How to Treat Gastroparesis

Using diet / nutrition

Drink plenty of water. To avoid insufficient alkalizing pancreatic juices, which would prevent pyloric valve from opening;

Assure sufficient magnesium. To ensure muscle valves operate/relax properly; can be obtained from organic whole food sources, but supplementation (orally ~600 mg /day) or transdermally (with magnesium chloride) may be necessary.

Magnesium - "The Missing Miracle Mineral"

Sensible, healthy eating is vital to reduce dysmotility

- Take time to eat and enjoy food

- Don't drink too much alcohol

- Eat lighter, smaller meals regularly throughout the day

- Avoid identified trigger foods

- Don't eat too much fat - which causes the release of hormones that slow down stomach emptying;

- Combining only specific food-types shortens digestion time in stomach

• DON'T eat Carbohydrates with protein

• Eat Protein with vegetables or fruit

• Eat carbohydrate with vegetables

• Try to eat fruit on its own on an empty stomach (don't mix melons with other fruits)

Control glucose levels. High blood sugar tends to slow gastric emptying. Iodine supplementation can normalize thyroid hormone levels.

Blood sugar control

Note that cinnamon can SLOW gastric emptying. Studies of patients with type 2 diabetes have shown that cinnamon lowers fasting serum glucose, triacylglycerol, LDL and total cholesterol concentrations. However, Hlebowicz et al found that the addition of 6 g of cinnamon to rice pudding significantly delayed gastric emptying and lowered the postprandial glucose response without affecting satiety in healthy subjects. Thus, people with gastroparesis need to be mindful of cinnamon intake at daily doses of 6 g (about 2 tsp.) or higher;

Hlebowicz J, Darwiche G, BjÃ¶rgell O,AlmÃ©r LO. Effect of cinnamon on postprandial blood glucose, gastric emptying, and satiety in healthy subjects. Am J Clin Nutr. 2007;85:1552-1556. AAbstract/FREE Full Text

Herbal Solutions

Iberogast ™

Iberogast™. In addition to gastroparesis, this synergistic herbal extract of 9 plants has been very succesfully used against non-ulcer dyspepsia (NUD), irritable bowel syndrome (IBS), gastritis, and bloating. Shown effective in over 15 clinical studies, this patented herbal extract relieves gastrointestinal problem symptoms, and unlike mainstream medications, without serious side-effects:

• Accelerates gastric emptying

• Reduces pain and cramping

• Alleviates heartburn

• Relieves bloating and induces expulsion of gas from the intestines

Iberogast

Peppermint

Enteric-coated peppermint oil capsules. Peppermint helps relax the digestive tract's muscles and relieve excessive gas, according to the University of Maryland Medical Center.

- Study found that peppermint oil accelerated the early phase of gastric emptying while inducing pyloric sphincter relaxation

Inamori M, Akiyama T, AkimotoK, et al. Early effects of peppermint oil on gastric emptying: a crossover study using a continuous real-time 13C breath test (BreathID system). J Gastroenterol. 2007;42:539- 542. CrossRef

- Caution should be used in patients with known gastroesophageal reflux (GERD) - sInce peppermint oil decreases lower esophageal sphincter (LES) pressure;

- Enteric-coated peppermint oil capsules deliver oil directly to the intestines - instead of being absorbed into the blood stream from the stomach

- IBS dose is 0.6 ml per day -can be used concurrently with Iberogast™

- Peppermint oil is sometimes combined with rosemary and thyme oils -for IBS treatment

Ginger root

Ginger root reported to improve upper GI symptoms. Also studied for postoperative nausea, morning sickness, and chemotherapy-induced nausea;

Ernst E, Pittler MH, Efficacy of ginger for nausea and vomiting: a systematic review of randomized clinical trials. Br J Anaesth. 2000; 84:367-371 Abstract/"FREE Full Text

Ginger has also been shown to accelerate gastric emptying and stimulate antral contractions in healthy volunteers

- Wu et al demonstrated that ginger(1,200 mg / ~½tsp. daily) accelerated gastric emptying and stimulated antral contractions in healthy volunteers. These investigators reported that gastric antral area decreased more rapidly (P < .001) and the gastric half-emptying time was less after ginger ingestion than after placebo ingestion, whereas the frequency of antral contractions was greater. Thus, ginger may promote gastric antral contractions and promote gastric emptying at a daily dose of 1,200 mg.

Wu KL, Rayner CK, Chuah SK, et al. Effects of ginger on gastric emptying and motility in healthy humans. Eur J Gastroenterol Hepatol. 2008;20:436- 440.CrossRef Medline Order article via Infotrieve Web of Science

Drugs / Other

Prokinetics

Prokinetics are medicines that stimulate stomach contractions. Thus promote the emptying of the stomach.

E.g. Metoclopramide lowers the pressure threshold in the stomach that triggers the process of peristalsis (coordinated, rhythmic muscle contractions that help move food through the GI tract). It also boosts both strength and frequency of muscle contractions, and relaxes the pyloric sphincter.

- Disadvantages of prokinetics:

• Provide only short-term relief;

• Have serious side effects limiting their use:

• Metoclopramide is associated with depression and severe muscle twitching;

•Bethanecol may cause dizziness or lightheadedness;

•Cisapride has been linked to fatal heart arrhythmias.

Botulinum Toxin

Botulinum Toxin has been used to improve symptoms of gastroparesis in some patients. Used in very small doses to treat muscle spasms; decreases muscle activity by blocking the release of ACETYLCHOLINE hormone;

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