Gastroparesis
When eating becomes a calculation — when nausea has rewritten your relationship to food — the standard 'try smaller meals' advice is not an answer.
What we mean when we say Gastroparesis.
Gastroparesis is defined by delayed gastric emptying in the absence of mechanical obstruction. It produces chronic nausea, vomiting, early satiety, postprandial fullness, abdominal pain, and weight loss. Etiologies include diabetic, idiopathic, post-surgical, post-viral, connective tissue, and autonomic causes.
Gastric emptying scintigraphy remains the diagnostic standard, but interpretation requires care — slow emptying alone does not establish causation, and many patients with gastroparesis-like symptoms have functional dyspepsia, cyclic vomiting, or autonomic-driven dysmotility that requires different management.
Gastroparesis is a quintessential systemic-overlap condition. It is one of the most reliable GI manifestations of POTS, hEDS, MCAS, and post-viral syndromes — yet GI-isolated workups frequently miss this context.
Approximately 1.5–3% of the US adult population reports symptoms consistent with gastroparesis; confirmed prevalence by scintigraphy is lower. True burden is likely under-counted.
Why Gastroparesis gets missed.
Gastroparesis sits at the intersection of GI, autonomic, and metabolic medicine — and no specialty fully owns it. Patients accumulate workups across specialists who each evaluate one dimension, and the systemic context that explains the gastroparesis is rarely synthesized.
- 01Gastric emptying scintigraphy is the diagnostic standard, but interpretation requires care. Slow emptying alone does not establish causation, and many patients with gastroparesis-like symptoms have functional dyspepsia, cyclic vomiting, or autonomic-driven dysmotility requiring different management.
- 02The systemic context — POTS, hEDS, MCAS, post-viral syndromes, diabetes — is frequently the driver of the gastroparesis, but GI-isolated workups rarely characterize it. Treating the gastric emptying without identifying the underlying physiology produces incomplete responses.
- 03Pharmacologic options are limited and the off-label evidence (low-dose erythromycin, prucalopride, pyridostigmine in autonomic-driven cases) is underutilized. Patients are routed to metoclopramide and given little else.
- 04Procedural and surgical options — gastric electrical stimulation, pyloric interventions, jejunostomy feeding — are sometimes considered before the systemic workup is complete, leading to interventions that don't address the actual driver.
The Ternary Health approach to Gastroparesis.
Characterize the gastric emptying picture properly — scintigraphy results, breath testing, manometry where available — and distinguish gastroparesis from functional dyspepsia, cyclic vomiting, and other dysmotility syndromes that produce similar symptoms.
Evaluate the systemic context — POTS, hEDS, MCAS, post-viral syndromes, diabetes, medication effects — that frequently underlies the gastroparesis. The driver determines the management.
Audit pharmacologic options including off-label and combination strategies — prokinetics, antiemetics, neuromodulators, pyridostigmine in autonomic-driven cases — against the specific phenotype and prior medication history.
Review procedural and surgical considerations — gastric electrical stimulation candidacy, pyloric interventions including G-POEM, jejunostomy feeding — with attention to evidence quality and appropriate timing relative to medical optimization.
The Ternary Signal Library for Gastroparesis.
Our Signal Library for Gastroparesis codifies the specific patterns that matter — gastric motility findings, autonomic and metabolic markers, medication and surgical history, and the dysautonomia and connective tissue comorbidities that frequently underlie the condition. Your case is mapped against these signals; each present signal is identified and prioritized for your presentation.
