Women face 4x higher risk of underdiagnosed stomach condition, major review finds

• A new JAMA review of 82.6 million patients finds gastroparesis is far more common than previously believed, with women diagnosed at 2 to 4 times the rate of men.
• The condition involves delayed stomach emptying without physical blockage, causing nausea, early fullness, bloating and vomiting.
• Type 2 diabetes accounts for more than half of all cases, while GLP-1 medications like Ozempic can contribute to or worsen symptoms.
• Diagnosis requires a gastric emptying study showing more than 10% food retention after four hours.
• Treatment ranges from small-particle diets and antiemetics for mild cases to procedures like G-POEM for severe, treatment-resistant gastroparesis.

The hidden epidemic in plain sight

A comprehensive review published July 29, 2026 in JAMA has pulled back the curtain on gastroparesis, a digestive condition that has long flown under the medical radar despite affecting hundreds of thousands of Americans. The analysis drew from a U.S. health study covering 82.6 million patients and incorporated updated guidelines from both the American College of Gastroenterology and the American Gastroenterological Association, which released new recommendations in 2025. What researchers found challenges longstanding assumptions: Gastroparesis is not rare, women bear a disproportionate burden of the disease, and many cases go unrecognized or misdiagnosed for months or even years.

What gastroparesis actually does to the body

Gastroparesis is defined by delayed gastric emptying in the absence of any mechanical obstruction. The stomach’s normal muscle contractions slow or fail, or the pyloric valve connecting the stomach to the small intestine fails to relax properly, leaving food sitting in the stomach far longer than it should.

The confirmed prevalence stands at 21.5 per 100,000 people, though researchers acknowledge this figure likely undercounts the true burden. Many cases get attributed to acid reflux, irritable bowel syndrome, or general digestive sensitivity, delaying proper diagnosis and treatment.

Women hit hardest, diabetes driving most cases

One of the review’s most striking findings involves gender disparity. Women receive a gastroparesis diagnosis at two to four times the rate of men, making this one of the most consistent patterns in the epidemiological data.

Type 2 diabetes accounts for 51.7% of all cases, making it the single most common underlying cause. Postsurgical effects follow at 15%, then medication-induced causes at 11.8%, idiopathic cases at 11.3%, and Type 1 diabetes at 5.7%. Additional risk factors include neurological conditions like Parkinson’s disease, hypothyroidism, connective tissue disorders and viral infections including norovirus, cytomegalovirus, Epstein-Barr virus and SARS-CoV-2.

The GLP-1 link that changes treatment

The review carries particular significance for the millions of Americans taking GLP-1 receptor agonists such as semaglutide, marketed as Ozempic and Wegovy. These medications appear on the list of drugs that can delay gastric emptying and contribute to gastroparesis. Current guidelines recommend discontinuing them as part of treatment. Other medications flagged include opioids, cannabis and anticholinergics.

How eating changes with gastroparesis

Treatment follows a tiered approach based on severity, measured by gastric retention at four hours on a gastric emptying study.

Mild cases, defined as 10% to 15% retention, respond to a small-particle diet combined with antiemetic medications. The diet involves food that is blended or chopped into small pieces, low in fat and hard-to-digest fiber. Moderate cases, with 16% to 35% retention, add prokinetic medications such as metoclopramide or erythromycin to help the stomach contract and move food along. Severe cases exceeding 35% retention may require a liquid diet or jejunal tube feeding.

Why this diagnosis keeps getting missed

The hallmark symptoms of gastroparesis include nausea, vomiting, early satiety, bloating and abdominal pain or discomfort. These overlap extensively with other digestive issues, creating a diagnostic blind spot that can persist for years. Standard laboratory tests often appear normal, though HbA1c levels may vary widely. Clinicians should also measure TSH and fasting cortisol to rule out hypothyroidism and Addison’s disease.

Diagnosis requires either gastric emptying scintigraphy showing more than 10% food retention at four hours, or the FDA-approved carbon-13 spirulina breath test when scintigraphy is unavailable.

The takeaway for patients

Gastroparesis remains underdiagnosed largely because its symptoms are easy to dismiss or attribute to other conditions. Women face significantly higher risk, and specific factors such as diabetes, abdominal surgery and GLP-1 medication use raise the odds further. Anyone experiencing persistent nausea, feeling full after a few bites, or unexplained vomiting should raise the possibility with their healthcare provider rather than accepting it as normal digestive sensitivity. With updated diagnostic guidelines and clearer treatment pathways now available, the gap between suffering and solutions has finally narrowed.

Sources for this article include:

MindBodyGreen.com

JAMANetwork.com

MayoClinic.org