Gastroparesis affects the normal spontaneous movement of the muscles (motility) in your stomach which contracts push food through your digestive tract and as a result, your stomach's motility is slowed down or doesn't work at all, preventing your stomach from emptying properly.
The cause of gastroparesis is usually unknown. Sometimes it's a complication of diabetes, and some people develop it after surgery. And some certain medications, such as opioid pain relievers, some antidepressants, and high blood pressure and allergy medications, can also lead to slow gastric emptying and cause similar symptoms. As a result of slow emptying of the stomach, early satiety i.e. feeling full soon after beginning to eat, postprandial (after dinner/lunch) fullness, nausea, vomiting, bloating, and upper abdominal pain develop. This can cause fluids, electrolytes and nutritional loss.
The most commonly known mechanism in this is autonomic neuropathy of the nerve which innervates the stomach: the vagus nerve. Autonomic neuropathy is a form of polyneuropathy that affects the non-voluntary, non-sensory nervous system (i.e., the autonomic nervous system), affecting mostly the internal organs such as the bladder muscles, the cardiovascular system, the digestive tract, and the genital organs. These nerves function automatically and are not under a person's conscious control. Uncontrolled diabetes mellitus is a major cause of this nerve damage; other causes include post-infectious and trauma to the vagus nerve [https://en.wikipedia.org/wiki/Gastroparesis], as high levels of blood glucose may effect chemical changes in the nerves. The vagus nerve becomes damaged by years of high blood glucose or insufficient transport of glucose into cells resulting in gastroparesis.
To have an overview what is effective in managing gastroparesis as well as what elements of yoga may help us to manage gastroparesis, the following studies have been taken into consideration, but all these modalities discussed in research studies should be consulted with your physician to come to any conclusion:
- According to one research study submitted at National Library of Medicine (National Center for Biotechnology Information) at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3722580/, the very first line of management for gastroparesis should include restoration of fluids and electrolytes, nutritional support and in diabetics, optimization of glycaemic control. In normal cases, oral intake is preferable for nutrition and hydration and one should consult dietician regarding consumption of frequent small volume nutrient meals that are low in fat and soluble fiber. In case of intolerance to solid food, homogenized or liquid nutrient meals is recommended. Depending on the severity of the disorder, where the oral intake is insufficient, then enteral alimentation by jejunostomy tube feeding is pursued (after a trial of nasoenteric tube feeding).
- Mayoclinic at https://www.mayoclinic.org/diseases-conditions/gastroparesis/symptoms-causes/syc-20355787 suggests that although there's no cure for gastroparesis, changes to your diet, along with medication, can offer some relief.
- In one study at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7377964/, autonomic dysfunction has been found as common in patients with gastroparesis and chronic unexplained nausea and vomiting. Parasympathetic dysfunction was associated with delayed gastric emptying and more severe upper gastrointestinal symptoms. Conversely, sympathetic hypofunction was associated with milder symptoms.
- One study was done at NASA as Autogenic Feed Training Exercise : Controlling Physiological Responses to Mitigate Motion Sickness. During space travel approximately 50% of the crew experience symptoms of motion sickness that can range from mild forms of nausea or dizziness to severe malaise and vomiting. Developing an effective treatment for these symptoms has become a priority of the NASA. Autogenic-Feedback Training Exercise (AFTE) has been found as a nonpharmacological countermeasure for mitigating motion sickness which causes nausea/vomiting. It involves training subjects to control physiological responses in high stress environments. The primary goal of this experiment is to evaluate the effectiveness of AFTE for increasing tolerance to motion sickness in high stress environments[https://www.academia.edu/20016478/Autogenic_feedback_training_as_a_potential_treatment_for_the_symptoms_of_gastroparesis]. The use of this autonomic retraining showed that patients with more intact autonomic nervous system activity responded better than patients whose autonomic function was more impaired [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3722580/].
- Another study concludes that Gastroparesis is associated with significant psychological distress and poor quality of life [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5323455/]
- Further, higher state and trait anxiety was associated with increased gastroparesis severity, bloating, and postprandial fullness in another study at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5323455/
- One study at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3734640/ advocates the use of kapalbhati and Agnisara kriya in addressing GERD as they can increase diaphragmatic tone, thus decreasing reflux from the stomach to esophagus. The combined practices of Kapalbhati and Agnisar Kriya yoga have found to increased diaphragmatic tone and lead to reduced transient lower esophageal sphincter relaxation and its increased tone. This synergistic effect can thereby decrease the reflux episodes experienced in GERD.
Considering the above studies which indicate autonomic dysfunction and psychological state of the patient as the cause of gastroparesis, an opinion can be drawn for gastroparesis that autogenic training, yoga nidra, naadhi shuddhi pranayama, kapalbhati and Agnisara kriya may help to manage gastroparesis, with prior consultation with the physician, as these modalities have been associated to induce relaxation, balance the sympathetic and parasympathetic activityof the autonomic nervous system and improve the diaphragmatic tone. There may be other research studies which you should explore in consultation with your physicians to come to any conclusion. In addition to autogenic training and yoga nidra, you may also take the help of the other relaxation techniques include progressive muscle relaxation, diaphragmatic breathing, biofeedback, imagery training, and mind–body therapy (MBT) such as mindfulness. The above modalities should be consulted with your physician to discuss if they can help you. Please feel free to write to us for further clarifications, if any.
