The word paresis is of Greek origin and it indicates letting go of or weakening or slackness of muscle. It refers to partial paralysis rather than a complete stopping of movement (paralysis). When this word describes what’s going on with a person’s digestive system, it is a problem indeed.
Gastroparesis (delayed stomach emptying) is just one more of the many issues we can associate with Ehlers-Danlos syndromes, particularly if our version is the hypermobile manifestation. It can also be a factor related to our MCAS, if we are afflicted with over-active mast cells. And yes, dysautonomia can also affect how well our stomachs empty (or not).
TL/DR: If you follow this blog because you are a member of the community you’re probably not surprised when your digestion does not move along as smoothly as it should. (This doesn’t always mean gastroparesis but it’s useful to at least know about this condition, if only to rule it out).
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Chinese medicine has been gut-health obsessed since the beginning of time, so of course there are some pearls of wisdom for you here in this blog post. But first, it helps to understand gastroparesis from the biomedical point of view so that we are all on the same page. Whether you are already a fan of Chinese medicine, here because you are curious and interested, or if you feel more confident when you start with biomedicine, starting this way gives a useful launchpad, don’t you think?
I do. And so, without further ado…
Gastroparesis per Western biomedicine medicine
Gastroparesis (GP) is when you have a movement problem in your stomach. The motility, or movement, of your stomach is impeded. Whether you call it stomach dysmotility or gastroparesis, the outcome is the same. In essence: the food you eat sits in your stomach and doesn’t move along to the next step of the process the way it should.
The root cause of GP and other forms of gastric dysmotility can usually be traced back to the vagus nerve and whether or not it’s in decent working condition. Why the vagus nerve is not working properly is another root in this tangled affair. If it’s not the vagus nerve, then the delayed gastric emptying could be due to muscle injury, viral infection, surgery, medication, or an unknown cause (in other words: idiopathic).
Some of my patients have issues that revolve almost entirely around their digestive systems. Consequently, I want to mention that dysmotility of the digestive tract is not the same thing as gastroparesis. When we refer to that, what we’re talking about is slow transit constipation and it relates to the large intestine. Both of these movement issues are not surprising for people with EDS.
Gastroparesis, for its part, usually has symptoms related more to the upper region than the lower. Some of those associated with GP include severe nausea, vomiting, pain, and early satiety. You just don’t feel like you have room in your stomach even if you were hungry when you started eating. You might also get bloated, experience acid reflux, unwanted weight loss, malnutrition, and abdominal pain. If you’ve got the combo two-for-one deal and your intestines don’t move things along either, you may also suffer from constipation, diarrhea, and/or belly pain that can radiate throughout your mid-section and pelvic floor.
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How is it diagnosed & treated?
All of these symptoms can be mistaken for other issues that are common to people with EDS. When a person has MCAS, they might present with these symptoms along with clear signals of anaphylaxis. Is the problem gastroparesis, then, or is the main issue that mast cell mediators are causing inflammation and damage? Someone with MALS or a floating kidney or two can feel a sense of bloating and discomfort that has nothing to do with how well the digestive process is working and more to do with blood flow and constriction.
It’s not always easy to figure out that the issue is a motility disorder, but your doctor has an array of potential testing mechanisms. They’ll probably start with a gastric emptying scan (scintigraphy), which can track the rate of stomach emptying. Next, you might have to try an upper endoscopy to check for blockage. Although the root cause of gastroparesis comes back to the vagus nerve, there are other things to consider that can affect nerve function. Consequently, you may get blood tests to check for diabetes and they could decide to see about your thyroid hormones as well.
Of course, when a person is already diagnosed with EDS or EDS plus comorbid conditions, one root cause is pretty much a given: the issue is, as they say, in the tissues.
There is no cure, per se, for gastroparesis. Generally, your MD’s goal will be to control your symptoms and to make sure you get good nutrition when you eat. Usually, this entails medication to stimulate the stomach muscles and a dietary plan tailored to your unique needs.
