Symptoms and Signs
Common Symptoms
Early Satiety & Fullness:
- • Feeling full (satiated) soon after beginning to eat
- • Poor appetite
- • Feeling full long after having eaten
- • Fullness disproportionate to quantity of food eaten
Digestive Symptoms:
- • Bloating, often described as feeling and looking pregnant
- • Abnormal amount of belching, heartburn
- • Abdominal pain, vomiting, nausea
- • Poor nutrient absorption
Associated Complications
- • Dysbiosis (Small Intestinal Bacterial Overgrowth (SIBO), Small Intestinal Fungal Overgrowth (SIFO))
Co-Morbidities
Common Co-occurring Conditions
Connective Tissue & Autonomic:
- • Ehlers-Danlos Syndrome (EDS)
- • Dysautonomia, Postural Orthostatic Intolerance Syndrome (POTS)
- • Mast Cell Activation Syndrome (MCAS), Hereditary alpha Tryptasemia (HaT)
Other Conditions:
- • Small Intestinal Bacterial Overgrowth (SIBO), Small Intestinal Fungal Overgrowth (SIFO)
- • Diabetes
- • Neuropathy
Care Team
Recommended Care Team
Medical Specialists:
- • Gastroenterologist - ideally one specializing in motility and/or EDS and/or mast cell diseases
- • Functional/integrative/naturopathic medicine doctor experienced with addressing dysbiosis (SIBO, SIFO), environmental toxins
- • Osteopath, chiropractor
Physical Therapy & Manual Therapy:
- • Physical Therapist specializing in the pelvic floor,* visceral manipulation, dry needling**
- • Certified Lymphatic Massage Specialist/Lymphedema Specialist
- • Neuro Performance Trainer (Z-Health Performance trainer)
- • Acupuncturist
Additional Support:
- • 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
Important Notes:
*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.
Care Team Recommendations
Visit our Provider Directory for recommended specialists who understand gastroparesis and related conditions.
Management
Water Management
Hydration Guidelines:
- • 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 Management
Eating Practices:
- • Practice mindfulness when eating (noticing salivation); chew food well
- • Drink homemade juice and smoothies for better nutrient absorption
- • Eat only when in a calm state and environment
- • Avoid eating when preoccupied, rushed, stressed, or distracted
- • Practice slow breathing before, during, and after eating
Meal Timing & Size:
- • 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 Strategies
Movement & Physical Care:
- • Walk as much as possible every day, especially upon waking and after eating
- • Abdominal massage using Tune Up Fitness Coregeous ball, Yamuna Pearl ball
- • Modified downward dog pose when safe for POTS, with oil, etc.
- • Wear an abdominal binder
- • Release psoas muscles, back muscles, abdominal muscles
Lifestyle Optimization:
- • 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
- • Prioritize getting quality sleep
Note on bathroom positioning: 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.
Medications and Supplements
Medications & Supplements
Natural Options:
- • 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
Prescription Medications:
- • Prokinetic (motility-enhancing) medications: Including Motegrity and Domperidone
- • Domperidone: 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
Professional Treatment Options
Manual Therapies:
- • Joint mobilization
- • Spinal manipulation
- • Craniosacral therapy
- • Visceral manipulation
- • Dry needling
- • Lymphatic massage
Neurological & Training:
- • Neural retraining
- • Vestibular training
- • Medical hypnosis