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*Gastroparesis
is a condition characterized by impaired transit of food from the stomach. There may also be a total loss of nerve and
muscle movement in the stomach and intestines; therefore gravity continues the path for the food through the gastrointestinal
organs. Patients may also be diagnosed with a more rare form of Gastroparesis called- Idiopathic Gastroparesis in
which there is no known cause.
*Gastroparesis is most commonly caused by diabetes, but can also
be hereditary or occur as a result of surgery on the stomach or vagus nerve, viral infections, food poisoning, medications
that slow contractions in the intestines such as anticholinergics and narcotics, gastric bypass, lapband, gastric sleeve surgery,
smooth muscle disorders, Gastroesophageal reflux disease, metabolic disorders, autoimmune disorders, chemo/radiation therapy, Bells
Palsy syndrome, Ramsey Hunt syndrome, MS, Parkinsons disease, stroke, Anorexia nervosa and Bulimia.
Many people have what is called Idiopathic
Gastroparesis, meaning the cause is unknown and cannot be found even after medical tests.
*Symptoms of Gastroparesis may include
chronic or intermittent nausea, heartburn, reflux of food and liquids into the esophagus, difficulty swallowing, hypoglycemia
(low blood glucose) after a meal following high blood glucose, constipation or diarrhea, weight loss, vomiting,
early satiety, abdominal distention(bloating) after eating that seems to linger due to hours or days of undigested food, abdominal
pain, hair loss, insomnia, acid reflux, GERD, dehydration, and malnutrition.
Other consequences and complications include the erratic absorption
of medicines taken by mouth, electrolyte imbalance (electrolytes include salts such as sodium and potassium), and potentially
even coma or death.
*Diagnosing Gastroparesis is commonly
first with the patients medical history.
Any prior ulcer disease, gastric surgery,
other medical illnesses or current medications can be an effective first tool.
The most valuable test to diagnose
Gastroparesis is the Gastric Emptying Scan (GES)-The test involves eating a small meal or an egg with a trace
of radioactive material so that the rate of the digestion can be observed. There are pictures taken by the radiologist every
15 minutes of so over a length of time(90 Mns-6 Hours). If the test shows a large amount of food left over in the stomach, indication
of Gastroparesis is extremely likely.
Gastric Manometry-A thin tube is inserted through
the mouth into the stomach. A wire in the tube takes measurements of the stomach's electrical and muscular activity as it
digests food, indicating whether the stomach is contracting in an efficient manner.
MRI (Magnetic Resonance Imaging)-A body scan is
done using a magnetic field and radio waves to take three dimensional pictures of the gastrointestinal tract.
Upper Scope (Gastroscopy)-After sedation, a flexible,
lighted instrument with a very small camera attached is inserted through the mouth to the stomach and first part of the small
intestine. This enables the doctor to see any abnormalities in the esophagus, stomach and small intestine. This test can rule
out causes of gastroparesis other than diabetes.
Barium X-Ray-After fasting for 12 hours, the person
drinks a shake containing barium, which makes the stomach visible on the x-ray. The stomach is then x-rayed to see if any
food is present.
*There is neither known cure nor specific
drug for Gastroparesis due to poor medical study and research. Current medications that are available only help to eliminate
some symptoms but do not work for all patients. -Tranzyme Pharma is currently in the second phase for new Gastroparesis
drugs that may be used worldwide for all chronic and severe Gastroparesis patients in the near future. There are some
types of treatments now available that may possibly help improve and ease the symptoms suffered daily
by all Gastroparesis patients.
Diet-Changing what foods
to eat can be helpful as well the portion sizes, large meals are not encouraged. Liquid meals are highly recommended due to
it is easier to pass through the stomach. Avoid high fats, fiber, spices and red meats due to they can remain in
the stomach too long and cause toxic backup. Diet is often trial and error to adjust what foods are more tolerable.
MEDICATIONS:
Erythromycin- An
antibiotic that acts to stimulate the muscles of the stomach to contract.
Bethanechol (Urecholine)-Increases muscle contractions
in the gastrointestinal tract.
Cisapride (Propulsid)-Increases the contractions
of the gastrointestinal tract. In the United States, this drug is restricted to people who meet certain eligibility requirements
due to its effects on the heart.
Domperidone (Motilium)-Increases
stomach contractions, accelerating emptying of solid foods. This drug also lessens nausea and vomiting. There is a potential
undesired effect on the heart. This drug is only available in Europe, Mexico and Canada.
Metaclopramide (Reglan)-Normalizes contractions,
decreasing the amount of time the stomach needs to empty. *2009-FDA PLACED BLACK BOX WARNING.
"If you have been injured from taking
Reglan / metoclopramide, here's an attorney who's America's most experienced Reglan lawyer:
http://RalphPittle.com."
Octreotide (Sandostatin)-Improves contractions of
the gastrointestinal tract. May also enhance effects of erythromycin.
Botulinum Toxin-An injection given into the pyloric
sphinctor muscle at the end of the stomach which can help to improve some Gastroparesis symptoms-still under research by Johns
Hopskins Bayview Medical Center.
*DRUG CURRENTLY PULLED OFF THE MARKET BY FDA (APRIL
2007)Tegaserod (Zelnorm)-Increases stomach emptying time, moving food into the intestine and reducing the chance of bezoar
formation.
*All listed drugs are not 100 percent totally
effective and without unwanted side effects.
*Surgery is seldom done for Gastroparesis
but one option is a feeding tube that can be placed surgically. The tube goes through the skin of the abdominal wall bypassing
the mouth, esophagus and stomach to allow immediate nutrition.
TPN (Total Parenteral Nutrition)-People
who do not improve with medicines and who cannot get the proper nutrition through eating are often hospitalized so they can
benefit from intravenous fluids that provide calories, minerals, vitamins and nutrients. A tube may be threaded through the
person's nose into the stomach to drain fluid and air.
Enternal Nutrition-An alternative to total parenteral
nutrition is enteral nutrition, in which the necessary medicines and nutrients are provided directly into the gastrointestinal
tract via a tube placed into the stomach or small intestine. The tube can also be used to drain liquid and air from the gastrointestinal
tract. Both treatments may last for a long time, depending on when the stomach is able to handle solid food again.
Botox-Injections of Botulinum toxin (Botox) at the
connection between the stomach and small intestine have recently been used to increase the emptying of food from the stomach.
This method works because the muscle that controls the opening of the stomach into the small intestine, when injected with
Botox, becomes paralyzed by the Botox and allows food to pass through continuously.
*HELP BAN AGAINST GASTRIC
PACER ANIMAL TESTING! Say NO to 'National Institutes of Health' clinical research using canine pacers!
Gastric Pacemakers-
In 2000 for only "Compassionate Use". This electrical device is implanted in the abdomen and functions like the a pacemaker
would for the heart forcing the stomach to contract by electric stimulation. Potential side effects include infection,
unwanted movement of the device, a hole in the gastrointestinal tract, an undesirable change in stimulation due to movement
of the electrodes, bleeding, bruising, pain at the site of an electrode, allergic reaction, pneumonia and dehydration.
*EXPERIMENTAL TREATMENTS- One treatment for Gastroparesis
that is currently investigation is the use of nitric oxide to normalize the movements of the gastrointestinal tract. Acupressure
therapy is also being considered as a way to relieve the nausea, vomiting and bloating is caused by Gastroparesis.
*Spreading GP Awareness One Person At A
Time*
You My Friend Will Never Again Walk
Alone.
©2010EWD
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