A Guide To Gastroparesis Symptoms, Causes, And Natural Treatments
As an integrative gastroenterologist (GI), I treat many patients with gastroparesis, which is just a fancy name for slow emptying of the stomach. While this condition is common in my line of work, not everyone is familiar with it.
Gastroparesis can lead to symptoms, including: upper abdominal pain, bloating, nausea, vomiting, fullness, early satiety, belching, and in some cases, regurgitation. It occurs when the stomach isn't working as well as it should be, and as a result, food doesn't leave the stomach at the right pace.
If you think you may have this condition, consult with a doctor or GI, and read on to understand the causes, signs, and possible management techniques.
What is gastroparesis?
Gastroparesis is a motility disorder, meaning something isn't moving fast enough (in this case, the stomach.)
It's important to make sure there aren't any physical or mechanical obstructions leading to slow motility. For example, if your stomach doesn't empty well because you have cancer in your stomach, that could block the exit of food from the stomach and might explain your gastroparesis-like symptoms. Always work with a physician to ensure you get the correct tests for a solid diagnosis.
Causes of gastroparesis.
There are several possible causes of gastroparesis and many cases of gastroparesis are idiopathic, meaning it's unclear exactly what causes them.
Some of the more common known causes of gastroparesis include diabetes, spinal cord injury, gastrectomy, or certain medications that block nerve signals.
One of the common underlying themes in some of these conditions is nerve or nervous-system-related dysfunction. In the case of diabetes, experts believe that chronically elevated blood sugars are associated with a higher risk of neuropathy. Oxidative stress and dysfunction of the nervous system contribute to the development of gastroparesis.
How to know if you have gastroparesis.
If you have symptoms that could suggest gastroparesis, it's likely that you will be referred for an upper endoscopy1. This is a procedure in which a long, flexible tube with a camera and light is inserted into the mouth and upper gastrointestinal tract. The procedure involves evaluating the esophagus, stomach, and the beginning portion of the small intestine, called the duodenum. The primary purpose of an upper endoscopy is to make sure nothing is obstructing food motility.
If nothing shows up in the procedure, you may be referred for a gastric emptying scan2. This is when you eat a meal tagged with radiolabeled isotope so the radiologist can determine what pace the food leaves the stomach. If it doesn't empty quickly enough, you could be diagnosed with gastroparesis.
How to manage gastroparesis.
If your doctor identifies a particular cause, then I advise treatment and management that focuses on the underlying cause, not just the symptoms. Here are a few ways it may be treated (but only under the supervision and recommendation of your doctor.)
Dietary modifications are at the core of any management strategy for gastroparesis. It's important to make sure fluids and electrolytes are balanced and blood sugar is controlled. It's suggested that people eat frequent small meals, rather than two or three moderate-to-large meals a day, and some people may even need to blend food.3
Remember, this is all a matter of how much your stomach can take based on how fast it can move. If you try to fill your stomach faster than it can empty, then you're going to have a problem. So go slowly when filling the stomach in order to give it more time and less stress to empty. 3
A gastroparesis diet usually consists of meals low in fat, and high in soluble fiber. This is because it's easier for the stomach to process this type of diet, compared to complex fats and insoluble fibers.
Hopefully, as your symptoms improve, you can liberalize your eating patterns and food choices. It can be helpful to work with a dietitian skilled in helping people with gastroparesis. Some people also consider food sensitivity testing to see if it might offer some insight into how they can optimize their dietary choices.
If dietary adjustments are not enough to control symptoms, then speak to your doctor about options for prescription medication or surgeries.
As an integrative gastroenterologist, I try to look beyond the conventional approaches, like medication and surgery. Sure, we need to keep conventional algorithms and treatments in mind—especially when it comes to making a diagnosis. However, there are other less conventional tools to help manage symptoms.
- Ginger is one of my favorite herbs, and conveniently, it contains properties that help with gastric emptying and gastrointestinal motility4.
- Iberogast5, or STW-5, is another therapy that includes a mixture of several herbs, and has been shown to affect intestinal electrophysiology.
- Swedish bitters have also been shown to be helpful in managing gastroparesis6, as have acupuncture and electroacupuncture.
The brain is directly connected to the gastrointestinal tract via the vagus nerve, which is a bidirectional information superhighway. Understanding the role of stress in modulating the motility of the GI tract7 is an often underappreciated, but highly valuable concept.
Because of the brain-gut axis8, modifying some of the chemical messages from the brain may support the state of the gut. In my practice, I often employ mindfulness, breathwork, and meditation as part of that treatment plan.
While gastroparesis may sound like a daunting diagnosis, there are ways to manage or help your symptoms. Using a combination of conventional and integrative approaches, with the support of a doctor, may allow you to optimize the outcome and get your gut health back on track.
Marvin Singh, M.D is an Integrative Gastroenterologist in San Diego, California, and a Member of the Board and Diplomate of the American Board of Integrative Medicine. He is also trained and board certified in Internal Medicine and Gastroenterology/Hepatology. A graduate of Virginia Commonwealth University School of Medicine, Singh completed his residency training in Internal Medicine at the University of Michigan Health System followed by fellowship training in Gastroenterology at Scripps Clinic Torrey Pines. Singh was trained by Andrew Weil, M.D., a pioneer in the field of integrative medicine, at the Andrew Weil Center for Integrative Medicine.
Singh is currently the Director of Integrative Gastroenterology at the Susan Samueli Integrative Health Institute at UC Irvine. He is also currently a voluntary Assistant Clinical Professor at UCSD in the Department of Family Medicine and Public Health; prior to this, he has been a Clinical Assistant Professor at UCLA and an Assistant Professor of Medicine at Johns Hopkins University. Singh is a member of the American Academy of Anti-Aging Medicine, American College of Lifestyle Medicine, and many other societies. He is actively involved in the American Gastroenterological Association. He is one of the editors of the textbook of Integrative Gastroenterology, 2nd edition (a Weil Series text) and has written several book chapters and articles.
He is dedicated to guiding his clients toward optimal wellness every step of the way, using the most cutting edge technologies to design highly personalized precision based protocols. Towards this end, he founded Precisione Clinic and wrote the book Rescue Your Health to bring the best in preventive medicine to his clients.