65 And Older

Gastroparesis What?

February 23, 2018

What is Gastroparesis aka Slow Stomach Emptying

Three years ago, I was diagnosed with Gastroparesis. Our digestive system performs wonderous complicated functions. Gastroparesis? I had never heard of this. I was bloated and feeling sick all the time. My stomach protruded, and I lost my waist, I looked like I had a watermelon for a stomach. My clothes no longer fit, and I was exhausted and couldn’t sleep.
When we eat, our digestive system produces strong muscular contractions that propels the food through our digestive tract. Our intestines are divided into two major sections. We have a small intestine (20 feet long) and the large intestine (5 feet long). The organ walls of digestive system propel food and liquid and can mix contents of both. First it flows through the esophagus, then stomach, and intestines and this is called peristalsis. It takes approximately six to eight hours for food to reach the small intestine. And finally, the large intestine or the colon.
In some cases, motility may not even work at all and this creates larger issues. Now that I know what it is, I am pretty sure my dad had it because his stomach was so big (we used to tease him and ask him when he was expecting). Our bodies do not get the nutrients it needs because they are not being absorbed properly, and in some cases such as mine, I was gaining weight. The body goes into starvation mode and will not release stored fat. (The opposite is loss of weight). Sometimes I wasn’t hungry, but I thought I had to eat to keep my strength up.
Enough was enough and my family doctor referred me to a gastroenterologist who then referred for diagnostic testing, also known as a gastric emptying study. When I arrived, I was fed a breakfast that consisted of two scrambled eggs with 2 slices of toast with butter. I had to eat all of it within 10 minutes. It contained radioactive material, so the food could be tracked via scanner as the scanner moves through our abdomen. Of course, I researched the topic and read that Bezoars can form, which is rare. Food remains in the stomach for a long time and forms a hard lump. (It gets stuck). Who is susceptible? From what I can gather there are three subdivisions:
diabetic gastroparesis
idiopathic gastroparesis
post-surgical gastroparesis

 

About 1 in 10 patients eventually become disabled with the condition.  Diabetics are susceptible and women more than men. Some patients require a G-J tube (J-tube for jejeunal or G-tube inserted into stomach). There is no cure. Some of the signs and symptoms include:

  • Vomiting
  • Nausea
  • A feeling of fullness after eating just a few bites
  • Vomiting undigested food eaten a few hours earlier
  • Acid reflux
  • Abdominal bloating
  • Abdominal pain
    Changes in blood sugar levels
  • Lack of appetite
  • Weight loss and malnutrition

I suffered from Nausea, feeling full all the time, horrible acid reflux, abdominal bloating and pain. While it’s not clear what causes gastroparesis, in many cases it is believed to be caused by damage to a nerve that controls the muscles called the vagus nerve. It can be damaged by diabetes or surgery. In my case, I suspect it was a surgery I had approximately four years ago. I was in the hospital for three months and in a great deal of pain. To control the pain, I was on heavy doses of pain narcotics.

There are other risk factors as identified by the Mayo Clinic.

  • Diabetes
  • Abdominal or esophageal surgery
  • Infection, usually a virus
  • Certain medications that slow the rate of stomach emptying, such as narcotic pain medications
  • Scleroderma (a connective tissue disease)
  • Nervous system diseases, such as Parkinson’s disease or multiple sclerosis
  • Hypothyroidism (low thyroid)

To add insult to injury, I suffered from low thyroid, of course the pain medications, and the hospitalization was caused by a rare infection virus called pseudomonas, (pronounced: “soo-duh-MOH-nuss”). I never heard of it!
Recovery
Knowing that I would never recover, I started to read about the disease. When I left the gastroenterologist’s office, I was given a “diet”, if you want to call it that. It consisted mainly of liquids (all liquids – bummer). I was to drink liquids for two weeks, then introduce solid food and, eventually, I could try to eat well cooked food again. The liquids were better for me than the solid food. My symptoms lessened and my stomach began to look normal again. I’m not a smoker, but if you are, stop. Your symptoms will not improve. I thought about trying acupuncture (I’ll keep you posted, I’m still deciding). There is a Japanese herbal formula that contains nine herbs called Rikkunshito that reduces the abdominal pain and post-meal fullness. (It didn’t work for me) And then there is Cannabis, but there are no published clinical trials, it’s thought to ease the nausea. (I haven’t tried this yet). I didn’t know what to eat! Everything made me sick except liquids. I wasn’t about to eat baby food (I tried it and didn’t like it). I started to experiment, I let my body decide what it could tolerate.
Here is a suggested list of foods to follow:
Eat smaller meals more frequently
Chew food thoroughly
Eat well-cooked fruits and vegetables rather than raw fruits and vegetables
Avoid fibrous fruits and vegetables, such as oranges and broccoli, which may cause bezoars
Choose mostly low-fat foods, but if you can tolerate them, add small servings of fatty foods to your diet
Try soups and pureed foods if liquids are easier for you to swallow
Drink about 34 to 51 ounces (1 to 1.5 liters) of water a day
Exercise gently after you eat, such as going for a walk
Avoid carbonated drinks, alcohol and smoking
Try to avoid lying down for 2 hours after a meal
Take a multivitamin daily

You can download a PDF of the complete list of foods here. It’s mostly trial and error, your body will let you know what it likes and what it does not like because you will feel either worse, or better.

Summary
I found my work-around. This may not work for you (and then it may). I drink two meals a day. It’s a Paleo powder (If interested, you can find it here) with animal protein. For my third meal I eat a high protein vegetarian meal. I eat 5 to 6 times a day, very small portions of food. No raw vegetables, everything is cooked thoroughly. It took me a while to test different foods to see what my body could tolerate. The blander, the better; like cottage cheese, canned fruit, oatmeal, peanut butter. Watch the bread, I don’t tolerate massive quantities of bread, rice or pasta. Don’t include a lot of fiber in your diet, that will make the symptoms worse.
Exercise I try to walk on the treadmill at least 30 minutes a day, if not the treadmill then the bike. It gets everything moving. I even bought a mini trampoline, it helps the digestion. Every morning I now include a probiotic, magnesium and digestive enzymes before every meal. It works for me.
I have my acid reflux under control, my doctor prescribed something for that and the small meals help. My voice has changed and is deeper than before and it crackles from the acid reflux. I do have swallowing issues, and that was addressed by my gastroenterologist. Your esophagus can be dilated (who knew) so that feeling goes away. (Well, sort of)
My body and I have finally found a way to coexist! It didn’t happen overnight. It took a lot of reading and reaching out to those affected by this disorder. It helps when you can share with other people.
If you have these symptoms or have this illness, I hope this article helps. If you noticed a loved one displaying symptoms, show them this article and suggest a visit to the doctor. The longer you wait, the worse the symptoms and the harder it is to regain control.

 

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