Western biomedicine will suggest small meals that are low in fat and fiber. Fat is a challenge to digest when your stomach is balky and, if it sits around undigested for long enough, fiber can get stuck and turn into a solid mass called a bezoar, so this is important. A person may end up needing to eat puréed foods or even liquid.
If it’s severe, the only option may be surgery or a feeding tube (either a jejunostomy tube, which is placed in the small intestine or a gastric venting tube to relieve pressure from stomach contents).
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Chinese medicine and gut health
Chinese medicine has been obsessed with gut health since its inception over five thousand years ago. This is a fact. And, though it is important to have a biomedical diagnosis in hand if you struggle with complicated gastro symptoms, it is also true that Chinese medicine has a lot to offer you if you have intractable digestive problems.
One of the very pillars of Chinese medical history, in fact, is one Li Dong Yuan (1180-1252 C.E.) who developed the earth school of thought (the Spleen in Chinese medicine is the organ associated with the earth element). The earth school centered gut health above all else and built upon previous approaches to wellbeing that put digestion first and foremost. The earth school is, to this day, a pillar of Chinese medical thought. It is certainly one that informs my philosophy of practice.
The TL/DR here? Chinese medicine is a great resource for gut health, no matter where the problem starts or how it manifests.
There is some overlap in treatment approaches. When we start from the perspective of the vagus nerve, we might frame it in terms of qi, or energy of the digestive system (“Stomach qi”). We might begin by also addressing inflammation (Heat) and/or Dampness (a pathology that can lead to Phlegm accumulation), depending on syndrome pattern. Otherwise, and especially when MCAS is a factor, we might focus on dispersing Wind. It’s not so vastly different from what an MD sees, but we do have our perspective on what’s important for you and we have our own ways of framing things.
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Chinese medicine is more than just acupuncture
If you decide to work with a practitioner of Chinese medicine, we may opt for acupuncture treatment (so good, and no, the needles do not hurt). But as I always do in my blog posts: please let me remind you that there is more to Chinese medicine than acupuncture.1
The practitioner may or may not work with you on your nutrition plan. Chinese herbal formulas are almost always going to be an option, and your practitioner can create custom formulas for you or give you a prescription for pills. One herb you may have already tried is huang qi, which–if you’re not getting it from a Chinese medicine practitioner–is also known as astragalus.
If you’d like to learn more about huang qi, here is the blog post for you: “Astragalus for Ehlers Danlos Syndrome and MCAS (Or… What is Huang Qi?).” This herb is a Chinese treasure.
Especially if you have a history of reacting badly to Pharma drugs (I do, I do…!) you might be pleased to discover that Chinese herbs work just fine for you and don’t leave you in danger of experiencing unpleasant side effects and adverse events.2
We might also suggest gentle movement in the form of tai chi or qigong, and people in the community have a wonderful resource in Earth Balance Tai Chi, a woman-owned business in the UK. Nicola, the owner, has EDS herself so she knows about calibrating the workouts for her audience, and she offers on-demand courses online.
Nicola gave me a wonderful interview and to see it (and get her social media info), take a look at “Traveling With Hope: An Interview With Nicola of Earth Balance Tai Chi.”
Best of all (I think so, anyway) is abdominal massage. Either tui na (pronounced “twee nah”), which is medical massage or chi nei tsang (a daoist approach to abdominal massage) can be a relaxing and beneficial way to get things moving.3
The TL/DR: If you want to try Chinese medicine you do have options beyond acupuncture.
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Taking care of your gut is a lifestyle practice
Depending on your practitioner, you might also want to consider health coaching with them or with a coach who holds Chinese medical philosophy as central to their approach. The entire philosophy is based on right balance. Achieving homeostasis isn’t just a biological process in Chinese medicine. Instead, it is an art and a core value of the tradition.
Speaking for myself as a former professor who offers health coaching infused with this philosophy, I encourage clients and work with them to find ways to integrate the restricted diet into their necessary lifestyle shifts without developing orthorexia, or an obsession with “clean eating.” Speaking for myself (and this goes for my philosophy as a practitioner of Chinese medicine too), I do not think that loading people up with supplement stacks is beneficial, either. Each client is different, but my feeling that less is more when it comes to supplements is equal for everyone. Not all health coaches (or holistic healthcare providers, for that matter) feel the same, but this is something to consider before working with anyone.
