How to Use CBD Oil for Gastroparesis

Are you or a loved one grappling with the discomfort and digestive challenges of gastroparesis? Living with this condition can be a daily struggle, but there’s a natural remedy that may offer relief: CBD oil. Gastroparesis, a condition characterized by delayed stomach emptying, often leads to nausea, bloating, and abdominal pain. While traditional treatments focus on symptom management, CBD oil presents a promising alternative. In this comprehensive guide, we’ll explore how to harness the potential of CBD oil to alleviate the symptoms of gastroparesis. CBD, short for cannabidiol, is a non-psychoactive compound derived from the cannabis plant. It has gained popularity for its therapeutic properties, including anti-inflammatory and analgesic effects. Recent research has suggested that CBD may have a positive impact on gastrointestinal issues, making it a potential game-changer for those dealing with gastroparesis. Throughout this article, we’ll delve into the science behind CBD, its interaction with the endocannabinoid system, and practical tips on how to use CBD oil effectively to manage gastroparesis symptoms. Discover the natural relief that CBD oil may provide and regain control over your digestive health.

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Definition and Overview of Gastroparesis

Gastroparesis is a gastrointestinal disorder characterized by delayed stomach emptying, which can result in a range of uncomfortable and debilitating symptoms. The term “gastroparesis” can be broken down into two parts: “gastro” meaning stomach and “paresis” meaning paralysis or impairment. Essentially, gastroparesis refers to the partial paralysis or impaired functioning of the stomach muscles, particularly those responsible for moving food and liquids through the digestive tract.

In a healthy digestive system, the stomach contracts rhythmically to grind and mix food with digestive juices, facilitating the efficient movement of contents into the small intestine for further digestion and absorption. However, in individuals with gastroparesis, these stomach contractions become weak or irregular, causing food to linger in the stomach for an extended period. This delayed gastric emptying can lead to a variety of distressing symptoms and complications, affecting an individual’s overall quality of life.

Prevalence and Symptoms

The prevalence of gastroparesis is not precisely known, as it is often underdiagnosed or misdiagnosed due to its diverse and sometimes nonspecific symptoms. However, it is estimated that gastroparesis affects approximately 1 in 25 individuals in the United States. The condition can occur in people of all ages, but it is more commonly diagnosed in women, and its frequency tends to increase with age.

Symptoms of gastroparesis can range in severity and may include:

  1. Nausea: Persistent feelings of nausea are a hallmark symptom of gastroparesis. This can often lead to frequent vomiting.
  2. Vomiting: Individuals with gastroparesis may experience recurrent vomiting, which can be particularly distressing and debilitating.
  3. Early Satiety: A sensation of fullness and bloating, even after consuming small amounts of food, is common among those with gastroparesis.
  4. Abdominal Pain: Some individuals experience abdominal discomfort or pain, which can vary in intensity and location.
  5. Heartburn: Gastroparesis can contribute to the backflow of stomach acid into the esophagus, leading to heartburn or gastroesophageal reflux disease (GERD).
  6. Malnutrition and Weight Loss: Over time, gastroparesis can interfere with nutrient absorption, leading to malnutrition and unintended weight loss.
  7. Fluctuating Blood Sugar Levels: In diabetic individuals, gastroparesis can make blood sugar control challenging, as it can delay the absorption of glucose from food.
  8. Fatigue: Dealing with the persistent symptoms of gastroparesis can be physically and emotionally draining, leading to fatigue.

The Potential Role of CBD Oil in Managing Gastroparesis

The management of gastroparesis typically involves dietary modifications, medication, and in some cases, surgical interventions. However, emerging research and anecdotal evidence suggest that cannabidiol (CBD) oil, a compound derived from the cannabis plant, may have potential therapeutic benefits for individuals with gastroparesis.

CBD is one of over 100 cannabinoids found in cannabis and is known for its non-psychoactive properties, which means it does not produce the “high” associated with tetrahydrocannabinol (THC), another prominent cannabinoid. CBD interacts with the endocannabinoid system, which plays a role in regulating various bodily functions, including digestion and inflammation.

The potential role of CBD oil in managing gastroparesis primarily revolves around its purported anti-inflammatory, analgesic (pain-relieving), and antiemetic (anti-nausea and anti-vomiting) properties. Additionally, CBD may modulate the endocannabinoid system to help regulate digestive processes and reduce the severity of symptoms associated with gastroparesis.

