by Nancy Brown for G-PACT.org
YOU ARE NOT ALONE
Gastroparesis (GP) is one of several digestive motility disorders that impact the body’s ability to digest food. Severity ranges from mild GP, where the disease can be managed by diet, to severe, requiring a feeding tube in order for the body to process nutrition. There is no cure for GP, although it can be managed through diet and medication. Symptoms include:
- early satiety
- weight gain or loss
Being diagnosed with GP can be overwhelming. One in twenty-five people in the US, including children have been diagnosed with GP. Causes of GP include diabetes, injury to the vagus nerve (the nerve that controls stomach muscles), infections, medications that slow motility, Parkinson’s disease, Multiple Sclerosis, or for unknown reasons (idiopathic).
WHAT TO EXPECT
Diagnosis is difficult to determine based on symptoms alone. Your doctor or a Gastroenterologist (GI) may order several tests including Gastric Emptying Study (GES), endoscopy, smart pill, and EGG to confirm the diagnosis. Other tests may be administered to rule out other digestive issues.
GP is an under-served disease, which means it has not gotten the attention from the medical community that it should for the number of people suffering from it. It’s important to find a doctor who is knowledgeable about GP to determine the right treatment plan. It may be necessary to visit a motility specialist. A motility specialist is a GI that specializes in slow stomach diseases like GP. Don’t be afraid to change doctors and find someone to work with to manage GP. Having a trusting patient / doctor relationship is a vital part of the treatment plan. Symptoms and concerns need to be shared with your doctor, so keep a running list of observations or questions to discuss during your doctor visits.
DEVELOP A TREATMENT PLAN
Managing your diet is a key component of managing your GP. Your doctor will probably suggest a low fiber, low fat diet and eating 5 – 6 small meals per day. A nutritionally balanced diet should be your goal. Keep a food diary to document what you eat, the amount you eat, the time you eat, and any symptoms that you encounter after the meal. This will help you to identify what you are able to eat and not eat. There are several GP diets available on the internet that will give you an idea of what foods can be eaten. Unfortunately, GP is not a one size fits all condition. Your diet must be tailored to what you can eat, eliminating foods that trigger symptoms. Consulting with nutritionist (who is familiar with GP) to develop your diet plan will aid you in identifying healthy, tasty meals for you to enjoy.
Many GP patients require medications to aid in digestion and reduce vomiting and nausea. Prokinetics are used to stimulate digestion. Anti-emetics control nausea and vomiting. In the US, Metoclopramide (Reglan) and Erythromycin are approved for GP. Domperidone is approved for GP patients, but doctors must obtain advanced approval from the FDA to prescribe it. Medications to control nausea and vomiting include over the counter and prescription drugs. Over the counter drugs examples include ginger capsules, Benadryl, Unisom, Dramamine. Zorfran, Compazine, and Promethazine are examples of prescription medication for nausea and vomiting. Please work with your doctor to identify which prokinetic, anti-emetic, or other medications you need to manage your GP.
Sometimes diet and medication are insufficient to manage GP. Surgical options are available to manage symptoms. These include Botox injections, gastric pacemakers, feeding tubes, and most recently gastric peroral endoscopic pyloromyotomy or G-POEM. Alternative treatments include acupuncture and hypnotherapy.
LIVING YOUR LIFE WITH GP
GP is a life changing disease for many who have the condition. To effectively manage your condition, here are a few tips:
- Educate yourself on your condition.
- Educate your friends and family.
- Keep a food diary.
- Become aware of new medications and/or surgical options for treating GP and discuss them with your doctor.
- Reduce your stress and if your doctor approves, add exercise into your daily routine.
- Find social activities to do with family and friends, that don’t involve food.
- Enjoy social activities involving food by finding restaurants that have GP friendly meals or bring your own food to enjoy. Or purchase a GP Cookbook and cook a GP meal for family and friends.
- Ask questions. Your doctor should be your chief source of information, but social media sites (Facebook) are a great place learn from the experiences of others.
There are many resources about GP available via the internet, books, Facebook and online support groups, and blogs. Living (Well) with Gastroparesis by Crystal Zaborowski Saltrelli CHC is an excellent book to help get started with managing GP. Be wary of sites that offer a cure. There is no cure for GP.
About the author:
Nancy Brown lives in Virginia with her husband of 38 years, Ed. They’re empty nesters and are enjoying retirement. Prior to retiring, Nancy was a Manager of Requirement Analysis at Navy Federal Credit Union.
Resources used to develop this article.