Here is the second part of the article “Natural Treatments for Gastroparesis” written for and originally posted on the Unchargeables. You can learn more about what Gastroparesis is, how it’s diagnosed and traditional treatments, here.
In Natural Treatments for Gastroparesis: Part One, we discussed what gastroparesis (GP) is and ways in which people with gastroparesis can modify their diet and their medications to help improve symptoms. This article will cover natural substances that can further aid the GP patient. Also included is a discussion about a few tactics to stimulate and promote healing in the vagus nerve, which is believed to be responsible for causing gastroparesis.
Gastroparesis and Supplementation
There are a variety of supplements and herbs that can benefit a person with gastroparesis. I have broken them down by the symptoms they are best at addressing and note crossovers where applicable.
Dysbiosis, Constipation and Diarrhea
People with gastroparesis usually suffer from a variety of GI concerns due to low motility. Our gut flora is often out of balance and we often have IBS or SBBO (Small Bowel Bacterial Overgrowth). The use of probiotics with prebiotics can often help with this, along with the consumption of fermented foods like yogurt, kombucha or kim chi, if tolerated. Probiotics will help with these symptoms and come with a variety of other benefits, such as supporting the immune system, and curbing symptoms like heart burn, gas, bloating, nausea, constipation, and diarrhea.
While most of us cannot handle insoluble fiber, there is one company making a low FODMAP fiber supplement with which I’ve had great success, Pronourish Fiber. Designed specifically for people with gastrointestinal disorders, it can help with both constipation and diarrhea, keeping your system more regular overall and bulking your stool so it’s much more comfortable to pass.
Heart Burn and Reflux
If GERD is an issue, it’s tempting to use a proton pump-inhibitor, but these should really be avoided, given that they decrease stomach acid and motility. An H2 antacid like Zantac (ranitidine) may be a better choice, though they are also known to slow motility. For whatever reason, I have better motility with the latter than the former, but this is just my personal experience. If you find both a proton pump inhibitor and H2 antacids cause your system to slow, there are a variety of natural remedies for treatment, as well.
Stinging Nettle Tea can provide relief of both heart burn and nausea. When taken daily, I have found it’s quite effective at keeping my GERD at bay. It is safe to use daily for most, but there are a few precautions with this herb, so be certain to read about it to ensure it’s not contraindicated for use with any of your conditions or medications.
A ½ teaspoon baking soda dissolved in 4 ounces of water often brings relief, as does soda or seltzer water. However, baking soda is a remedy that should only be used occasionally as a spot treatment. It shouldn’t be taken when the stomach is uncomfortably full, making it perhaps not the best choice for gastroparesis. It may still come in handy at times, as we all know we can get heart burn whether our stomachs are full, empty, or somewhere in between.
There are other things which can also help reduce heart burn by treating the whole digestive tract and absorption issues, much like probiotics. These are covered below.
Malnutrition and Malabsorption
Since absorption is often an issue for people with GP and we are at high risk of malnutrition, it is often necessary to supplement with vitamins. Since the processing of solids is hardest of all, it’s best to take either liquid or methylated vitamins that are easier for our bodies to process. Liquid vitamins can be consumed normally, while methylated vitamins are designed so that they are absorbed by the skin. While multivitamins get a bad rap, for us, they are essential. Usually additional amounts of other key nutrients are also necessary.
The most important vitamins to replenish are usually Vitamin D, Vitamin C (for immune health), Magnesium, B vitamins (we tend to be particularly deficient in B12, but B2 and B6 are very important for migraine sufferers, and all B vitamins help provide added energy), and iron. A doctor can test your levels and tell you for certain where you’re deficient and whether or not you’re taking enough once you begin supplementation.
To aid absorption and reduce inflammation in the GI tract, consuming an aloe vera juice or gel drink is an excellent way to go. Aloe can increase the absorption of nutrients by as much as 300% and decrease inflammation, making for a calmer, more regular digestive tract overall.
Digestive enzymes are being touted as another way to help food break down and get additional absorption of nutrients from your food, but I’m somewhat on the fence about whether or not they’re appropriate and haven’t taken them personally. This article from diet-vs-disease, a trusted site I rely on for my FODMAP diet information, seems pretty wary of it. But other health bloggers and advocates, including some doctors, are in favor of using digestive enzymes to increase stomach acid production in people with gastrointestinal disorders like GP.
Before your body can absorb nutrition from food, it must be broken down. Consuming digestive enzymes prior to a meal could potentially assist in the process and reduce symptoms like reflux, gas, and bloating. It makes sense in theory, but there are few tests to back them up. If you do decide to supplement digestive enzymes, it’s important that you choose a digestive enzyme without any fillers that may be hard on your stomach. According to Gastroparesis Natural Treatment, one such enzyme is Betaine HCI, which increases stomach acid. Choosing a Betaine supplement with pepsin is best, as most people with GP are low in both.