Understanding Gastroparesis

Causes and Risk Factors

Gastroparesis is a complex disorder with various underlying causes and risk factors, making it challenging to pinpoint a single origin. Some common causes and risk factors associated with gastroparesis include:

  1. Idiopathic Gastroparesis: In many cases, the exact cause of gastroparesis remains unknown, referred to as idiopathic gastroparesis. It may be related to damage or dysfunction of the nerves controlling stomach contractions.
  2. Diabetes: One of the most common identifiable causes of gastroparesis is diabetes mellitus, especially type 1 diabetes. High blood sugar levels over time can damage the nerves that control stomach function.
  3. Post-Surgical Gastroparesis: Gastroparesis can develop as a complication of certain surgeries, particularly those involving the stomach or the vagus nerve, which controls stomach muscle contractions.
  4. Viral Infections: Some viral infections, such as Epstein-Barr virus or cytomegalovirus, can lead to gastroparesis by causing inflammation and damage to the stomach’s nerves.
  5. Medications: Certain medications, such as opioids, anticholinergic drugs, and some antidepressants, may slow down stomach contractions and contribute to gastroparesis.
  6. Autoimmune Disorders: Autoimmune conditions like lupus or scleroderma can affect the digestive system, potentially leading to gastroparesis.
  7. Nervous System Disorders: Conditions that affect the autonomic nervous system, like Parkinson’s disease or multiple sclerosis, can disrupt the regulation of stomach contractions.

Diagnosis and Medical Treatment Options

Diagnosing gastroparesis involves a combination of clinical evaluation and diagnostic tests. Common steps in the diagnostic process include:

  1. Medical History and Physical Examination: A thorough medical history is taken to assess symptoms and potential risk factors. A physical exam may reveal abdominal tenderness or signs of malnutrition.
  2. Gastric Emptying Studies: These tests involve consuming a meal or drink containing a small amount of a radioactive substance or dye. Imaging techniques, such as a gastric scintigraphy or a breath test, are then used to track the movement of the substance through the digestive tract. Delayed gastric emptying confirms the diagnosis of gastroparesis.
  3. Endoscopy: An upper gastrointestinal endoscopy may be performed to rule out other gastrointestinal conditions or to look for signs of inflammation, ulcers, or blockages.

Medical treatment options for gastroparesis aim to alleviate symptoms and improve stomach emptying. These options may include:

  • Dietary Modifications: Patients are often advised to follow a gastroparesis-friendly diet, which includes consuming smaller, more frequent meals and avoiding foods that are difficult to digest, like high-fiber or high-fat foods.
  • Medications: Prokinetic drugs, such as metoclopramide or domperidone, may be prescribed to stimulate stomach contractions and improve motility. Antiemetic medications like ondansetron can help manage nausea and vomiting.
  • Botulinum Toxin Injections: In some cases, botulinum toxin injections into the pyloric sphincter (the valve between the stomach and the small intestine) can relax the sphincter and improve stomach emptying.
  • Enteral Nutrition: In severe cases where oral intake is inadequate, enteral nutrition through a feeding tube may be necessary to ensure adequate nutrition.
  • Surgical Interventions: For refractory cases, surgical options like gastric pacemakers (electrical stimulation devices) or pyloroplasty (surgery to widen the pyloric sphincter) may be considered.

Limitations and Challenges of Conventional Treatments

While conventional treatments for gastroparesis can provide relief for some patients, they are not without limitations and challenges:

  1. Medication Side Effects: Prokinetic medications like metoclopramide can have side effects, including neurological issues, which can limit their long-term use.
  2. Variable Response: Treatment outcomes can vary widely among individuals, and some may experience only partial relief or no improvement with available therapies.
  3. Risk of Complications: Severe gastroparesis can lead to malnutrition, dehydration, and complications like small intestinal bacterial overgrowth (SIBO) due to the stagnation of food in the stomach.
  4. Surgical Risks: Surgical interventions carry inherent risks, and not all patients are suitable candidates for these procedures.
  5. Dietary Restrictions: Following a gastroparesis-friendly diet can be challenging and may result in dietary limitations that impact a person’s overall quality of life.
  6. Need for Ongoing Management: Gastroparesis often requires long-term management, and finding the right combination of treatments for each individual can be a time-consuming process.