If you’re thinking about health coaching, it might help to consider what kind of coach most resonates for you. Some thoughts: “Health coaching, Edu-coaching, Consultation: The Which and Why and When for People with Ehlers-Danlos Syndrome.”
Instead, at least in my practice, we create ways for living with the condition and without shame or undue strain. There is a lot that can be done to improve vagal tone and gut health if one is willing to work consistently and in a healthy and self-affirming way. A good health coach can help you to create your program and, especially if you struggle with the daily toll of condition management, your health coach can be a real life-line for you.
In my estimation, knowledge is power. When you know what’s going on with your body and you know your options, you have some choice in the matter. It is important to have a clear diagnosis and yes, there are some elements of this condition that may be better served by biomedicine. And yet…you do have options. Chinese medicine and/or health coaching could certainly be one of them.
Where would you like to begin?
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Dr. Paula Bruno, Ph.D., L.Ac., is a licensed acupuncturist and herbalist, an AOBTA-CP traditional Chinese bodywork therapist, an author, and a health coach. She maintains an active and growing practice at Two Hearts Wellness, her Austin, TX office. Dr. Bruno is also available for distance appointments for wellness consultation or coaching.
In her first career, she was a Spanish professor.
Dr. Bruno’s specialties as a Chinese medicine practitioner include: • Musculoskeletal health (acute or chronic pain relief; Ehlers Danlos syndrome & hypermobility support) • Digestive support, gut health, and weight loss • Aesthetic treatment, including scar revision • Men’s health • General preventative care and wellness support for all persons.
She is the author of Chinese Medicine and the Management of Hypermobile Ehlers Danlos Syndrome: A Practitioner’s Guide.
When you are ready to discover what traditional medicine plus a vibrant and engaged approach to holistic health can do for you, either contact Dr. Bruno or book an appointment online.
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Two Hearts Wellness/Holistic Health & hEDS does not accept paid advertising on this website
Note: Material on this web site site is not intended to diagnose, prevent, treat, or cure any disease, illness, or ailment. A Chinese medicine practitioner in Texas identifies syndrome patterns but does not diagnose illness. Material on this web site does not purport to identify syndrome patterns.
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- Finding an acupuncturist, especially if there are complex issues at hand, can be a challenge. It helps to know what you’re looking for and how to spot in when you’re checking out websites, too. For useful information on this subject, refer to “Acupuncture & EDS: How to Find a Practitioner of Chinese Medicine When You’re a Zebra.” ↩︎
- The standard drug given to people with diabetic gastroparesis is metoclopramide, for instance, and side effects include neurological problems like tardive dyskinesia. Usually, treatment with this drug is time limited because the longer a person takes it, the more vulnerable to this side effect they are. One of the better posts about gastroparesis drugs that I’ve seen is “Medications for Gastroparesis.” If you are someone who does not react well to drugs (again, I am a walking history of adverse events) then none of them might seem worth the risk. At the same time…this is a challenging condition to treat, however you approach it, so if you and your doctor figure out a successful medication plan that works, then more power to you. ↩︎
- Not all practitioners are expert in abdominal massage. If you’d like to learn more about tui na, specifically, then refer to “Chinese-Style Abdominal Massage Can Change Your Life (Seriously, It’s Amazing.” Another option might be Arvigo Techniques of Maya Abdominal Therapy, (or ATMAT). This is traditionally an approach used for postpartum women and you may have heard of it in terms of Mayan abdominal massage. The name has been changed to Tul’ix Indigenous Arts but the premise is the same: a dedicated focus on the abdominal area. They note on their website that practitioners also can work with digestive concerns. As we see with Chinese tui na and chi nei tsang, there is an intentional and philosophical connection of mind and body and spirit with this form of massage. It may be easier to find an ATMAT practitioner where you are, but either way, what matters is that (A) your practitioner has substantive familiarity with your condition and its ramifications and (B) that they are expert in abdominal treatment. ↩︎
Holistic Health and hEDS 