How To Treat Gastroparesis Without Medication

by 
Dr. Jennifer L. Weinberg
How To Treat Gastroparesis Without Medication

When you have gastroparesis, your stomach takes too long to empty its contents, leading to various symptoms and complications. This slow emptying of the stomach may be temporary or chronic and can be caused by several factors.

The vagus nerve is responsible for stimulating stomach muscles that move food through the digestive tract. When the vagus nerve does not function normally, it can lead to symptoms of bloating, abdominal pain, nausea, and vomiting. Natural remedies for gastroparesis address underlying causes like blood sugar imbalances and support vagus nerve function and digestion.

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What is Gastroparesis

In gastroparesis, the nerves or stomach muscles do not work properly. Usually, nerves stimulate muscles in the stomach to contract to propel food through the digestive tract to be digested and absorbed in a timely manner.

When the movement of the stomach pushing food through the digestive tract is slowed down or does not work at all, food does not leave the stomach at the rate it should. When this happens, it is known as delayed gastric emptying or gastric dysmotility.

When gastroparesis delays digestion, food can remain too long in the stomach, leading to various symptoms and complications.

Gastroparesis Signs & Symptoms

The delayed stomach emptying that occurs with gastroparesis can cause a range of symptoms that can vary in severity. These include

  • Upper abdominal pain
  • Bloating
  • Nausea
  • Vomiting,
  • Acid reflux, heartburn, or regurgitation
  • Feeling full after eating only a little
  • Loss of appetite
  • Unintended weight loss

Since gastroparesis can interfere with normal digestion, it may cause problems with blood sugar levels and absorption of various nutrients. Over time, this can lead to complications, including:

  • Dehydration, especially with ongoing vomiting
  • Malnutrition due to poor appetite and intake as well as reduced absorption
  • Bezoars or collections of undigested food that hardens and remain in the stomach and can block food from passing through
  • Small Intestinal Bacterial Overgrowth (SIBO)
  • Unpredictable blood sugar changes due to an unstable rate and amount of food passing into the small bowel

What Cause Gastroparesis

While the cause of gastroparesis is not always easily identified, it is often due to damage or malfunction of the vagus nerve. The vagus nerve (cranial nerve X) is the main nerve of the parasympathetic (rest and digest) division of the autonomic nervous system. This important nerve travels from the brain to the digestive tract. It helps control the contraction of stomach muscles in addition to helping to slow down breathing and heart rate, promote relaxation, stimulate digestion, and bring about a sense of calm.

A dysfunctional vagus nerve does not send proper signals to the stomach muscles, which can cause food to remain in your stomach longer versus move into your small intestine to be digested and absorbed.

Some factors that can damage the vagus nerve and its branches and increase the risk of gastroparesis include

  • Diabetes or abnormal control of blood sugar since consistently high glucose can cause vagus nerve damage (autonomic neuropathy)
  • Surgery to the esophagus, stomach, or small intestine
  • Viral or bacterial infections,
  • Connective tissue diseases like scleroderma or lupus
  • Eating disorders including anorexia nervosa bulimia
  • Nervous system diseases such as Parkinson's disease or multiple sclerosis
  • Stroke
  • Hypothyroidism
  • Traumatic brain injury

In addition, certain medications can slow the rate of stomach emptying and cause similar symptoms or make gastroparesis worse. These include opioid pain medications and some antidepressants, high blood pressure and allergy medications, and tobacco.

Functional Medicine Labs for Gastroparesis Patients

There are several ways to measure how fast the stomach empties its contents.

  • Endoscopy visualizes the esophagus and stomach with a small camera on a scope.
  • A gastric emptying scan or scintigraphy is where you eat a light meal with a small amount of radioactive material and use a scanner to follow the movement of the food through the gastrointestinal tract.
  • Upper Gl barium series (barium swallow) uses imaging to show how the stomach expands while looking for delayed emptying of barium or retained gastric debris (bezoars), which would suggest slowed emptying.
  • Electrical testing of nerve impulses to the stomach with an electrogastrogram (EGG).
  • Smartpill or wireless motility capsule to look at the inside of the gastrointestinal tract and track how long it takes to move through.
  • Gastric emptying breath tests where you eat a specific food or liquid and later test to see if substances produced during digestion can be detected in your breath over several hours.

Blood Sugar Balance

Several tests assess how the body handles sugars:

These can identify blood sugar imbalances that can contribute to inflammation and damage the vagus nerve.

Nutrition Status

Since gastroparesis increases the risk of malnutrition and nutritional deficiencies, testing can evaluate areas of concern to target. The NutraEval FMV measures a variety of antioxidants, vitamins, minerals, fatty acids, and other biomarkers to determine nutritional deficiencies and imbalances.