What is CBD Oil?

Definition and Extraction Methods

CBD, short for cannabidiol, is a natural compound found in the cannabis plant, which belongs to the Cannabaceae family. Unlike its more famous counterpart, tetrahydrocannabinol (THC), CBD does not produce the psychoactive effects associated with cannabis use. Instead, CBD is known for its potential therapeutic properties, which have gained significant attention in recent years.

Extraction Methods: CBD oil is typically extracted from the cannabis plant using various methods, with the most common being:

  1. CO2 Extraction: This method uses pressurized carbon dioxide to extract CBD and other cannabinoids from the plant material. It is considered one of the cleanest and most efficient extraction methods, as it leaves behind no residual solvents and preserves the integrity of the compounds.
  2. Ethanol Extraction: Ethanol (alcohol) can also be used to extract CBD from the plant. It is less expensive than CO2 extraction but may not be as selective, potentially extracting unwanted compounds.
  3. Solvent Extraction: Some producers use hydrocarbon solvents like butane or hexane to extract CBD. While effective, this method carries a higher risk of leaving behind residual solvents and is less preferred for safety reasons.

Once extracted, CBD is typically combined with a carrier oil, such as hemp seed oil or MCT (medium-chain triglyceride) oil, to create CBD oil. The resulting product can vary in terms of CBD concentration, quality, and other cannabinoids and compounds present, depending on the extraction method and source plant.

Different Types of CBD Products Available

CBD is available in a variety of forms to suit different preferences and needs. Some common types of CBD products include:

  1. CBD Oil and Tinctures: These are liquid extracts of CBD that can be taken sublingually (under the tongue) for fast absorption. They are available in various concentrations, making it easy to adjust dosage.
  2. CBD Capsules and Softgels: These are pre-measured doses of CBD in pill form, offering convenient and consistent dosing.
  3. CBD Edibles: CBD-infused foods and beverages, such as gummies, chocolates, and beverages, provide an enjoyable way to consume CBD. They take longer to take effect as they must pass through the digestive system.
  4. Topical CBD Products: Creams, lotions, balms, and patches infused with CBD are designed for localized relief and are applied directly to the skin.
  5. CBD Isolate: This is pure CBD in crystalline form, containing no other cannabinoids or compounds. It is often used for precise dosing or to create custom CBD products.
  6. Full-Spectrum CBD: Full-spectrum products contain CBD along with other cannabinoids, terpenes, and compounds found in the cannabis plant. Some believe that these products offer an “entourage effect,” where the combined compounds enhance each other’s effects.
  7. Broad-Spectrum CBD: Broad-spectrum products are similar to full-spectrum but with THC removed entirely. They may still provide some of the potential benefits of the entourage effect without the psychoactive effects of THC.
  8. CBD Vape Products: Vape pens or e-cigarettes can be used to inhale CBD-infused vapor for quick absorption. However, vaping raises concerns about lung health and safety.

Legal Status and Safety Considerations

Legal Status: The legal status of CBD varies from country to country and even within regions of countries. In the United States, for example, CBD derived from hemp containing less than 0.3% THC was legalized with the passage of the 2018 Farm Bill. However, laws can change, so it’s essential to be aware of local regulations before purchasing or using CBD products.

Safety Considerations:

  1. Quality Control: The lack of strict regulation in the CBD industry means that product quality can vary widely. Look for products from reputable manufacturers that provide third-party lab testing to verify their CBD content and purity.
  2. Dosage and Consultation: It’s crucial to consult with a healthcare provider before starting any CBD regimen, especially if you have underlying medical conditions or are taking medications. They can help you determine the right dosage and ensure there are no potential interactions.
  3. Potential Side Effects: While CBD is generally considered safe, some individuals may experience side effects, such as dry mouth, diarrhea, changes in appetite, or dizziness. These effects are typically mild and well-tolerated.
  4. Drug Interactions: CBD can interact with certain medications, potentially affecting their efficacy or causing adverse effects. Discuss CBD use with your doctor if you are taking other medications.
  5. Purity and Contamination: Be cautious of CBD products that may contain contaminants like pesticides, heavy metals, or residual solvents. Reputable manufacturers provide lab reports that detail the product’s purity.

