The Connection Between Gastroparesis and Dysautonomia

Bridging the Gap

Let’s start with the basics. I have POTS and NCS, which are two of many forms of dysautonomia. We’re obviously focusing on gastroparesis, or slowing/paralysis of the stomach. The autonomic nervous system is basically the automatic response system of the body. It regulates how your different bodily functions respond to either emergent or non-emergent situations. In emergencies your body will either “fight or take flight,” and in non-emergencies your body will “rest and digest.” The “fight or flight” part is the sympathetic state, while “rest and digest” is called parasympathetic. In the “fight or flight” state during emergencies, your body tenses up and your body recognizes that your digestive tract is not necessary at that moment in time, so it becomes temporarily dormant. For those with autonomic dysfunction, it’s not so temporary. Dysautonomia forces your body into the sympathetic state a majority of the time, making it difficult to be able to “rest and digest.” That’s the “dys” part of dysautonomia. The body doesn’t know how to regulate the autonomic nervous system and falsely “believes” that minuscule problems are life altering issues. This puts, and keeps, the body in the sympathetic state, altering the function of several body systems for longer periods of time.

For the gastrointestinal system, the GI sphincters contract and peristalsis is inhibited. This makes it quite easy to explain how gastroparesis is a direct result of dysautonomia. If you’re stuck in sympathetic mode, your GI sphincters are tense and your food can’t move from the stomach into the small intestine. When they do relax and food passes through, your stomach doesn’t contract, making it difficult to propel the food from the stomach into the duodenum. Peristalsis + sphincter relaxation = happy, empty belly that’s ready for more food. If you take away these two processes, you officially have gastroparesis. This can be confirmed with a gastric emptying scan (GES), where they give you eggs with tracer in them and take abdominal x-rays at two to four hour intervals, up to 48 hours to see how quickly the eggs pass through your GI tract. I was diagnosed with severe idiopathic gastroparesis in August of 2012. In my post from February of last year (link above) I questioned why there aren’t any esophageal, intestinal or colon problems with dysautonomia. After my experiences with gastroparesis, whether related to POTS and NCS or not, I have now been diagnosed with esophagitis, which slows down the peristalsis of my throat, duodenoparesis, and pelvic floor dysfunction, which causes chronic constipation. All of these things are related to general inhibited GI peristalsis.

Personally…
I am unsure if my gastroparesis is related to POTS or NCS because it is so severe. The two diseases progressed quickly but at different times. I was on a clear liquid diet long before I began having intense syncopal episodes. It’s possible they’re related, but my stomach is so paralyzed I just have a hard time believing that this is a sign of dysautonomia. With neurocardiogenic syncope I pass out frequently, so fainting is another major symptom that affects my life. But why is gastroparesis extremely severe and the others are just moderate to severe? My lightheadedness isn’t destroying my life and the neuropathy is bad but it’s not paralyzing my entire body. Why this symptom? Shouldn’t they all be equal, to some extent? When someone asks me my diagnoses, I tell them “gastroparesis, POTS, NCS..” because I suffer so greatly from gastroparesis that it’s definitely a disease process and not just a symptom to me. I refer to my form of gastroparesis as idiopathic, because I, nor the doctors, truly know why I have it. And until we do, I feel that adjective describes it perfectly.

For more information, head to the POTS Treatment Center page. I am always open for questions, as well. ♥

 

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