Gastroparesis

Gastroparesis, which means “partial paralysis of the stomach” and is also known as “delayed gastric emptying,” is a disorder that slows or stops the movement of food from the stomach to the small intestine.

Symptoms and Signs

  • Feeling full (satiated) soon after beginning to eat, poor appetite

  • Fulling full long after having eaten, often disproportionately to the quantity of food you ate

  • Bloating, often described as feeling and looking pregnant

  • Abnormal amount of belching, heartburn

  • Abdominal pain, vomiting, nausea

  • Poor nutrient absorption

  • Dysbiosis (Small Intestinal Bacterial Overgrowth (SIBO), Small Intestinal Fungal Overgrowth (SIFO))

Co-Morbidities

  • Ehlers-Danlos Syndrome (EDS)

  • Dysautonomia, Postural Orthostatic Intolerance Syndrome (POTS)

  • Mast Cell Activation Syndrome (MCAS), Hereditary alpha Tryptasemia (HaT)

  • Small Intestinal Bacterial Overgrowth (SIBO), Small Intestinal Fungal Overgrowth (SIFO)

  • Diabetes

  • Neuropathy

Care Team

Click here for care team recommendations

  • Gastroenterologist - ideally one specializing in motility and/or EDS and/or mast cell diseases

  • Physical Therapist specializing in the pelvic floor,* visceral manipulation, dry needling**

  • Certified Lymphatic Massage Specialist/Lymphedema Specialist

  • Neuro Performance Trainer (Z-Health Performance trainer)

  • Functional/integrative/naturopathic medicine doctor experienced with addressing dysbiosis (SIBO, SIFO), environmental toxins

  • Osteopath, chiropractor

  • Acupuncturist

  • Certified colon hydrotherapist - colonics can be helpful for managing acute constipation

  • Mental health professionals who can help address stress and trauma, which can affect gut issues

*Pelvic floor dysfunction or muscle tightness can play a role in constipation and bloating issues.

**Dry needling of the muscles all around your digestive organs can help release tension around the organs that are preventing blood flow, oxygenation, and proper function.

Management

Water

  • Stay very well hydrated

  • Drink water away from food (at least 20 minutes before or after eating); allow meal/snack time to be focused on food

Food

  • Practice mindfulness when eating (noticing salivation); chew food well.

  • Drink homemade juice and smoothies for better nutrient absorption and easy-to-digest nutrition.

  • Eat only when in a calm state and environment; avoid eating when preoccupied, rushed, stressed out, or distracted (such as watching TV).

  • Practice slow breathing before, during, and after eating.

  • Eat small meals, but try to avoid grazing endlessly throughout the day.

  • Eat last meal/snack of the day no later than 3 hours before bedtime.

  • Incorporate ginger into diet, which is helpful for reducing nausea and enhancing motility.

  • Keep fat and fiber consumption low; experiment increasing amounts very slowly and carefully.

  • Check out my general food recommendations.

General Management

  • Walk as much as possible every day, especially upon waking and after eating.

  • Abdominal massage using Tune Up Fitness Coregeous ball, Yamuna Pearl ball, upside down in a modified downward dog pose when safe for POTS, with oil, etc.

  • Wear an abdominal binder.

  • Release psoas muscles, back muscles, abdominal muscles.

  • Improve tongue strength, coordination, and function via tongue exercises.

  • Practice lymphatic drainage massage, focusing on the abdomen.

  • Put feet up on a stool when going to the bathroom (I prefer a stool over a squatty potty because I’m short and my physical therapist friend pointed out to me that because of my height, the squatty potty doesn’t give me enough angle/height).

  • Prioritize getting quality sleep.

Medications and Supplements

  • Iberogast (has at times been magical, other times neutral, other times problematic).

  • Ginger supplements can be taken before meals to help with motility and nausea.

  • Prokinetic (motility-enhancing) medications, including Motegrity and Domperidone (Domperidone is not approved in the United States but patients can obtain it from pharmacies in other countries, including Canada).

  • Low dose naltrexone (LDN) may decrease inflammation and increase motility.

Provider Team Therapies

  • Joint mobilization

  • Spinal manipulation

  • Craniosacral therapy

  • Visceral manipulation

  • Dry needling

  • Lymphatic massage

  • Neural retraining

  • Vestibular training

  • Medical hypnosis