Gastroparesis Evaluation and Treatment in NYC and Manhattan

Gastroparesis can cause nausea, vomiting, bloating, early fullness, upper abdominal pain, poor appetite, and symptoms that overlap with autonomic dysfunction.

Gastroparesis can cause stomach pain, nausea, bloating, and difficulty digesting food. Dr. Siefferman explains the conditions that can contribute to delayed stomach emptying and the importance of treating the underlying cause.

Understanding Gastroparesis and Delayed Gastric Emptying

Gastroparesis, also called delayed gastric emptying, is a disorder in which the movement of food from the stomach to the small intestine slows or stops without a blockage.

Symptoms may include feeling full soon after starting a meal, feeling full long after eating, nausea, vomiting, bloating, belching, heartburn, poor appetite, and upper abdominal pain. Gastroparesis can affect nutrition, hydration, blood sugar stability, and quality of life.

Because symptoms may overlap with functional dyspepsia, constipation, autonomic dysfunction, POTS, EDS, MCAS, pelvic pain, and chronic pain sensitization, careful evaluation and coordinated care are important.

Specialist Care for Gastroparesis-Related Pain

At Manhattan Pain Medicine, evaluation begins by understanding the full symptom pattern, prior GI workup, and pain presentation. For patients looking for gastroparesis treatment in Manhattan, MPM does not replace gastroenterology, nutrition, primary care, endocrinology, or emergency care when those are needed.

Instead, MPM helps evaluate pain contributors that may overlap with gastroparesis, including abdominal wall pain, visceral pain, autonomic dysfunction, pelvic overlap, hypermobility, medication effects, nerve-related pain, post-viral symptoms, MCAS-related symptoms, fibromyalgia, and chronic pain sensitization.

Care may include medication management, pain psychology, acupuncture, and selected interventional options when appropriate.

Why Gastroparesis Can Overlap With Chronic Pain

Gastroparesis is a stomach motility disorder, but many patients experience more than delayed emptying. Chronic nausea, bloating, early fullness, pain after eating, nutrition concerns, autonomic symptoms, constipation, pelvic pain, and fatigue can become part of a broader symptom pattern.

Some patients have diabetes-related gastroparesis. Others develop symptoms after surgery, infection, medication exposure, neurologic conditions, autoimmune disease, or for reasons that remain unclear. Gastroparesis may occur with diabetes, after infection or surgery, with neurologic or autoimmune disorders, and with medications that impair gastric emptying.

MPM’s diagnosis-first approach helps determine whether abdominal pain appears related to visceral sensitivity, abdominal wall pain, pelvic overlap, autonomic dysfunction, hypermobility, nerve irritation, or chronic pain amplification. This pain-focused work should occur alongside GI-led evaluation and motility management, not in place of it.

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Diagnosis-first care

How MPM Approaches Gastroparesis-Related Pain

MPM uses a stepwise process to evaluate gastroparesis-related pain, autonomic symptoms, pelvic overlap, and chronic pain contributors.
  • 1

    Review the GI Diagnosis

    MPM begins by reviewing whether gastroparesis has been diagnosed, what testing has been completed, and whether blockage or other conditions have been evaluated. This may include gastric emptying study results, endoscopy, imaging, motility testing, nutrition history, blood sugar concerns, medications, and prior gastroenterology recommendations.
  • 2

    Map the Pain Pattern

    Evaluation includes where pain occurs, whether it is upper abdominal, burning, cramping, sharp, pressure-like, meal-related, constant, or episodic, and whether it occurs with nausea, vomiting, bloating, early fullness, constipation, pelvic pain, dizziness, fatigue, or autonomic symptoms. This helps identify whether pain is visceral, abdominal wall-related, nerve-related, pelvic, autonomic, or multifactorial.
  • 3

    Identify Overlapping Drivers

    Gastroparesis-related pain may overlap with POTS, EDS, hypermobility spectrum disorder, MCAS, fibromyalgia, CRPS-like sensitization, post-viral symptoms, pelvic pain, endometriosis, fibroids, hernia-related pain, or chronic pain processing. MPM evaluates these contributors so treatment is not limited to delayed gastric emptying alone.
  • 4

    Coordinate a Pain Plan

    Care may include medication management, pain psychology, acupuncture, autonomic-informed care, and selected pain procedures only when pain drivers support them. Celiac plexus block, stellate ganglion blocks, and lidocaine or ketamine infusions are not standard gastroparesis treatments, but may be discussed for selected pain or autonomic patterns when clinically appropriate.

