Leo/Conditions/Gastroparesis

Gastroparesis. With or without the device.

Two kinds of gastroparesis patients use Leo: the ones who manage with diet and medication, and the ones with a gastric electrical stimulator who need to track their device adjustments alongside their symptoms. The hub serves both — same GCSI diary, same food log, the device track folded in only if it's yours.

Status · in app today·Diary · validated 12-item GCSI·Devices · Enterra I · Enterra II · Other GES
The condition

Delayed gastric emptying, without an obstruction.

Gastroparesis is delayed stomach emptying in the absence of a mechanical blockage. It looks like nausea, vomiting, early satiety, post-meal fullness, bloating, and upper abdominal pain — usually some combination of those, in patterns that change from meal to meal. The two most common causes are diabetic gastroparesis and idiopathic gastroparesis; post-surgical and connective-tissue-disease-related forms exist too.

Management splits roughly into three layers — dietary adjustments (smaller meals, lower fat and fiber, liquid nutrition when needed), prokinetic and anti-emetic medications, and for refractory patients, a gastric electrical stimulator. The hub is designed to surface what's relevant to you: if you don't have a device, the device sections stay hidden.

Sources · Camilleri M et al. “ACG Clinical Guideline: Gastroparesis.” Am J Gastroenterol. 2022. · International Foundation for Gastrointestinal Disorders, “What is Gastroparesis?” (2024).
The diary

The validated 12-item GCSI, on your phone.

The Gastroparesis Cardinal Symptom Index — GCSI — is the standard daily symptom scale your gastroenterologist learned in fellowship. It's twelve items across three subscales, rated 0 to 5 (None / Very Mild / Mild / Moderate / Severe / Very Severe). Leo's diary takes about a minute and a half to fill out. Subscale means and the total score (the average of the three subscale means) compute live as you log.

Nausea / Vomiting
  • ·Nausea
  • ·Vomiting
Fullness / Satiety
  • ·Early satiety
  • ·Postprandial fullness
  • ·Loss of appetite
  • ·Excessively full
Bloating
  • ·Bloating
  • ·Stomach visibly larger
  • ·Upper abdominal pain
Extra (tracked, not in total)
  • ·Reflux / heartburn
  • ·Constipation
  • ·Diarrhea
Severity classification: 0 = none, 0.01–1.5 = mild, 1.5–2.5 = moderate, 2.5–3.5 = severe, 3.5–5 = very severe. The diary supports back-dating and a notes field per entry. History is exportable as part of your Leo health record.
The food log

Log a meal. Get a reminder. Capture when symptoms hit.

For gastroparesis, the gap between bite and symptom matters. Leo's food log is purpose-built for that. When you log a meal, you choose a follow-up reminder — 15, 30, 45, or 60 minutes. When the reminder fires, you tap one of five buckets:

Immediate
to onset
15 min
from meal
30 min
from meal
45 min
from meal
60 min
from meal

Then a 0–10 severity slider, a checklist of sixteen gastroparesis-specific symptoms (nausea, vomiting, bloating, fullness, reflux, upper-abdominal pain, etc.), and an optional note. “No symptoms” is also one of the buckets — and just as valuable as a positive entry.

Over a couple of weeks, the time-to-symptom-onset field is what makes the food log clinically useful — which meals are tolerated, which ones empty quickly, which ones tip you over. It's a structured record you can hand to a dietitian.
Device track (optional)

For folks with a stimulator: profile, adjustment log, and history.

If you have a gastric electrical stimulator, three surfaces unlock. First, a full device profile:

Model
Enterra I · Enterra II · Other GES
Serial
Serial number, implant date, implanting surgeon, clinic & hospital
Settings
Amplitude (mA) · Pulse width (µs) · Frequency (Hz) · Cycling ON / OFF (sec) · Impedance (Ω) · Voltage (V) · Electrode configuration
Battery
Five-state status (good / fair / low / end-of-life / unknown) and last-checked date
MRI
MR Conditional / MR Unsafe / Unknown — Enterra II auto-flags Conditional, Enterra I auto-flags Unsafe

Second, an adjustment log. After every settings visit, you log:

Setting change
Any of the seven device parameters; pre-filled with current settings
GCSI snapshot
Today's score (total + 3 subscales) auto-populated if you logged today, else manual entry
Provider
Doctor name, clinic, optional doctor notes
Date
Adjustment date + optional next-appointment date
Adjustments write back to the device profile so current settings stay in sync. Standard baseline shown in the UI for reference: 14 Hz / 5 mA / 330 µs / 0.1s ON / 5.0s OFF.
The chart shelf

Five chart views, all built around the same data.