The Science Behind CBD and Gastroparesis

Endocannabinoid System and Its Role in Digestion

The endocannabinoid system (ECS) is a complex network of receptors, endocannabinoids (naturally occurring compounds produced by the body), and enzymes. It plays a crucial role in regulating various physiological processes, including digestion. Two primary receptors within the ECS are CB1 (found mainly in the central nervous system) and CB2 (found primarily in immune cells).

In the context of digestion, the ECS is involved in modulating:

  1. Gastrointestinal Motility: The ECS helps regulate the contraction and relaxation of the smooth muscles of the digestive tract. This control influences the pace at which food moves through the stomach and intestines.
  2. Inflammation: The ECS can influence immune responses within the gastrointestinal tract, potentially reducing inflammation and associated symptoms.
  3. Nausea and Vomiting: The ECS can affect the brain centers responsible for nausea and vomiting, making it relevant to conditions like gastroparesis.

Research on CBD and Its Effects on Gastrointestinal Issues

While research on CBD’s effects on gastrointestinal issues, including gastroparesis, is still in its early stages, several studies have explored its potential benefits in managing symptoms:

  1. Anti-Inflammatory Effects: CBD has demonstrated anti-inflammatory properties that may be relevant in managing conditions characterized by gastrointestinal inflammation, such as Crohn’s disease and irritable bowel syndrome (IBS).
  2. Nausea and Vomiting: CBD’s potential to reduce nausea and vomiting has been studied, particularly in cancer patients undergoing chemotherapy. These effects may also be relevant to gastroparesis-associated nausea and vomiting.
  3. Appetite Regulation: Some studies suggest that CBD can influence appetite regulation, potentially helping individuals with gastroparesis who struggle with early satiety and a lack of appetite.

Potential Mechanisms of CBD in Alleviating Gastroparesis Symptoms

While the exact mechanisms through which CBD may alleviate gastroparesis symptoms require further investigation, several potential pathways have been proposed based on the existing scientific evidence:

  1. Modulation of the Endocannabinoid System: CBD interacts with the ECS by indirectly affecting CB1 and CB2 receptors. In the context of gastroparesis, this modulation may help regulate gastrointestinal motility and reduce inflammation.
  2. Anti-Inflammatory Effects: CBD’s anti-inflammatory properties may mitigate inflammation within the stomach lining, potentially reducing pain and discomfort associated with gastroparesis.
  3. Nausea and Vomiting Control: CBD’s influence on the brain’s nausea and vomiting centers could help manage these distressing symptoms in individuals with gastroparesis.
  4. Pain Relief: Some individuals with gastroparesis experience abdominal pain, and CBD’s analgesic properties may provide relief.
  5. Stress and Anxiety Reduction: Stress and anxiety can exacerbate gastrointestinal symptoms. CBD may help manage stress and anxiety, indirectly benefiting individuals with gastroparesis by reducing symptom severity.

Finding the Right CBD Product

Factors to Consider When Choosing CBD Oil

Selecting the right CBD product for managing gastroparesis symptoms is crucial, as various factors can influence its effectiveness and safety. Here are some key factors to consider:

  1. CBD Concentration:
    • CBD products come in various concentrations, typically measured in milligrams (mg) per milliliter (ml) for oils and tinctures. The appropriate concentration depends on individual needs and the severity of gastroparesis symptoms.
    • Start with a lower concentration and gradually increase the dosage until you achieve the desired effects. Keep in mind that higher concentrations may require smaller doses for the same effect.
  2. Full-Spectrum vs. Isolate:
    • Full-spectrum CBD products contain not only CBD but also other cannabinoids, terpenes, and compounds found in the cannabis plant. Some believe that this “entourage effect” enhances CBD’s therapeutic potential.
    • CBD isolate, on the other hand, is pure CBD, containing no other cannabinoids or compounds.
    • The choice between full-spectrum and isolate depends on individual preferences and sensitivities. Some individuals may prefer the added potential benefits of full-spectrum products, while others may opt for isolates to avoid any trace of THC or other cannabinoids.
  3. Method of Consumption:
    • CBD products come in various forms, including oils, tinctures, capsules, edibles, topicals, and vapes. The choice of consumption method depends on personal preference and the specific gastroparesis symptoms being targeted.
    • For rapid relief of nausea and vomiting, sublingual CBD oil (administered under the tongue) may be preferred due to its faster absorption. Topical products may be useful for localized pain or discomfort.
  4. Dosage Guidelines:
    • Determining the right CBD dosage can be challenging, as it varies depending on factors like body weight, metabolism, and individual response.
    • It’s advisable to start with a low dose (e.g., 10-20 mg) and gradually increase it until you achieve the desired relief from gastroparesis symptoms.
    • Keep a journal to track your CBD usage, symptoms, and dosage adjustments. This can help identify the most effective dosage for your specific needs.

