What is the best probiotic supplement for Gastroparesis?
The Living With Gastroparesis blog just posted some interesting survey data about Gastroparesis which does include information about probiotic usage w/ Gastroparesis. Of 46 people who responded as taking probiotics, 25 reported mild to significant improvements of their Gastroparesis symptoms, which is actually impressive as I was not thinking they would have that large of an effect. It is important to note that the majority of positives results, were on the mild side, but some people did respond well to probiotics.
If you’re not aware, Gastroparesis is paralysis of the stomach. Basically the stomach no longer churns properly or doesn’t do it as often as it should. There can be variations on why this is, such as nerve damage, muscle damage or the pyloric sphincter does not relax. Basically, food does not empty from the stomach like it should. The symptoms essentially are like having a stomach flu 24/7. It is very difficult to eat food like a normal person and it can be very debilitating. The causes range from viral infection to diabetes to gastric surgeries.
Probiotics are healthy bacteria that live in the lower gut. These bacteria help digest food & aid in preventing infection. They do not usually have a direct impact on the stomach, but keeping your lower gut healthy, may prove beneficial. This would be especially true if you’re dealing with a wonky upper digestive tract.
Here are a few things I’d suggest trying, possibly before trying probiotics. But there is nothing saying that you can’t try probiotics at the same time.
1. Iberogast
2. B12 Vitamins – There is a theory that gastroparesis could be caused by damage to the vagus nerve. B12 is VERY important in the recovery of damage to nerves. Given that someone dealing with gastroparesis might not have very good absorption, talk to your doctor and get a B12 deficiency test or ask to get B12 injections. Not only could this be helpful for nerve health, but could also improve your energy levels as well.
If you want to try oral supplementation, you could try Nature’s Bounty B Complex 
3. Digestive Enzymes – Enzymes breakdown your food, I’ve read some reports that they are not effective with gastroparesis, but I would not write them off. Anything you can do to help breakdown your food before your stomach tries to go to work on it can help! You could try Enzymatic’s CompleteGest
4. Probiotics - While they don’t directly affect the stomach, having a healthy lower digestive tract could help keep things in sync and hopefully reduce symptoms. I’d suggest Align Digestive Care
Don’t give up hope. Many people have recovered from Gastroparesis. I myself dealt with some very tough symptoms for 3 months during the summer of 2006. I know for some they have dealt with it much longer than I ever did. As far as I know my cure was a steady diet of Rice Krispie Treats & Nature’s Bounty B Complex
Even for those who are not helped by these suggestions, there are still options like the Enterra Pacemaker or hopefully Tranzyme will see the light of day. Don’t give up hope!
If you’ve used a probiotic and have or have not found success, please post the brand/type you use.
-Best Wishes
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Thanks for posting this, Gabriel! Great suggestions. I’ve been on Align for a long time, but I think I’m going to try the probiotic you recommend as I recently noticed that Align has a lot of additives. Thanks for sharing the info!
Thanks for the comment!
I am pretty firm believer in starting small with probiotics and it’s pretty hard to find one with a low CFU amount, which is why I recommend Primadophilus Junior. Align seems to be really costly and actually has a very low probiotic colony forming unit count of 1 billion. I actually wouldn’t mind finding a decent 1 Billion CFU probiotic pill that I could double/triple as I ramp up, but I don’t want to pay almost $1 per pill for it :P! You are right that there seems to be additives in Align like “milk protein”, Sugar, “Titanium Dioxide”(white food coloring), “Blue 1″ food coloring… Why would they put food coloring in a probiotic?
I once found some ‘granola breakfast’ bars from Kellogg that supposedly had probiotics in them. They were also loaded with sugar, artificial colors & flavors galore, plus they didn’t taste very good.
I have gastrperesis and I have just started to take align and hopefully it will work for me , but I wanted to let all of you know that I take a tablespoon of ”braggs” organic apple cider vinegar before each meal and it helps me tons!!! Please try it!!!
@sarah
Thanks for the comment.
I have tried Braggs’ unfiltered vinegar before. It can give some people heartburn, but that is a good suggestion to try. Supposedly it’s good for a lot of things involving digestion.
I’ll have to put a post up about it :)!
I am battling digestion issues right now and boy it had me quite depressed. Basically on Ensure for the last 4 months. Thank you for all the tips on this blog. I hope they work. I really want to eat.
I appreciate your blog and helpful info for those with gastroparesis – I’ve been suffering with it for almost a year. I was on Reglan, which completely relieved my symptoms, but I developed multiple side effects – severe anxiety & depression. After some research, I found that domperidone is a very effective druge with few side effects, but the FDA hasn’t approved it in the US – it’s used in Canada & Europe, everywhere but here. After more research, I found two clinical trials – doctors who are able to prescribe domperidone through the compassionate guidelines of clinical trials. I have an appointment at the one in Pittsburgh, PA (the other is in Urbana, IL), and I’m anxious to get a medication that works! If anyone with gastroparesis wants more info, check out the clinical trials on this website: http://www.digestivedistress.com/main/page.php?page_id=30
@Nicole, I hope they will help you out. I wish you the best of luck with recovery.
