Can Trauma Make Gastroparesis Feel Worse? What a New Cleveland Clinic Study Found
What a Cleveland Clinic study of 207 patients found about trauma, gastroparesis symptoms, and how the stomach works.
Photo: Zulfugar Karimov / Unsplash
In a new study of 207 people with gastroparesis, a positive screen for post-traumatic stress disorder (PTSD) wasn't linked to slower stomach emptying, but it was linked to worse symptoms. Gastroparesis is a stomach that empties too slowly when nothing is physically blocking it. Researchers at Cleveland Clinic screened their gastroparesis patients for PTSD, and the patients who screened positive didn't have significantly more delayed emptying than those who screened negative. They did report more severe symptoms and more psychosocial impairment, meaning more strain on mood and daily functioning.
What the Cleveland Clinic team measured
Simons and colleagues published the study in Neurogastroenterology and Motility in October 2026. It is a cross-sectional study, which means each person filled out questionnaires once, at their first evaluation, rather than being followed over time. The team also pulled objective measures of stomach function from the medical record.
PTSD here was a questionnaire screen, not a diagnosis made by a clinician. The team used the PCL-5, a symptom checklist based on the DSM-5 (the manual used to diagnose psychiatric conditions), and counted a score above 33 as probable PTSD.
Of the 207 patients, 128 (61.8%) said they had experienced a traumatic event at some point, and 58 (28%) screened positive for probable PTSD. That trauma figure is lower than national surveys that ask about specific events one by one, where 89.7% of US adults report at least one, so the clinic questionnaire may have missed some people. The group was 93% female and 93% White, with an average age of 45.5, and all of them came from one tertiary care center, a specialist referral hospital. The results apply most clearly to people who resemble that group.
No significant difference in emptying
Patients who screened positive didn't have significantly more delayed gastric emptying than patients who screened negative. There was no significant difference in gastric accommodation either, which is the way the upper stomach relaxes to make room for a meal.
I think this result is the most useful one in the paper, because the worse symptoms in this group came without a slower stomach. On the two measures that describe how the stomach handles a meal, the study found no significant difference between the groups.
Where the two groups differed
Patients with probable PTSD had reduced myoelectric activity on electrogastrography, a test that records the stomach's electrical rhythm through electrodes on the skin over the stomach. The PTSD group also reported worse symptoms on most of the outcomes measured, including gastrointestinal (GI) symptom severity, along with more psychosocial impairment.
The team also looked at what predicted how severe someone's PTSD symptoms were. Age, depression or anxiety, and anorectal dysfunction were the strongest predictors. In anorectal dysfunction, the pelvic floor muscles often tighten during a bowel movement when they should relax. That pattern has been linked to trauma before, particularly sexual abuse: in a small 1995 study of women seeking care for bowel problems, 39 of 40 who had been sexually abused showed it on testing, compared with 6 of 20 healthy women.
How stress reaches the stomach
The nervous system has two branches with opposite effects on digestion. Fight-or-flight is the sympathetic branch, and rest-and-digest is the parasympathetic branch, which supports gut motility. When the body shifts toward fight-or-flight, digestion usually slows down. Simons and colleagues write that PTSD may contribute to chronic overactivation of the sympathetic nervous system and make GI symptoms worse.
Small studies in healthy volunteers fit part of that picture. In 2004, Yin and colleagues recorded the stomach's electrical activity in 10 healthy people around a test meal, once with no task, once while they listened to a guided meditation tape, and once while they watched a horror movie. The meal normally raises that electrical activity, and the horror movie inhibited those after-meal increases. The horror movie also reduced the regularity of the stomach's slow waves, the electrical pulses that pace its contractions (82% compared with 66% under stress), and heart rate measures showed less vagal (rest-and-digest) activity and more sympathetic activity after eating. The authors wrote that the effect may involve both pathways.
Short-term stress can slow the stomach down in healthy people. In a 2013 crossover study, where each person was tested both ways, Lee and colleagues gave eight healthy volunteers (seven men and one woman) a meal twice, once with stressful noise and once without. With the noise, it took an average of 130.8 minutes for half the meal to leave the stomach, compared with 105.0 minutes without it, a difference of about 26 minutes, and people reported more discomfort and fullness after eating.
In healthy people, acute stress slowed emptying. In people who already had gastroparesis, a positive PTSD screen wasn't linked to slower emptying, but it was linked to reduced electrical activity in the stomach and to how bad the symptoms were.
Researchers have studied trauma and gut symptoms together before. In a meta-analysis published online in 2018, Ng and colleagues pooled eight earlier studies with 648,375 people, most of them conducted in US army veterans, and found that people with PTSD had nearly three times the odds of irritable bowel syndrome (IBS), a different gut condition, with the true figure plausibly anywhere from about twice to three and a half times.
What this does and doesn't tell you
Since the team assessed everyone once, the study shows an association. It can't tell you that trauma caused anyone's gastroparesis, or that treating trauma would improve it, and the authors don't claim either in their summary. They write that further work should assess whether trauma-focused therapy improves symptoms, and this study didn't test that.
Two things can both be true in the same person: an emptying result that is no worse, and symptoms that are worse. If your nervous system has been through trauma, its effect on digestion is part of your body's physiology. That makes it a second problem to address alongside the stomach. When motility won't recover after several prokinetics (treatments that help the gut move food along) have each worked for a little while, I usually look for something that was missed, and a nervous system held in constant hypervigilance (being on high alert), which can suppress vagal activity, is one of the first places I look.
If trauma is part of your history, it might be a good idea to ask your doctor about screening for it and about support alongside your gut care, rather than in place of it. Checklist scores on their own aren't a diagnosis, so that conversation should happen with someone who knows your history.
Our post on gastroparesis pain and pain sensitivity covers a related 2026 study. How much a gastric emptying result can change from day to day is the place to start if the scan itself is your question, and the rest of the motility posts are gathered on the SIBO and motility hub.
If you want to understand what keeps food moving through your gut, the free Motility Masterclass Taster Module explains what the migrating motor complex does in plain language.
FAQ
Does trauma cause gastroparesis?
This study can't answer that, because it assessed each person once. In 207 people who already had gastroparesis, a positive screen for probable PTSD wasn't linked to slower gastric emptying, but it was linked to more severe symptoms, reduced electrical activity on electrogastrography, and more psychosocial impairment.
If trauma makes my symptoms worse, does that mean they're psychological?
No. The patients who screened positive didn't have significantly more delayed emptying than those who screened negative, and they also had a measurable difference in the stomach's electrical activity. The nervous system is part of how the gut works, so its involvement is part of the physiology.
What is electrogastrography?
It is a noninvasive test that records the stomach's electrical rhythm through electrodes placed on the skin over the stomach. That rhythm helps set the pace for the muscle contractions that move food along. In the Cleveland Clinic study, patients who screened positive for probable PTSD had reduced myoelectric activity on this test.
Does stress slow down stomach emptying?
In healthy people, short-term stress can. In a 2013 crossover study of eight healthy volunteers, stressful noise around a meal lengthened the average time it took half the meal to leave the stomach from 105.0 minutes to 130.8 minutes. Among the Cleveland Clinic gastroparesis patients, though, a positive PTSD screen wasn't linked to slower emptying.
Will trauma therapy help gastroparesis?
This study didn't test that. The study authors write that further work should assess whether trauma-focused therapy improves symptoms. If trauma is part of your history, you can still bring it up with your care team as a concern of its own.
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