Gastroparesis Across Chronic Pain, Autonomic, and Pelvic Care

Gastroparesis fits across several MPM Zones of Expertise, including Complex Chronic Pain, Autonomic Dysfunction, and Pelvic Pain. This matters because delayed gastric emptying may appear alongside abdominal pain, nausea, bloating, constipation, dizziness, POTS-like symptoms, hypermobility, pelvic pain, fatigue, or chronic pain sensitivity.

MPM uses the Zones of Expertise framework to evaluate whether symptoms appear primarily motility-related, visceral, autonomic, pelvic, connective tissue-related, nerve-related, or part of a broader chronic pain pattern. For some patients, the priority is coordination with gastroenterology and nutrition. For others, pain remains a central issue and requires careful evaluation of abdominal, autonomic, pelvic, and nervous system contributors.

Treatments Related to Gastroparesis-Related Pain

Treatment depends on whether symptoms involve motility, visceral pain, autonomic dysfunction, pelvic overlap, nerve sensitivity, or chronic pain pathways.
PATIENT STORIES

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Hear from patients who came to Manhattan Pain Medicine looking for answers, clarity, and a more thoughtful path forward.
  • Madaline. M

    5 star review

    I cannot say enough good things about Manhattan Pain Medicine. From the moment I walked in, I felt truly cared for and taken seriously. Dr. Nino Mikaberidze, Director of Rheumatology, is exceptional — knowledgeable, compassionate, and incredibly thorough. She takes the time to listen, explains every...

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  • Haleigh Y.

    5 star review

    The best care I've received as a chronic pain patient. I traveled from out of state to visit Manhattan Pain Medicine because I could not find knowledgeable doctors in my hometown for my hypermobility, and Ehlers-Danlos syndrome symptoms and comorbidities. Let me tell you, it was worth every travel e...

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  • Damien P.

    5 star review

    I was injured in a bicycle accident over 8 years ago. I’ve suffered throughout the years since my accident with nothing seeming to work. PT, Yoga, lifestyle changes, NOTHNG! I finally made an appointment with Dr Kane and I’m feeling an improvement in my life. I no longer stay up all night in pain, a...

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  • JP S.

    5 star review

    One of the best experiences, if not the best, I have ever had at the doctor’s office. From the front desk to the nurses to the PA assisting the doctor this was a great experience. Dr.Nino actually listened to me and came up with a game plan. Would recommend this practice to as many people as I could...

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  • Richard B.

    5 star review

    I have very unique & severe nerve pain from CRPS which has no known specific cure. Dr. Siefferman has a huge tool box, far greater than the other 23 Drs. I have seen. He saved me from jumping off a bridge and continues to help me with both treatments and advice. Dr. S. is in a different league!

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  • Clare F.

    5 star review

    After two years of searching and feeling lost and let down, I finally found real help at Manhattan Pain Medicine. With Dr. Siefferman, Adam Rosenberg, Dr. Mikaberidze, and the whole team, I feel heard, supported and understood. Every symptom is being considered and I’m finally getting answers with m...

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  • Jonathan C.

    5 star review

    Why is Dr Dr. Tayyaba Ahmed one of the top pevic Floor specialists - 1- She wants to know a full history of what led the patient to get to this point. 2 - She listens intensley to the patient 3- She does not rush you 4- Extremely skilled at giving pelvic floor injections 5- I thank my luck stars she...

