Stomach Pain & Early Fullness: Is it Gastroparesis or POTS?

The Dinner Table Struggle

You spent time cooking a healthy meal, hoping your teenager would finally get some nutrition. They sit down, take three bites, and push the plate away. "I’m full," they say. Or worse, "My stomach hurts."

As a parent, your alarm bells go off. Is it an eating disorder? Are they just picky?

Dr. John Fortunato wants you to know: It is likely a physical problem, not a behavioral one. This sensation is called "Early Satiety" (getting full too soon), and for teens with POTS or Dysautonomia, there is a very real biological reason why it happens.

The Clinical 'Why': The Stomach is an "Innocent Bystander"

Digestion is hard work. When a healthy person eats, the body naturally sends extra blood flow to the stomach to help break down food.

But in a teenager with POTS, the body is already struggling to circulate blood against gravity.

• The Blood Flow Problem: Because blood is pooling in the legs, the stomach doesn't get the "fuel" (blood flow) it needs to do its job. It essentially shuts down because it’s starved of oxygen.

• The Adrenaline Problem: When your teen stands up or sits upright, their heart rates spike. This releases adrenaline (catecholamines). While adrenaline helps the heart pump, it hits the "brakes" on the stomach, slowing digestion to a crawl.

• The Sensitivity Problem: Many of our patients suffer from Visceral Hyperalgesia. This means the nerves in the gut are hypersensitive. A normal amount of food stretching the stomach feels like extreme pain or fullness to them.

Is it Gastroparesis?

Dr. Fortunato notes that many POTS patients also have Gastroparesis (delayed stomach emptying), especially those with joint hypermobility or Ehlers-Danlos Syndrome (EDS). This means food literally sits in the stomach for hours, making them feel full before they’ve barely eaten.

Actionable Tips: How to Eat When You Can't Eat

If your teen is struggling to finish meals, Dr. Fortunato recommends changing how and what they eat:

• Grazing is Good: Stop aiming for 3 big meals. Aim for 6 small "mini-meals" throughout the day. A smaller volume is easier for the stomach to handle without demanding too much blood flow.

• The "Easy-to-Digest" Hierarchy: If symptoms are bad, stick to foods the stomach can process quickly. Follow this order of operations:

  1. Liquids: (Smoothies, protein shakes, soups) – Easiest to digest.

  2. Carbohydrates: (Crackers, rice, toast) – Moderate work for the stomach.

  3. Proteins: (Chicken, eggs) – Harder work.

  4. Fats: (Fried foods, heavy creams) – Hardest work (slowest emptying).

• Hydrate & Salt: Keeping blood volume up helps ensure there is enough blood to go around for both the brain and the stomach.

  
  

Get the Right Testing

Because these symptoms are internal, patients are often told "it's just anxiety." It is critical to listen to the patient. If this sounds like your child, they may need motility testing to see exactly how their stomach is functioning.