- —Gastric emptying scintigraphy — solid and liquid phase results
- —Wireless motility capsule findings where performed
- —Breath testing for gastric emptying alternatives
- —Esophageal and small bowel manometry where indicated
- —Endoscopic findings — retained food, pyloric appearance
- —Autonomic reflex screen — frequently abnormal in idiopathic cases
- —Tilt-table or 10-minute stand for POTS overlap
- —HbA1c, fasting glucose — diabetic gastroparesis assessment
- —Thyroid function — bidirectional impact on motility
- —Electrolyte and nutritional markers — depletion patterns
- —Prokinetic trial history — metoclopramide, erythromycin, prucalopride
- —Antiemetic strategy and response patterns
- —Opioid and anticholinergic burden audit — frequently iatrogenic contributors
- —Prior abdominal surgery and post-surgical pattern
- —Procedural history — Botox, G-POEM, gastric stimulator considerations
- —POTS criteria and subtype evaluation
- —Hypermobility — Beighton score, connective tissue findings
- —MCAS evaluation — frequently exacerbates GI dysmotility
- —Post-viral or post-COVID onset timeline
- —Cyclic vomiting and abdominal migraine differential
How a Gastroparesis case moves through our workflow.
Our nine-stage workflow is the same for every engagement. What changes per condition is the content at each stage — the records we pull, the signals we apply, the specialists we map, the pathways we evaluate. Below, how your case specifically would move through each stage.
What you receive.
- —A written case synthesis covering motility phenotype, systemic context, and prior treatment trajectory
- —Integration of motility studies, autonomic testing, metabolic workup, and medication history into a single view
- —Pharmacologic decision framework with off-label and combination strategies appropriate to your phenotype
- —Procedural and surgical candidacy assessment — G-POEM, gastric stimulation, pyloric interventions, feeding access
- —Specialist identification for motility-experienced GI, autonomic medicine, and any indicated comorbid workup
- —A written action plan and follow-up support as you implement it
What a Precision Deep Dive provides for Gastroparesis.
A Ternary Health Precision Deep Dive for gastroparesis characterizes the gastric emptying picture, evaluates the systemic context (POTS, hEDS, MCAS, post-viral), audits pharmacologic and prokinetic options including off-label evidence, and reviews nutritional and procedural interventions when conservative management fails.
See the published sample reports · read the Ternary Method
What we look for alongside Gastroparesis.
Patients with Gastroparesis frequently present with one or more of the following. Ternary reports evaluate the full picture rather than the condition in isolation.
- Postural Orthostatic Tachycardia Syndrome
- Hypermobile Ehlers-Danlos Syndrome
- Mast Cell Activation Syndrome
- Diabetes mellitus
- Long COVID
- Cyclic vomiting syndrome
What prospective Gastroparesis clients ask most.
Three ways to engage Ternary on Gastroparesis.
From a free starting point to a full personalized action plan — three tiers, one methodology, all tailored to Gastroparesis.
Free Brief
A 3–5 page personalized starting point on your condition. Most relevant labs, specialist categories, first decisions worth pursuing. No charge.
Generated instantly, no charge.
Get a free Brief→Launchpad
A research-based preparedness guide. Current literature, realistic prognosis, test and treatment categories worth exploring, and a checklist of what you might consider to better manage and understand your condition.
Delivered in 3–5 business days
Start a Launchpad→Precision Deep Dive
A vigorously researched and highly personalized action plan: the specialists and centers of excellence worth considering, evidence-graded options, and a prioritized set of questions to raise — all curated for your specific condition and lifestyle, for you and your physicians to weigh together. The plan includes 30 days of follow-up support and tailored insights into how best to navigate your situation now and in the future.
September 2026 cohort
Apply for a Deep Dive→See exactly what you receive.
A composite sample illustrating the structure and depth of every Ternary Health Precision Deep Dive. Same universal 17-section format used for Gastroparesis — drawn from four research-validated patient profiles across four conditions.
Every Ternary engagement produces a report with the same architecture: client profile, applied methodology, signal analysis, lab and genetic findings, imaging synthesis, disease model, intervention prioritization, specialist pathway, staged medical therapy, 90-day roadmap, and monitoring cadence. The composite shows you exactly how that architecture renders.
Ready for clarity on your Gastroparesis?
Applications for the September 2026 cohort are open now and reviewed in the order received. Not ready? A free Ternary Brief on Gastroparesis is generated instantly, no charge.