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  • Jodi K.

    5 star review

    The staff was friendly and helpful. Dr. Siefferman was thoughtful, listened, asked questions and proposed simple safe ways to come to further conclusions regarding my pain and discomfort. The office staff including Dr. Siefferman is responsive even after the initial in-person visit. Very pleased.

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  • Sabrina S.

    5 star review

    Dr. Siefferman is a brilliant provider. While my pain is still a work in progress, Dr Siefferman always gives me options and explains his reasoning behind things. He listens to my feedback and concerns. I never feel rushed; and am grateful he works to meet me where I am. I highly recommend him.

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  • Lorraine B.

    5 star review

    What a great find! They listen to me, I listen to them and the diagnosis is made and a plan developed to develop an approach to treat all of my chronic pain. I wish I could have discovered this type of treatment sooner. This doctor and group give me hope.

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Gastroparesis FAQs

Understanding Insurance Before You Begin

Before care begins, our team helps patients understand the practical side of treatment, including insurance verification, out-of-network benefits, cost-share estimates, self-pay options, and billing questions. We believe patients should have as much clarity as possible before moving forward.

Insurance & Billing

Pain Care That Starts With Understanding

When pain is complex, the first step should not be another generic treatment. Manhattan Pain Medicine looks deeper to understand what is driving the pain, why it has persisted, and what path forward makes sense for you.

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Insights & Research

Explore MPM Insights and Research, including patient-friendly articles, clinical perspectives, and research from our team to help explain how we understand complex pain, evaluate care options, and guide the path to treatment
Patient education

A Deeper Look at Gastroparesis, Abdominal Pain, and Autonomic Symptoms

Gastroparesis can involve delayed stomach emptying, chronic GI symptoms, nutrition concerns, autonomic overlap, and persistent abdominal pain.

Gastroparesis

Gastroparesis, also called delayed gastric emptying, is a disorder in which food moves too slowly from the stomach to the small intestine without a blockage. When the stomach does not empty normally, patients may feel full quickly, remain full long after eating, or develop nausea, vomiting, bloating, belching, upper abdominal pain, heartburn, and poor appetite.

For some patients, gastroparesis is primarily a GI motility condition. For others, it becomes part of a larger pattern involving chronic abdominal pain, autonomic dysfunction, POTS, EDS, hypermobility spectrum disorder, MCAS-like symptoms, pelvic pain, fibromyalgia, post-viral symptoms, medication effects, or chronic pain sensitization. MPM’s role is not to replace GI care, but to help evaluate pain contributors that may overlap with gastroparesis.

What Gastroparesis May Feel Like

Many patients with gastroparesis describe nausea, bloating, early fullness, and discomfort after eating. Some feel full after only a few bites. Others feel as though food sits in the stomach for hours. Vomiting, reflux, poor appetite, weight changes, dehydration, and fatigue may occur. Symptoms can make eating unpredictable and may affect social life, work, sleep, and emotional wellbeing.

Upper abdominal pain can be part of the picture. Pain may feel pressure-like, burning, cramping, or aching. It may worsen after meals, during bloating, with constipation, or during autonomic flares. Some patients develop fear around eating because meals are followed by discomfort, nausea, or pain.

What Causes Gastroparesis?

Gastroparesis may be associated with diabetes, nerve injury, prior surgery, infections, neurologic conditions, autoimmune disorders, and medications that slow stomach emptying. Some cases are idiopathic, meaning no clear cause is found. Medications that may impair gastric emptying can include opioids, GLP-1 agonists, and high-dose tricyclic antidepressants, among others.

The cause matters because treatment may change depending on whether symptoms are related to diabetes, medication effects, post-surgical changes, post-infectious onset, autonomic dysfunction, neurologic disease, or another medical condition. Patients should not stop or change medications without guidance from the prescribing clinician.

