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Gastroparesis: Your Indigestion May Not Be Regular Old Heartburn

August 9, 2018 (Updated: August 16, 2018)
Lily Moran

When you think of digestive issues, the well-known ones probably come to mind: Irritable bowel syndrome, heartburn, gastroesophageal reflux disease (GERD), or inflammatory bowel diseases like ulcerative colitis. But there’s another digestive condition that many people have never heard of—which is surprising considering an estimated 4 million in the US alone are affected. It’s called gastroparesis, and it can be quite debilitating.

Gastroparesis is partial paralysis (-paresis) of the stomach (gastro-). To understand what exactly this means, it helps to know how the digestive tract normally functions.

After we chew and swallow food, it travels down your throat to your esophagus. At that point, automatic, unconscious contractions take over the digestive process, propelling the food down toward the stomach, then to the small intestine, through the rest of the digestive tract. How quickly the food moves from one area to the next is precisely timed and coordinated for optimal digestion, nutrient extraction, and elimination.

However, in those who have gastroparesis, this timing is compromised. Food does not move from the stomach to the intestine as quickly as it should. This delayed gastric emptying isn’t caused by some physical obstruction, rather damage to the vagus nerve. This is one of the cranial nerves that connects your brain to your gastrointestinal (GI) tract and manages all the complex processes involved in digestion, including the signaling of the stomach muscles to move food along. Because the damaged vagus nerve doesn’t send the proper messages, food remains in the stomach for too long, leading to some really bothersome symptoms, like…

  • Feeling of fullness after only a few bites of food
  • Nausea or vomiting
  • Abdominal pain or bloating
  • Heartburn
  • Burping
  • Lack of appetite

How and why the vagus nerve sustains damage remains somewhat of a mystery. In about 25% of cases, diabetes plays a role. High levels of blood glucose can lead to negative changes in the vagus nerve and how it operates. Surgery to any part of the GI tract (such as bariatric surgery) can injure the vagus nerve, as can the use of certain medications (blood pressure drugs, opiods, antacids, and antidepressants, for instance).

In rare cases, neurological conditions such as Parkinson’s disease and multiple sclerosis, or connective tissue problems like scleroderma, are to blame. But in about 50% of cases, the cause is idiopathic (medical term for unknown).

How to Treat Gastroparesis

The only way to achieve a possible “cure” is, unfortunately, surgery. But even that’s not 100% effective—not by a long shot. And, as with all surgery, it’s a risky proposition, especially considering there’s a good chance the problem will still be there when you wake up.

So right now, the best option is to prevent and lessen symptoms.

There are medications such as motility agents that can increase the speed of contractions that push food through the digestive tract and empty the stomach more quickly. Of course all drugs come with potentially serious side effects, so you really have to evaluate if they are worth it for your situation.

Thankfully enough, natural options exist too.

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The first step is to make some important changes to your dietary habits. Reduce the amount of food you eat in one sitting, and eat several small meals per day instead of two or three big meals. Be sure to chew your food thoroughly, and avoid carbonated beverages or lying down for a few hours after eating. And go for a post-meal walk, which can promote healthy digestion.

While loading up on foods rich in fiber and healthy fats is generally recommended for the average person, they may cause discomfort for someone with gastroparesis. They take longer to digest, so you may want to consider limiting your intake.

A 2015 study of 45 patients (39 of whom had idiopathic gastroparesis) looked at foods that provoke and alleviate symptoms of gastroparesis. It was determined that foods that exacerbated symptoms are oranges and orange juice, fried chicken, cabbage, sausage, pizza, peppers, onions, tomato juice, lettuce, coffee, salsa, broccoli, bacon, and roast beef.

Saltines, Jello, and graham crackers moderately improved symptoms. And foods that did not provoke any symptoms included ginger ale, gluten-free foods, tea, sweet potatoes, pretzels, white fish, clear soup, salmon, potatoes, white rice, popsicles, and applesauce.

The researchers wrote, “Foods provoking symptoms were generally fatty, acidic, spicy, and roughage-based. The foods shown to be tolerable were generally bland, sweet, salty, and starchy.”

In fact, ginger may go a step further and actually reduce symptoms. In a study of 24 participants, supplementing with ginger was found to speed up gastric emptying and stimulate stomach contractions that move food along through the GI tract. The dose used in the study was 1,200 mg, taken after an 8-hour fast and followed an hour later by eating.

Taking other supplements that support general gut health and overall digestion can be helpful as well. These include digestive enzymes, probiotics, and vitamin D3.

As far as therapies, acupuncture is by far one of the best—and has no side effects whatsoever.  In one study, 80 diabetic patients with gastroparesis were divided into three groups: treatment with acupuncture, domperidone (medication), or nothing (control). After 25 days, those in the acupuncture group showed 94% improvement in symptoms—far greater symptom reduction than in the other two groups. The researchers stated that, “acupuncture can give quite good therapeutic effects on diabetic gastroparesis.”

Finally, if you are taking any drugs, check with your doctor or pharmacist if they could be causing your gastroparesis. Stopping or switching your medications (with the blessing of your physician) may be all you need to put an end to this problem.

References

  • Wytiaz llV, et al. Foods provoking and alleviating symptoms in gastroparesis: patient experiences. Dig Dis Sci. 2015 Apr;60(4):1052-8. Last accessed July 26, 2018.
  • Wang L. Clinical observation on acupuncture treatment in 35 cases of diabetic gastroparesis. J Tradit Chin Med. 2004 Sep;24(3):163-5. Last accessed July 26, 2018.
  • Wu KL, et al. Effects of ginger on gastric emptying and motility in healthy humans. Eur J Gastroenterol Hepatol. 2008 May;20(5):436-40. Last accessed July 26, 2018.

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