Introduction
Gastroparesis and pelvic floor dysfunction (PFD) are two conditions that may appear unrelated but can have cause and effect relationship.. Both conditions can significantly impact an individual’s quality of life, leading to chronic pain, digestive distress, and difficulty with bowel and bladder control.
What is Gastroparesis?
Gastroparesis is a chronic digestive disorder in which the stomach takes too long to empty its contents into the small intestine. This delayed gastric emptying occurs in the absence of any physical obstruction, often due to nerve or muscle dysfunction.
Causes of Gastroparesis
Diabetes – High blood sugar can damage the vagus nerve, which controls stomach motility.
Neurological Disorders – Conditions such as Parkinson’s disease, multiple sclerosis, and autonomic neuropathy can impair stomach function.
Post-Surgical Complications – Surgery involving the esophagus, stomach, or vagus nerve can lead to delayed gastric emptying.
Medications – Opioids, antidepressants, and other drugs that slow digestion may contribute to gastroparesis.
Autoimmune Disorders – Conditions like scleroderma, lupus, and Ehlers-Danlos Syndrome (EDS) may lead to dysautonomia, affecting stomach motility.
Idiopathic Gastroparesis – In some cases, the cause remains unknown.
Symptoms of Gastroparesis
Nausea and vomiting (especially after eating)
Early satiety (feeling full after a few bites)
Abdominal bloating and discomfort
Acid reflux or heartburn
Malnutrition and weight loss
Fluctuating blood sugar levels (in diabetic patients)
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What is Pelvic Floor Dysfunction?
Pelvic floor dysfunction (PFD) occurs when the muscles in the pelvic region do not work properly, leading to problems with urination, bowel movements, and sexual function. The pelvic floor muscles must coordinate to relax and contract at the right times. In dysfunction, these muscles may become too tight (hypertonic), too weak (hypotonic), or uncoordinated**.
Symptoms of Pelvic Floor Dysfunction
Chronic constipation or difficulty passing stool
Incomplete evacuation (feeling like you can’t fully empty bowels)
Urinary urgency or incontinence
Pelvic pain or discomfort
Painful intercourse (dyspareunia)
Lower back pain that does not resolve with treatment
The Link Between Gastroparesis and Pelvic Floor Dysfunction
Although they affect different parts of the body, gastroparesis and pelvic floor dysfunction share several connections, especially in individuals with neurological disorders, connective tissue diseases, or autonomic dysfunction. In some case Gastroparesis can be as a result of pelvic floor dysfunction or vice versa or they can coexist.
How Are They Related?
1. Nerve Dysfunction
- Gastroparesis is often caused by vagus nerve dysfunction, which affects stomach motility.
- Pelvic floor dysfunction can stem from pudendal nerve damage, impacting bowel and bladder control.
- Neurological conditions (MS, Parkinson’s, diabetic neuropathy) can simultaneously affect both the stomach and pelvic muscles.
2. Chronic Constipation and Dysmotility
- Many gastroparesis patients experience constipation, either from slow gut motility or medication side effects.
- Chronic constipation in PFD can worsen bloating, nausea, and delayed stomach emptying.
- Dyssynergic defecation (failure to relax pelvic muscles properly) may increase gastroparesis-related discomfort.
3. Autonomic Nervous System Dysfunction
- Dysautonomia, often seen in POTS (Postural Orthostatic Tachycardia Syndrome) and Ehlers-Danlos Syndrome (EDS), can cause both gastroparesis and pelvic floor dysfunction.
- This may result in widespread digestive dysfunction, including GERD, IBS, and slow intestinal transit.
4. Pelvic Floor Tension and Abdominal Symptoms
- Tight pelvic muscles can impair bowel movements, worsening bloating and nausea in gastroparesis.
- Some patients with hypertonic PFD may develop functional gastrointestinal symptoms due to muscle tightness affecting the gut-brain axis.
5. Abdomino Phrenic Dysnergia
APD is a dysfunctional breathing disorder where the diaphragm, instead of relaxing upon abdominal distension (as in normal physiology), contracts inappropriately, pushing the abdomen outward and worsening bloating. The abdominal muscles also fail to contract properly, leading to excessive visible bloating
Pelvic Floor Physical Therapy has been shown to show success for abdomial phrenic dysnergia.
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Managing Both Conditions Together
For patients dealing with gastroparesis and pelvic floor dysfunction, a multidisciplinary approach is key.
Treatment Strategies:
✔ Dietary Modifications
-Soft, easily digestible foods for gastroparesis.
- Adequate fiber, hydration, and stool softeners for PFD-related constipation.
✔ Physical Therapy:
- Pelvic floor therapy for bowel and bladder dysfunction.
- Abdominal massage and gut-directed exercises to stimulate motility.
✔ Medications:
✔ Lifestyle Adjustments:
Conclusion
Gastroparesis and pelvic floor dysfunction may seem unrelated but are often linked by nerve dysfunction, dysautonomia, and chronic motility disorders. Understanding this connection allows for better diagnosis, treatment, and symptom relief.
By working with a gastroenterologist, pelvic floor therapist, and neurologist, patients can develop a comprehensive treatment plan to improve their overall digestive and pelvic health.
At Pelvic Elements, we specialize in treating pelvic floor including constipation, gastroparesis, abdominal phrenic dyssynergia, fecal leaking, rectal pain and spasm. Our team of experts is dedicated to improving your quality of life through personalized treatment plans and advanced therapeutic techniques.
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