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.
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Gastroparesis is the doctor word for the stomach not emptying. Gastro is the stomach. Paresis, not moving. Gastroparesis happens with dysautonomia, but it also happens with migraine, with Raynaud’s, it can happen with sugars, it can happen with small fiber neuropathy, and with medication side effects. There are a variety of reasons why gastroparesis may occur. The end result is the decreased ability to eat and tolerate food. It can happen with stomach pain. There can be gas issues.
This is a situation that we see if it’s happening as part of dysautonomia or one of these other conditions I mentioned. That’s what we end up treating. Of course, the stomach motility is the issue, but we need to understand why it’s happening and treat that underlying reason.
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.
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.
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.
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.
These guys are the best. I've been going here for over 6 years and their familiarity with my Schwannomatosis (most ppl have never even heard of it - its rather rare) and their ability to diagnose my CRPS quickly and accurately and then treat it like I was merely getting a flu shot is just incredible...
Highly recommended for those who need Pain Management. Everyone at Manhattan Pain Medicine is extremely nice and helpful. I have had very good interactions with both Dr. Siefferman and Dr. Louis. All of the staff is very responsive. 5 stars.
The providers at Manhattan Pain Medicine are exceptional. I wish I had found them 30 years ago!
I genuinely can’t say enough good things about the team at Manhattan Pain Medicine. I have MCAS, EDS, and an inflammatory autoimmune disease, and I’ve basically been searching for answers since I was a kid. I had years of unexplained inflammation markers, chronic pain, and allergic reactions despite...
I have a complex medical history and have seen a lot of doctors over the years. Dr. Mikaberidze and Dr. Siefferman each took the time to really listen and understand everything I had been dealing with. I also appreciated how they work together and communicated about my care. I left with a plan that...
Sharing my gratitude for the pleasant experience last week during my visit, the medical team provided great care and also treated my session as a learning experience, I left my session with a wealth of knowledge. A big thank you to the kind, and professional staff who welcomed me to the office as a...
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...
Dr Siefferman is the most thorough, patient doctor I have even been to. Currently I travel from miami to nyc to see him because his bed side manner and desire to help is incomparable.
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This practice is wonderful. I have been a patient of Dr. Siefferman’s since 2019 and he’s extremely helpful and kind. He has brought in a Rheumatologist who is also great. They handle very complex pain issues and always try to find new ways to help me.
Dr. Siefferman is an incredible doctor! He is extremely diligent and knowledgeable. It feels like you are his only patient. He invests a lot of time and effort into your injuries and concerns. I did not find these wonderful qualities with other pain specialists before, who were always rushed and som...
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Dr. Siefferman is a doctor who combines the old world bedside manner of doctors from my childhood (60 years ago) with a sta te of the art embrace of modern technology. It is always a pleasure to have an appointment with him...always has options and solutions to my medical issues. He is truly the doc...
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Dr. Siefferman is a genius. He is very informed and listens attentively.
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Dr. Siefferman and his entire team continue to be efficient, dedicated, and driven by precision and a genuine desire to give fantastic care. Will always recommend.
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Doctor Siefferman is fantastic. Have been seeing him for 5 years. Couldn’t recommend more.
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Dr. Siefferman is the ONLY doctor who has ever been able to diagnose my pain and treat it. He is hands down the best
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Gastroparesis, also called delayed gastric emptying, is a disorder in which food moves too slowly from the stomach to the small intestine even though there is no physical blockage. This means food may remain in the stomach longer than expected, which can cause nausea, vomiting, bloating, belching, early fullness, poor appetite, heartburn, and upper abdominal pain. Gastroparesis can affect nutrition, hydration, blood sugar control, and quality of life. Because symptoms may resemble other GI or abdominal pain conditions, diagnosis usually requires testing and clinical evaluation.