Charts open as a tabbed surface so you can flip between views without losing context. Each chart marks adjustment dates with a red vertical line so visit-to-visit changes are easy to spot.

GCSI total

Single-line trend of your daily total over 30 / 90 / 180 / 365 days. Adjustment dates are marked as red dashed verticals so you can see when settings changed.

Subscales

Three lines on one chart — nausea, fullness, bloating — color-coded. Reveals which subscale is driving your score.

Individual symptom

Pick any of the 12 symptoms and chart just that one. Useful for isolating a single trigger or a single response to a med change.

Settings over time

Pick a device parameter (amplitude, pulse width, frequency, cycling, impedance, voltage); see every adjustment plotted on a timeline.

Correlation overlay

Plot a symptom score and a device setting on the same timeline. A visual overlay — labeled "scales may differ" — not a Pearson coefficient. It's pattern-spotting, not statistics.

The ER card

One screen. Offline. Built for a triage nurse who's never seen one of these.

Most ER staff have never seen a gastric stimulator. The ER Quick-Share card is a single screen, cached locally, that works without internet. It carries everything someone needs to triage you safely:

Device
Model, serial, implant date
MRI
Color-coded badge: green = MR Conditional · red = MR Unsafe · gray = Unknown
Battery
Current battery status and last-checked date
Settings
Current amplitude, pulse width, frequency, cycling
Provider
Implanting surgeon name + clinic + tappable phone number
Warnings
No MRI unless cleared · No shortwave diathermy · No therapeutic ultrasound · External defibrillation pads away from device
Recent GCSI
Latest GCSI total, if logged
Share via the system share sheet to iMessage, email, or the clipboard — plain text so a clinician can copy it into a chart on the spot.
What it isn't

The list of things we'd like to ship, and haven't yet.

The gastroparesis hub is one of the deeper condition surfaces in Leo, but it's not complete. This is the active backlog — every item is on the feature-parity tracker, and the page updates as items ship.

◦ Not yet
Statistical correlation on the overlay chart

Today the correlation chart is a visual overlay only — "scales may differ." A real Pearson coefficient with a confidence note is a worthwhile add.

◦ Not yet
QR code on the ER card

The code path is written but currently disabled. Will land soon — useful when sharing across rooms or shifts.

◦ Not yet
Provider-share PDF or secure link

Today the ER card and history can be shared via system share-sheet as text. A doctor-formatted PDF and a one-tap secure share to a clinic portal aren't built yet.

◦ Not yet
Feeding-tube logging (J-tube / G-tube / PEG)

Mentioned in journal templates but not a standalone tracking surface.

◦ Not yet
TPN logging tied to the gastroparesis hub

TPN exists as a hydration intake type elsewhere in Leo; a gastroparesis-specific TPN ledger with prescribed volume/cycle isn't in the hub yet.

◦ Not yet
Gastric-emptying-study import

If you've had a GES, the result lives in your medical records — Leo doesn't yet have a structured field for it. Coming.

◦ Not yet
Gastroparesis medication shelf

Reglan / Domperidone / Erythromycin can be logged in the general medications list; a curated gastroparesis-meds surface with onset times and contraindications is on the list.

◦ Not yet
Battery percentage and replacement reminder

Today battery is a five-state dropdown. Percentage and an automatic replacement-window flag would be better.

Leo doesn't recommend device-setting changes, doesn't interpret your GCSI score, and doesn't make dietary recommendations. The hub describes what you've logged. Setting adjustments, medication changes, and diet plans belong with your care team.
Gastroparesis hub

GCSI diary, food-to-symptom timeline, device-aware when it's yours.

The validated 12-item GCSI, a food log built around the gap between bite and symptom, a five-chart shelf, and an offline ER card for the night a triage nurse hasn't seen a stimulator before.