There is no doubt that gastroparesis is on the rise. It is associated with medical conditions such as diabetes, multiple sclerosis, Alzheimer's disease and connective tissue disorders, to name but a few. Many of these diseases are also on the rise but each is characterised by different causes underpinning gastroparesis. These causes need to be examined in detail before a lifetime of low fibre diets is succumbed to. Gastroparesis - as debilitating and distressing as it can be - can be a symptom of our life style choices which are so entrenched in our culture that they have become the norm and are seen as harmless. We all know that opioids can be constipating and delay gastric emptying but what other oft used analgesics have similar effects What over the counter medicines slow peristaltic action What are the hormonal and nervous contributions to peristaltic action Can we change their response and, if so, how The author examines common causes of gastroparesis and, more importantly, how to