Consulting with a Healthcare Professional

Before starting any CBD regimen for managing gastroparesis or any other medical condition, it is essential to consult with a healthcare professional:

  1. Medical Evaluation: Discuss your gastroparesis symptoms and medical history with your healthcare provider. They can help determine if CBD is an appropriate complementary treatment and if there are any contraindications or potential drug interactions to consider.
  2. Dosing Guidance: Healthcare professionals can provide personalized dosing recommendations based on your specific needs, considering factors like the severity of symptoms and your overall health.
  3. Monitoring: Regularly check in with your healthcare provider while using CBD to manage gastroparesis. They can assess your progress, address any concerns, and make necessary adjustments to your treatment plan.
  4. Interaction with Medications: If you are taking medications for gastroparesis or any other condition, it’s crucial to discuss potential interactions with CBD. Some medications may interact with CBD, affecting their effectiveness or causing adverse effects.
  5. Safety and Side Effects: Your healthcare provider can provide guidance on the safety of CBD use, especially if you have underlying health conditions or are pregnant or breastfeeding.
  6. Alternative Therapies: In addition to CBD, healthcare professionals may recommend other complementary therapies or lifestyle modifications to help manage gastroparesis symptoms effectively.

How to Use CBD Oil for Gastroparesis

Using CBD oil for gastroparesis involves a careful and individualized approach to determine the right dosage and ensure its effectiveness while minimizing potential side effects. Here are some essential steps to consider:

Start with a Low Dosage

  1. Low Initial Dose: When beginning your CBD journey for gastroparesis, start with a low initial dosage. A typical starting dose may range from 10 to 20 milligrams (mg) of CBD per day. This low dose allows your body to become accustomed to the compound and assess its initial effects.
  2. Product Selection: Choose a CBD product with a low to moderate CBD concentration. Look for products labeled with the total CBD content per serving, which can help you control your intake more accurately.
  3. Administration Method: Consider using CBD oil or tinctures for sublingual administration, as this method allows for faster absorption through the mucous membranes under the tongue. It can be especially helpful for addressing nausea and vomiting associated with gastroparesis.

Gradually Increase Dosage as Needed

  1. Titration: The process of adjusting your CBD dosage is known as titration. It involves incrementally increasing your CBD intake until you achieve the desired symptom relief.
  2. Monitor Symptoms: Keep a symptom journal to track the effects of each dosage adjustment. Note changes in nausea, vomiting, pain, and other gastroparesis-related symptoms.
  3. Slow Increases: When increasing your CBD dosage, do so gradually. For example, increase your daily intake by 5 to 10 mg every few days or as needed. This allows your body to adapt to the higher dose and reduces the risk of experiencing side effects.
  4. Patience Is Key: Finding the optimal CBD dosage can take time, so be patient and methodical in your approach. Avoid the temptation to rush into higher doses, as this may not necessarily yield better results.

Tracking Symptoms and Progress

  1. Symptom Journal: Maintain a detailed symptom journal to document your daily experiences with gastroparesis. Note the timing, duration, and severity of symptoms, as well as any changes in response to CBD use.
  2. Dosage Records: Record your CBD dosage, administration method, and any adjustments made over time. This log can help you identify trends and patterns in symptom management.
  3. Consult with a Healthcare Provider: Regularly discuss your progress with a healthcare provider who can provide guidance, make dosage recommendations, and ensure that CBD use aligns with your overall gastroparesis management plan.

