Gastroparesis

What causes gastroparesis, and how common is it?

Gastroparesis, also called delayed gastric emptying, is a disorder that slows or stops the movement of food from the stomach to the small intestine [1]. It happens when the stomach's muscles work poorly or not at all, so the stomach takes too long to empty its contents [1]. It is not common: out of 100,000 people, about 10 men and about 40 women have it [1]. It is more likely with diabetes, prior surgery on the esophagus, stomach or small intestine, or certain cancer treatments [1].

Why do GLP-1 labels mention gastroparesis?

Semaglutide and tirzepatide both delay gastric emptying, and the Wegovy and Zepbound labels say each drug is "not recommended in patients with severe gastroparesis" [2][3]. That is a "not recommended" statement, not a listed contraindication in the label's own contraindications section. Zepbound's label also notes rare postmarketing reports of pulmonary aspiration in patients undergoing elective surgery or procedures needing general anesthesia or deep sedation who had residual gastric contents despite reportedly following preoperative fasting recommendations [3].