lives around their symptoms.
A meal that was tolerated yesterday may cause nausea today. Going out to dinner can turn stressful. Maintaining work schedules can be difficult when vomiting or abdominal discomfort is unpredictable. Patients might avoid social gatherings because they are uncertain how they will feel or because they are following highly restrictive dietary recommendations.
And since gastroparesis is often invisible, patients may hear comments like, "But you don't look sick.” That disconnect is exactly why the #MoreThanInvisible message matters.
A person with gastroparesis may appear completely healthy while secretly battling nausea, vomiting, abdominal pain, nutritional issues, anxiety, isolation, and the constant uncertainty of how their stomach will react to the next meal. IFFGD's 2026 campaign highlights this invisible burden and promotes earlier recognition of symptoms and greater awareness among healthcare providers.
When Diet and Medication Are Not Enough
Treatment for gastroparesis typically starts with less invasive options. Dietary modifications may include smaller, more frequent meals and adjustments to the amount and type of fat, fiber, and other foods consumed. Medications may help manage nausea, vomiting, gastric motility, or other associated symptoms.
These strategies are important, but they do not work equally well for every patient.
I have cared for patients who were very disciplined with their diet and medications yet continued to experience debilitating symptoms. Some reached a point where eating enough for adequate nutrition became a daily challenge. Others had persistent nausea and vomiting despite multiple treatment attempts.
When gastroparesis becomes medically resistant, the discussion may need to move beyond diet and pharmaceutical management.
Enterra Gastric Stimulator for Severe Gastroparesis
One advanced treatment that has been used for appropriately selected patients is gastric electrical stimulation (GES) with an Enterra gastric stimulator.
The Enterra Therapy System is approved under an FDA Humanitarian Device Exemption for chronic, intractable, or hard-to-treat, drug-refractory nausea and vomiting due to gastroparesis of diabetic or idiopathic origin.
During surgical implantation, electrodes are placed on the stomach and connected to a small neurostimulator. The device delivers electrical stimulation intended to help control symptoms, particularly nausea and vomiting.
It is important to set realistic expectations. A gastric electrical stimulator is not a cure for gastroparesis, and it should not be seen simply as a device that normalizes stomach emptying. The American College of Gastroenterology describes gastric electrical stimulation as an option that may be explored for managing gastroparesis symptoms in suitable patients, but the evidence is classified as low quality and the recommendation as conditional.
That distinction is important. The aim is not to guarantee a specific outcome but to evaluate whether symptom control with gastric electrical stimulation may be appropriate for someone whose gastroparesis remains severe despite other treatments.
Selecting the Right Patient Matters
In my experience, treating severe gastroparesis means considering the whole patient and not just a gastric emptying test or a list of symptoms.
Before looking at advanced treatment options, I want to understand the patient's diagnosis, the severity and pattern of symptoms, nutritional status, prior treatments, underlying causes of gastroparesis, and how the disease affects daily life.
We also need to recognize that nausea and vomiting can have multiple causes. A thorough evaluation is essential before attributing persistent upper gastrointestinal symptoms solely to gastroparesis.
For some patients, nutritional support, medication adjustments, dietary counseling, treatments directed at the pylorus, or other interventions may be more fitting. For others with severe, ongoing symptoms, gastric electrical stimulation may need to be part of the discussion.
Gastroparesis Is #MoreThanInvisible
Gastroparesis deserves proper attention, not only because of its gastrointestinal symptoms, but because of what those symptoms can take away from a person's life.
When a patient cannot reliably eat, maintain weight, go to work, make plans, or engage in everyday activities, the consequences extend far beyond the stomach.
That is why awareness matters.
During Gastroparesis Awareness Month 2026, the #MoreThanInvisible campaign allows us to recognize those living with this complex condition and to foster more discussions about persistent upper gastrointestinal symptoms.
For patients, understanding that their symptoms may warrant evaluation can be a key first step. For healthcare providers, remembering gastroparesis when assessing persistent nausea, vomiting, early satiety, bloating, and other upper gastrointestinal issues can help patients get to the right diagnosis and treatment plan.
And for families, friends, coworkers, and communities, awareness can start simply by believing someone when they say they are struggling.
Gastroparesis may be invisible, but the person living with it is not.
If you or someone you love is dealing with ongoing nausea, vomiting, early fullness, bloating, abdominal discomfort, unexplained weight loss, or challenges maintaining proper nutrition, consult a qualified healthcare professional about whether gastroparesis or another gastrointestinal condition could be causing these symptoms. Treatment should always be tailored to fit the patient's diagnosis, symptoms, nutritional needs, and overall health.