@Denise, That is a helpful link. Domperidone definitely needs better availability in the USA. I don’t know why so many doctors are afraid of it, yet freely prescribe Reglan even when they know of it’s possible dangers.
I’ve been diagnosed with gastroparesis, but the doctors do not seem too keen on finding the cause of it. It’s more of a feeling of “We did our job, now go away” that I get from them.
I’ve been told to avoid pills — I’ll try anything, and the B12, even if it doesn’t work, shouldn’t hurt, right? What dosage and frequency was followed in your case?
@Dave
Ahh that’s too bad about the diagnosis & the doctors. There really needs to be more compassion and investigation into the causes of GP. Have they done upper and lower endoscopies? Have they done a gastric empty study? You might, try to find different doctors. I know how tough it can be though with that, especially in the USA there is a very long wait.
As far as pills, you can crush them up and mix them with soft foods like apple sauce. My diet was apple sauce & rice krispie treats for awhile. I’d mix the B vitamins in with the apple sauce after crushing it. I used “Nature’s Bounty High Potency Time-Released B-Vitamin Complex w/ Vitamin C”, really long name. It comes in green bottles, you might be able to find it at your local pharmacy. Here’s a pic from drugstore.com. You might also check out NSI Methyl-B12, which is the only Methyl-B12 supplement I’ve found that doesn’t have a bunch of fake stuff in it. You can twist open the gelatin pill and dump the powder on whatever you want to eat it with. Dosage would just be 1-pill of each per day.
I would strongly recommend trying Iberogast as well.
How long have you been diagnosed and dealing with GP? GP can be temporary, but can take months to resolve in some cases.
I wish you the best!
@Gabriel,
They did an upper endoscopy, and followed it immediately with a GES. When they confirmed delayed emptying, they stamped the diagnosis of GP on me, gave me the diet advice, told me to take reglan, and said I might get better, then ‘bye’.
I’ve had acute symptoms since December 17th, but I suspect things started around Nov 28th, when I had nausea and dumping in the very early morning. I’m usually the opposite — constipation has been a battle all my life. I’m basically just past the two month mark with it right now.
Most of the methyl-b I have nearby me seems to be sublinguals and lozenges. Do those absorb as well as swallowed forms?
@Dave
You can try the sub-lingual tablets out or the liquids as well. In some cases those may work better as they should be absorbed through the membranes of the tongue. Although some think that the structure of B12 is too large to make it in through the tongue. B-12 has to bind to something called “intrinsic factor” in your stomach to be absorbed in the intestine. If you’re having stomach issues, then you may have less or no intrinsic factor which would prevent you from absorbing B-12.A lot of complexes have Cyanocobalamin as their B-12 which your body has to break down into Methylcobalamin to be absorbed. Ultimately there are prescription B-12 injections/nasal sprays you can get that will allow you to absorb B-12 if you can take it internally or via sub-lingual methods. Helpful if you don’t have a wonky doctor.
There are other B-Vitamins(B-6,B-3, etc..) so it’s important to probably get a B-complex as well.
Also I was taking a multivitamin from GNC, I think but I can’t remember the name of it now. Maybe try Alive! from Nature’s Way.
My issues started in late May 2006 when I got sick to my stomach, perhaps food poisoning. About a month later in late June, I woke up to very bad cramping/abdominal pain. After that the abdominal pain/cramping/dumping started happening ever two weeks, then every week, then it just turned into everyday with round the clock nausea. Symptoms started improving probably in mid to late September 2006, around the time I took the B-Vitamins.
Probably the best thing is to try to eat what you can and attempt to stay in “health”, it’s hard with GP though. Definitely keeping vitamins going would be a good idea, even if it’s a small amount. If you don’t eat and your body tries to get better GP can actually occur due to anorexia(not eating). In some cases you could be getting better and not know it if you’re not eating. Best to give it all the help you can to kickstart it back into gear.
@Gabriel,
I went with a liquid B12(methyl-b) supplement. I have the Centrum chewables and some fruit-based liquid vitamins. I’m also going for fish oil softgels — anything to help the nerves mend.
Right now I drink several Boost Plus shakes per day, and get one serving of Cup o’Noodles. It doesn’t seem to upset my stomach, luckily. That’s sort of my ‘solid food’ test for bloating, pain, and nausea.
My doc has me on reglan for the present, and I’m weaning off of it slowly. Some days are still more touchy than others, but I want to be able to tell when/if I start to feel better. I do know that I actually get real hunger pretty late into the night, complete with all kinds of interesting noises from the abdomen at night/early morning. I’m hoping those are the sweet sounds of motility. :)