Increasing Motility and Curbing Nausea
One very unpleasant side effect of low motility is the nausea that comes along with it when gastric emptying slows. There are a number of herbs that can help. Not surprisingly, many of the herbs which combat nausea also increase gastric emptying.
Peppermint is an excellent antiemetic that also improves motility. I find it works best with a little sugar and usually use Red Bird peppermint puffs or Altoids, as these mints contain pure peppermint oil and sugar both without too many other ingredients. One mint usually gets me 20-30 minutes of nausea relief. You can also chew directly on mint leaf, drink mint tea or get mint oil. If you go this route, you should consume it with food, as it can cause heart burn. This is why I usually use mints. With their accompanying sugar, I don’t have to try to eat anything on top of it to avoid heart burn.
Stinging Nettle Tea is great at relieving nausea and acts as a mild anti-inflammatory. Since it also works well for heart burn and provides some mild pain relief, it’s a good option for daily use provided there are no contraindications for its use.
Ginger is another herb which works well for nausea. It’s also been proven to promote gastric emptying and motility. In addition to these great benefits, it works well on muscle pain when taken regularly and has anti-inflammatory properties that are helpful in arthritis. It’s even been shown in a small study to lower blood sugar. It’s best if eaten with meals or drank as a tea 2-3 times a day.
Triphala, while not known to curb nausea, has been proven in studies to help with constipation and promote appetite. It actually performed better than Reglan (metoclopramide) for gastric emptying. I have not taken this supplement personally, but I plan to try it.
Stimulating the Vagus Nerve to Improve GP
The vagus nerve is a fibrous network that runs from your brain throughout the body’s core. It is part of the parasympathetic nervous system.
- In the brain, the vagus helps control anxiety and depression.
- In the gut, it increases stomach acidity, digestive juices, and gut flow.
- In the heart, it controls heart rate variability, heart rate, and blood pressure.
- In the liver and pancreas, it helps controls glucose store and balance
- In the gallbladder, it helps release bile, which can help you get rid of toxins and break down fat.
It isn’t hard to see why gastroparesis tends to run concurrently with a variety of other health conditions. There are many ways to help stimulate the vagus nerve to improve function. The goal is to relieve stress and encourage relaxation. Therefore things like massage, meditation, yoga and deep, controlled breathing exercises are all high on the list of things recommended to stimulate the vagus nerve. Even singing, chanting, and laughing can have a positive effect on vagal tone. The vibration of the vocal chords helps to stimulate our organs and the vagus nerve. So go ahead, sing in the shower, laugh with friends, watch those comedies. It’s good medicine!
Another great technique for stimulating the vagus nerve is to shut off the hot water mid-shower, dousing yourself with cold water and shocking the system. Studies show that when your body adjusts to cold, your fight or flight (sympathetic) system declines and your rest and digest (parasympathetic) system increases – and this is all mediated by the vagus nerve. Even drinking cold water or splashing some on your face may be enough to stimulate the vagus nerve. However, I find the cold shower technique to be more effective and found some improvement to my heat intolerance and other symptoms of dysautonomia.
Probiotics are also good for the vagus nerve. Studies show that animals supplemented with L. rhamnosus experienced various positive changes in GABA (calming) receptors that were mediated by the vagus nerve.
In several small studies, acupuncture has shown that it may provide benefit in gastroparesis. One short-term placebo-controlled randomized study that included 19 patients with diabetic gastroparesis suggested improvement in overall symptoms including fullness and bloating (IFFGD). I haven’t tried acupuncture personally, but it makes sense that if massage works to stimulate the vagus nerve, so too would acupuncture.
Things Every Person with GP Should Consider
In addition to working with your pharmacist to clean up your medication list, you should also consult with a dietician. They can help you to manage the FODMAP diet and any other dietary restrictions you may have and help you decide what vitamins and minerals to supplement. It is possible to do these things on your own and there are plenty of resources out there to be had, but these things rarely replace the knowledge of a trained professional. A naturopathic doctor or pharmacist could also help you decide which supplements are right for you and might even be able to help suggest other supplements not included here.
It’s also important to keep in mind that while medications can sometimes offer great relief, they can also be unreliable and have unforeseen consequences. Doctors are in the business of pills and procedures and sometimes these things are both necessary and helpful, but it can be used in cooperation with naturopathic medicine and every day common sense solutions. Often, using a combination of the two seemingly opposed methods of healing yields the most beneficial outcomes for patients.
Finally, the things on this list I consider most essential to gastroparesis care are reviewing your medications, adapting the diet, taking probiotics and a low FODMAP fiber supplement, increasing motility, and stimulating the vagus nerve. Everything else is dependent on your specific symptoms and can help improve the overall quality of life for people who have gastroparesis.