Possible Side Effects and Their Management

While CBD is generally considered safe, some individuals may experience side effects. If you encounter side effects while using CBD for gastroparesis, consider the following steps:

  1. Common Side Effects: Common side effects may include dry mouth, dizziness, changes in appetite, diarrhea, or fatigue. These effects are typically mild and subside as your body adjusts to CBD.
  2. Dosage Adjustment: If side effects become bothersome, consider lowering your CBD dosage to a level where you experience relief from symptoms without the unwanted effects.
  3. Consult a Healthcare Provider: If side effects persist or worsen, consult your healthcare provider. They can provide recommendations, adjust your treatment plan, or explore alternative CBD products with different formulations.
  4. Medication Interactions: Be aware of potential drug interactions between CBD and any medications you are taking for gastroparesis or other conditions. Consult your healthcare provider to ensure that CBD does not interfere with your medications.
  5. Quality and Purity: Use high-quality CBD products from reputable manufacturers to minimize the risk of contaminants or impurities that could contribute to side effects.


Summary of Key Takeaways

In this comprehensive exploration of CBD oil as a potential complementary approach to managing gastroparesis, several key takeaways emerge:

  1. Gastroparesis Overview: Gastroparesis is a gastrointestinal disorder characterized by delayed stomach emptying, leading to symptoms like nausea, vomiting, early satiety, and abdominal pain.
  2. CBD Basics: CBD, or cannabidiol, is a natural compound derived from the cannabis plant. It is non-psychoactive and has gained attention for its potential therapeutic properties.
  3. Endocannabinoid System (ECS): The ECS plays a crucial role in regulating digestion, including gastrointestinal motility, inflammation, and nausea control.
  4. Research and CBD: While research on CBD’s effects on gastroparesis is still in its early stages, studies suggest that CBD may have potential benefits for managing gastrointestinal symptoms, including inflammation, nausea, and vomiting.
  5. Choosing CBD Products: When selecting a CBD product for gastroparesis, consider factors such as CBD concentration, full-spectrum vs. isolate, method of consumption, and dosage guidelines.
  6. Consulting with Healthcare Professionals: Always consult with a healthcare provider before incorporating CBD into your gastroparesis management plan. They can provide personalized guidance and monitor your progress.
  7. Dosage Titration: Starting with a low CBD dosage and gradually increasing it while monitoring symptoms is a prudent approach to finding the optimal dose.
  8. Symptom Tracking: Keeping a symptom journal can help you assess the effectiveness of CBD in managing gastroparesis symptoms.
  9. Possible Side Effects: Common side effects of CBD are generally mild and can often be managed by adjusting the dosage. Consult your healthcare provider if side effects persist or worsen.

The Potential of CBD Oil as a Complementary Approach to Managing Gastroparesis

CBD oil holds promise as a complementary approach to managing gastroparesis for several reasons:

  • CBD interacts with the ECS, which plays a key role in regulating gastrointestinal function.
  • Research suggests that CBD may have anti-inflammatory, antiemetic, and analgesic properties that could benefit individuals with gastroparesis.
  • CBD’s potential to reduce nausea and vomiting makes it particularly appealing for addressing some of the most distressing symptoms of gastroparesis.
  • CBD may offer an alternative or adjunctive therapy for individuals who have not experienced sufficient relief from conventional treatments or who wish to explore additional options.

However, it is essential to emphasize that the efficacy of CBD for gastroparesis is still being studied, and individual responses can vary. CBD should be approached as part of a comprehensive treatment plan under the guidance of a healthcare provider.

The Need for Further Research and Healthcare Professional Guidance

Despite the growing interest in CBD as a potential treatment for gastroparesis, several critical points must be emphasized:

  • The current body of scientific research on CBD and gastroparesis is limited, and more studies are needed to establish its efficacy and safety.
  • CBD can interact with other medications, potentially affecting their effectiveness or causing adverse effects. Consultation with a healthcare provider is essential to avoid potential drug interactions.
  • Finding the right CBD dosage for gastroparesis is a personalized process that requires careful titration and monitoring. Healthcare professionals can provide invaluable guidance in this regard.
  • High-quality CBD products from reputable manufacturers should be used to ensure purity and safety.
  • Patient-reported outcomes and anecdotal evidence can be valuable, but they should be considered alongside rigorous clinical research.

In conclusion, CBD oil presents an exciting avenue for exploring novel approaches to managing gastroparesis symptoms. However, it should be viewed as a complementary therapy, and individuals should seek guidance from healthcare professionals to ensure safe and effective use. As research continues to evolve, a better understanding of CBD’s potential in gastroparesis management may emerge, offering hope for improved quality of life for individuals affected by this challenging gastrointestinal condition.