Diagnosing gastroparesis

If gastroparesis is suspected, your health professional might request one of the tests below to help determine the cause of the symptoms and rule out other conditions that have similar symptoms. Note that you do not have to have all of these tests. But usually there will be one of these tests that is available in your local area that allows measurement of delayed stomach emptying, and others to make sur that there are no other conditions present.

Blood tests can provide a general assessment of your health and nutrition. They can also help to identify whether other medical conditions might be contributing to your symptoms.

Breath testing can help your health practitioner calculate how quickly your stomach is emptying. Prior to the breath test, a meal with a non-radioactive isotope is eaten. Then, as the meal is digested and metabolized, the isotope is expelled from the lungs through the breath. The amount of isotope in the breath provides an indication of how quickly the stomach is emptying.

Electrogastrography measures the electrical activity of the stomach. The test is non-invasive and involves placement of electrodes on the skin of the abdomen. The test may be used to detect abnormal rhythms in the activity of the stomach, but is still mostly a research tool.

An endoscopy involves a thin tube with a light and camera at the end (i.e. an endoscope) being passed down through the mouth, throat, esophagus, stomach and into the duodenum. The endoscope provides a video image of the organs, and allows the physician to look for any abnormalities. If required, instruments can be passed through the endoscope and tissue samples can be taken. In gastroparesis the endoscopy may show retained food, but is mostly done to exclude obstruction of the stomach as a cause for symptoms.

Gastric emptying scintigraphy (an alternative to Breath Testing – see above) is a type of scan that allows a radiologist to measure see how quickly the stomach empties. Prior to the scan, a small meal with a slightly small amount of a radioactive substance is eaten. The substance (a radioisotope) is not harmful, but allows the meal to be tracked through the digestive system using a scanner. The scans are usually performed every 60 minutes for up to 4 hours.

Gastric manometry involves a thin tube being passed down the throat, esophagus, and into the stomach. The tube is used to measure the electrical and muscular activity pressures within the stomach. The test can help to identify obstructions or lack of coordination in muscular contractions, which may affect digestion.

MRI is an imaging technology that uses radio waves to create 3D images of the body’s internal organs. MRI’s can be used to assess gastric emptying of solid and liquid meals. However, because MRI is a very expensive imaging technique, it is more likely to be used for research purposes than for clinical diagnosis of gastrointestinal function.

An ultrasound might be used to rule out other possible medical conditions. The ultrasound uses sound waves to create an image of the internal organs, which can help to identify any structural or functional abnormalities within the body.

In preparation for a Barium X-ray, a chalky liquid called Barium is swallowed. This liquid shows up in X-rays as it passes through the digestive system. A Barium X-ray can provide some indication of how the digestive system is working and how fast stomach contents move through the system.

The wireless motility capsule is used to measure gastric emptying time. A small electronic pill is swallowed and as it travels through the digestive system, information is relayed from the pill to a receiver that the patient wears on their belt or around their neck. A couple of days later, information from the receiver can be downloaded to a computer for analysis by a health professional.