Common gastroparesis symptoms include feeling full soon after starting a meal, feeling full long after eating, nausea, vomiting, bloating, belching, upper abdominal pain, heartburn, and poor appetite. Some patients also experience weight loss, dehydration, blood sugar changes, constipation, fatigue, or food avoidance because eating becomes uncomfortable. Symptoms can fluctuate and may worsen after larger meals, higher fat foods, or foods that are harder to digest. The symptom pattern should be evaluated by a clinician because similar symptoms can occur with functional dyspepsia, obstruction, medication effects, constipation, or other conditions.
Gastroparesis may be caused by diabetes, nerve injury, surgery, infections, neurologic conditions, autoimmune factors, or medications that slow stomach emptying. In some patients, no clear cause is found. Diabetes-related gastroparesis can occur when nerve function affecting the stomach is impaired. Post-surgical or post-infectious gastroparesis can develop when motility changes after a procedure or illness. Some medications, including opioids, GLP-1 agonists, and high-dose tricyclic antidepressants, may impair gastric emptying. Identifying contributing factors matters because treatment and medication decisions depend on the cause and overall health history.
Gastroparesis diagnosis usually requires testing that confirms delayed gastric emptying and helps rule out blockage or other conditions. A gastric emptying study is commonly used. Depending on symptoms, clinicians may also use endoscopy, imaging, motility testing, blood tests, gastric accommodation testing, gastroduodenal manometry, or autonomic nervous system testing. Testing is selected based on the patient’s history, symptom severity, prior workup, and suspected causes. MPM reviews existing testing and coordinates with gastroenterology or motility specialists when digestive management is needed.
Yes. Gastroparesis can cause upper abdominal pain, stomach discomfort, bloating, nausea, and pressure after eating. Pain may be related to delayed emptying, stomach distension, visceral sensitivity, constipation, autonomic dysfunction, or the burden of chronic symptoms. Some patients also have abdominal wall pain, nerve-related pain, pelvic overlap, hypermobility, fibromyalgia, or chronic pain sensitization that makes pain more persistent. MPM evaluates these contributors carefully. The goal is not to assume every symptom is caused by delayed gastric emptying, but to understand how gastroparesis and overlapping pain pathways may interact.
Yes. Autonomic dysfunction, POTS, Ehlers-Danlos syndrome, and hypermobility spectrum disorder may overlap with gastroparesis symptoms in some patients. The autonomic nervous system helps regulate digestion, including motility. Connective tissue differences and hypermobility may also influence pelvic mechanics, abdominal support, and pain sensitivity. These relationships are complex and should not be assumed without evaluation. MPM considers autonomic, connective tissue, pelvic, nerve-related, and chronic pain contributors when reviewing gastroparesis-related pain, while coordinating stomach motility care with GI or motility specialists when needed.
Gastroparesis treatment is usually led by gastroenterology and may include dietary changes, nutrition support, medication management, blood sugar control when diabetes is present, anti-nausea medication, prokinetic medication when appropriate, and selected advanced GI procedures. Eating habit changes can help control symptoms and support nutrients, calories, and liquids. MPM focuses on pain contributors that may overlap with gastroparesis, such as visceral pain, abdominal wall pain, autonomic symptoms, pelvic overlap, nerve sensitivity, and chronic pain sensitization. Pain-focused care may include medication review, pain psychology, acupuncture, and selected procedures only when clinically appropriate.
A pain specialist may be helpful when gastroparesis occurs alongside chronic abdominal pain, nerve-related symptoms, pelvic pain, autonomic dysfunction, hypermobility, fibromyalgia, CRPS-like sensitization, or pain that persists despite GI care. MPM does not replace gastroenterology, nutrition, endocrinology, or motility care for delayed gastric emptying. Instead, MPM helps evaluate pain drivers that may contribute to symptom burden, guarding, functional limitation, and chronic pain sensitization. The goal is to coordinate care so stomach motility, abdominal pain, autonomic symptoms, pelvic overlap, and nervous system contributors are considered together.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