How Gastroparesis Is Diagnosed

Gastroparesis diagnosis requires evidence of delayed stomach emptying and evaluation for other conditions that can cause similar symptoms. Testing may include a gastric emptying study, endoscopy or imaging to rule out blockage, blood tests, motility testing, gastric accommodation testing, gastroduodenal manometry, and autonomic nervous system testing when appropriate.

A normal endoscopy does not rule out gastroparesis, because endoscopy evaluates structure rather than stomach emptying. At the same time, delayed emptying does not automatically explain every pain symptom. This is why MPM reviews the full workup, symptom pattern, and pain presentation before recommending pain-focused care.

Gastroparesis, Autonomic Dysfunction, and Chronic Pain

The autonomic nervous system helps regulate digestion. When autonomic function is disrupted, patients may experience changes in heart rate, blood pressure, sweating, temperature regulation, and GI motility. Some patients with POTS or autonomic dysfunction also report nausea, bloating, constipation, early fullness, abdominal pain, and variable digestion.

Hypermobility and EDS may also overlap with GI symptoms and pain sensitivity. Pelvic pain, endometriosis, fibroids, hernia-related pain, abdominal wall pain, and fibromyalgia can further complicate the picture. These overlaps do not mean one diagnosis explains everything. They mean the evaluation should consider motility, autonomic regulation, connective tissue mechanics, pelvic overlap, and pain processing together.

Treatment Options for Gastroparesis-Related Pain

Gastroparesis treatment is typically led by gastroenterology and may include dietary changes, smaller meals, lower fat or lower fiber approaches when recommended, nutrition support, hydration strategies, blood sugar management, anti-nausea medications, prokinetic medications, and selected advanced GI interventions. Eating habit changes can help control symptoms and support nutrients, calories, and liquids, which is important because dehydration and malnutrition are major complications.

MPM focuses on pain-related contributors. Depending on the clinical picture, care may include medication management, pain psychology, acupuncture, autonomic-informed strategies, and selected interventional options. Pain psychology may help patients manage the nervous system effects of chronic nausea, food fear, symptom vigilance, sleep disruption, and stress. This does not mean symptoms are psychological. It means chronic GI symptoms and pain can affect the nervous system and daily function.

Celiac Plexus Block and Other Pain Procedures

A celiac plexus block targets a group of nerves that supply many abdominal organs. It may be performed for selected severe chronic abdominal pain or abdominal pain from cancer. It is not a standard treatment for delayed gastric emptying and should not be presented as a routine gastroparesis treatment.

Stellate ganglion blocks, lidocaine and ketamine infusions, and other pain-focused treatments should also be discussed only for selected pain, autonomic, or chronic pain patterns. They do not directly correct stomach emptying. The decision depends on diagnosis, anatomy, prior workup, severity, risk, and care goals.

When Gastroparesis Symptoms Need Urgent Care

Patients should seek prompt medical evaluation for persistent or worsening symptoms, dehydration, inability to keep food or fluids down, unintentional weight loss, vomiting blood, black stool, severe abdominal pain, fever, fainting, chest pain, blood sugar instability, or signs of malnutrition. These symptoms may require GI, emergency, nutrition, endocrinology, or primary care evaluation.

How MPM Approaches Gastroparesis-Related Pain

MPM approaches gastroparesis-related pain through a diagnosis-first, coordinated model. The evaluation considers GI diagnosis, stomach motility, abdominal pain, visceral sensitivity, autonomic symptoms, pelvic overlap, nerve-related pain, hypermobility, medication effects, nutrition concerns, and chronic pain sensitization. Care may involve coordination with gastroenterology, nutrition, primary care, endocrinology, pelvic pain specialists, psychology, or other clinicians when needed.

For patients looking for gastroparesis treatment in Manhattan, MPM offers a careful, patient-centered approach to the pain patterns that may overlap with delayed gastric emptying. The goal is to support clearer evaluation, safer coordination, and a treatment plan that reflects the patient’s digestive symptoms, pain drivers, prior workup, function, and long-term goals.