Small Intestinal Bacterial Overgrowth (SIBO)

Since gastroparesis can set the stage for developing SIBO, a breath test can evaluate the overgrowth of bacteria that do not belong in the small intestine. The 3-hour SIBO assessment is a non-invasive breath test that measures hydrogen and methane to assess bacterial overgrowth in the small intestine.

Digestive Function

The Gut Zoomer stool test evaluates microbes in the digestive tract to assess overall balance and suggest conditions like SIBO, metabolic imbalances, and functional digestive status. For example, stool elastase is a marker of pancreatic function and how well the digestive system makes enzymes to help digestive food.

4 Natural Treatment Options for Gastroparesis

Natural remedies for gastroparesis aim to manage identified underlying causes like diabetes, maintain balanced nutrition, improve the functioning of the stomach, and reduce symptoms. Targeting the underlying cause of dysmotility and chronic nausea guides targeted, specific treatment.

Nutrition

An essential goal of gastroparesis treatment is maintaining adequate nutrition in a way that does not cause additional symptoms. Diet modifications may include

  • Smaller meals
  • Well-cooked fruits and vegetables rather than raw
  • Soups and pureed foods
  • Reduced insoluble dietary fiber and fat
  • Decreasing portions of protein, especially red meat.

It is also important to maintain adequate hydration by consuming electrolytes like natural sea salt along with water and avoiding alcohol and carbonated drinks.

Low FODMAP Diet

A low FODMAP (Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) diet limits short-chain carbohydrates which can be difficult to digest. Eliminating foods like beans and legumes, corn, seeds and nuts, and cruciferous vegetables that can irritate the stomach or cause delayed emptying can reduce symptoms for some. Following a gluten-free or grain-free diet can also reduce symptoms.

Blood Glucose Stabilization

In those with diabetes as the cause of gastroparesis, careful control of blood sugars with an individualized low-glycemic/carbohydrate diet may reverse some of the damage to the vagus nerve and help to restore regular emptying of the stomach.

Eat Mindfully

Mindfulness, especially during meals, can help regulate plasma glucose levels and improve digestion by stimulating the parasympathetic or rest and digest part of the autonomic nervous system. Approaching food mindfully involves paying attention to your physical and mental processes while eating.

Give your mind and body the break they need to be truly nourished by sitting down and enjoying your food without distractions. Take time to savor your food, pausing between bites and chewing thoroughly to help with digestion.

It is also helpful for many to exercise gently after eating, such as taking a walk, and avoid lying down for about two hours after a meal to optimize digestion.

Strengthen the Vagus Nerve

Depending on the cause of damage or dysfunction, some exercises can strengthen the function of the vagus nerve.

  • Humming
  • Yogic breathing/pranayama (particularly Alternate Nostril Breath)
  • Slow, deep, controlled breathing
  • Gargling
  • Singing
  • Yoga
  • Visceral manipulation-massage that aims to stimulate the vagus nerve and release tension from abdominal organs

Acupuncture

Acupuncture is an effective way to deal with nausea and has long been used in traditional medicine. Studies show electroacupuncture can stimulate the vagus nerve and improve the ability of the stomach to empty.

Supplements

Under medical guidance, replacing acid (betaine HCl or apple cider vinegar) and enzymes such as papain or bromelain extracts and stimulation of digestion with bitters may help improve digestion for some with gastroparesis.

  • Ginger is a natural prokinetic that helps improve stomach emptying to relieve nausea.
  • Other herbal prokinetic combinations such as bitter candytuft, angelica root, chamomile, and caraway, commonly found in the herbal formula Iberogast, have also improved dysmotility by helping the stomach muscles function appropriately.

Summary

When the vagus nerve does not function well, the muscles of the stomach and intestines do not work correctly, causing gastroparesis. This condition most commonly occurs when the vagus nerve is damaged due to diabetes, surgery, infections, or other medical conditions.

Testing can measure how fast food moves out of the stomach and help identify underlying causes like blood sugar imbalances or nutritional issues.

Natural remedies for gastroparesis aim to address underlying causes and manage symptoms. Dietary modifications help ensure fluids and electrolytes are balanced, and blood sugar is controlled.

Eating mindfully, chewing well, and using breathing exercises and acupuncture to stimulate the vagus nerve can improve the stomach's functions, while ginger, enzymes, and bitters may improve digestion.

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References

Dr. Jennifer L. Weinberg
MD MPH MBE
Website
Dr. Jennifer L. Weinberg is a preventive and lifestyle medicine physician, author of The Whole Cure, educator, writer, and the founder of the Simple Pure Whole Wellness Method. She combines her training in Preventive Medicine, Public Health, Bioethics, Women’s Health, Nutrition, Global Health, and Environmental Medicine with her passions for using lifestyle and functional medicine to prevent and manage chronic disease, offer innovative wellness and education programs for individuals looking for sustainable optimal health, support health care providers with health communications, and develop comprehensive approaches to corporate wellness.
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