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Gastroparesis --- Causes and Top 7
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April 10, 2016
By A. Weinberg, Contributing Columnist






Upon first glance, “Gastroparesis” has the sound of a grave condition.
“Come quick, doctor! She’s going into gastroparesis!”  Gastroparesis is
derived from the Greek word, meaning “a weakness of movement.”  

While gastroparesis can be serious in some cases, the simple definition
is “delayed gastric emptying.” Or rather, when your body takes too
long to empty the contents of your gastric system.

Gastroparesis is a condition that may develop in those who suffer from
diabetes, infections, hypo or hyperthyroidism, Parkinson’s disease, or
in people undergoing cancer treatments.

But what exactly happens in gastroparesis? The mechanism is not fully
understood, but it is thought that it has to do with disrupted nerve cells.

Scientists have found the vagus nerve to be the cause, which when
damaged, causes the stomach to digest food extremely slowly, or in
some cases, not at all.

Symptoms of Gastroparesis

What those who have experienced it do know for sure are the
unpleasant symptoms that it causes, including nausea, vomiting,
heartburn, abdominal pain, changes in blood sugar levels, and a
swollen abdomen.

The good news is that continuing research is being performed on
methods to alleviate this discomfort and reduce the scourge of
gastroparesis. Here is what we've found:

































1.       
Try a Neurostimulator

Since gastroparesis has to do with nerve cells that don’t quite perform
their function, sometimes it’s necessary to give ‘em a little nudge. A
neurostimulator is a great device because it releases electric signals that
help control nausea and vomiting.

Many doctors and scientists are currently looking at the potential of a
gastric electostimulation system called Enterra.

In a recent 2016 study, E. Asti and researchers from the University of
Milan medical school in Italy looked at the case of one 57-year-old
woman diagnosed with early stage adenocarcinoma in 2007. She
experienced vomiting, as well as a 29-kilogram weight loss, and was
unable to eat. They implanted the Enterra gastric electrostimulation
system through the right thoracoscopic access and connected it to the
gastric conduit.

After six months, her total symptom score and quality of life had
improved.



2.       
Add Some Botox ---Botulin Toxin Type A

Toxin? But this is the good stuff; we promise. It reduces muscle activity
and relaxes the pyloric sphincter muscle, which controls the flow of
food from the stomach to the small intestine.

This means more of your last meal can pass into that intestine, reducing
gastroparesis.

In 2013, R. Bagheri from the Mashad University of Medical Sciences in
Iran published findings. 60 patients (with an average age of 61) with
esophageal cancer in the middle and lower third parts of the esophagus
participated in a study between 2010 and 2011.

The participants were divided into two groups: one that underwent
pyloroplasty and another that received injections of botulin toxin in the
pyloric sphincter muscle.  The success rate of the Botox injection was
90%, suggesting that it is a potential complication-free method.



3.
Or Combine the Two Methods

Studies show that the combination of gastric electric stimulation and
the injection of botulin toxin could be quite effective.

In 2009, M. Hummel from the Institute for Diabetes in München,
examined patients with increased symptomatic diabetic gastroparesis.
He discovered that the gastroparesis symptom score improved
dramatically under the combination therapy.

The time of gastric emptying slowed down by 50% and no
complications were noted.

  

4.
Change Your Diet

As well as these more invasive techniques, daily habits do make a
difference.

Most nutritional counselors advise reducing meal size and the
consumption of fiber and fat.

In 2015, V. Wytiaz and researchers from the Temple University school
of Medicine in Philadelphia aimed to categorize which foods provoked
symptoms of gastroparesis, which alleviated them, and which didn’t
affect them at all.

Participants filled out a questionnaire that used a scale of minus 3
(greatly worsening) to plus 3 (greatly improving). They found that the
foods that most provoked symptoms were typically fatty, acidic, spicy,
and roughage-based.

These included sausage, cabbage, broccoli, orange juice, fried chicken,
oranges, pizza, peppers, onions, tomato juice, lettuce, coffee, salsa,
bacon, and roast beef.

In contrast, those edibles that improved symptoms or were tolerable
had a bland, sweet, salty, or starchy quality.

Those that moderately improved symptoms were graham crackers,
saltine crackers, and Jello. Twelve more foods were found to be
tolerable and not provoke symptoms. Amongst these were: pretzels,
applesauce, white fish, ginger ale, gluten-free foods, tea, sweet
potatoes, clear soup, salmon, potatoes, white rice, and popsicles.



5.
Do Pyloroplasty

This is another option for a surgical procedure, which can be effectively
combined with others.

In this instance, the lower portion of the stomach, called the pylorus, is
cut and restructured in order to relax the muscle and widen the
opening into the intestine.

In a 2013 study by I. Sarosiek and researchers at the Texas Tech
University Health Sciences Center in El Paso, they evaluated the
advantage of pyloroplasty to control symptoms of diabetes mellitus and
idiopathic cases of gastroparesis.

A total of 49 patients underwent a treatment with the gastric
electrostimulation system Enterra, and 26% of them also received
pyloroplasty.

At seven months, the total symptoms score improved for both, but
gastric emptying improved by 64% for people who did interventions
with Enterra and pyloroplasty, as opposed to only 7% for people who
only received gastric electrostimulation. This implies that pyloroplasty
may sustain the long-term effects of the operation.



6.
Take Medication After Seeing Your Doctor

There are various options for medication, to help alleviate symptoms on
a more regular basis. In 2007, Hasse Abraham from Sahlgrenska
University Hospital compiled a report on the most common ones.

One option is Erythromycin, which can be taken intravenously, between
80 and 200 mg daily, and in severe cases, three times daily. It can also
be ingested before meals, in quantities ranging from 200 to 300
milligrams.

With this drug, tachyphylaxis (in other words, a decrease of response
to the substance soon after its administration; building up a tolerance)
may occur.

Increasing the dosage may be necessary. Dopamine antagonists are
also helpful. 10 mg of Metoclopramide or 10-20 mg of Domperidone
may be taken orally before meals. Rectal administration or
subcutaneous injections in the case of Metoclopramide are also
possible. Be sure to consult your doctor for your specific case.

7.
Give Acupuncture a Try

While, unlike surgery, it may not solve things in a more permanent way,
it does significantly reduce discomfort. In 2013, M. Yang from the
Diabetes Institute in China compiled a report based on various studies.
He and researchers looked through 744 studies, 14 of which were
considered eligible.

Overall, acupuncture had a much higher success rate than controls, and
improved symptoms in diabetic gastroparesis such as nausea, loss of
appetite, and stomach fullness.

Further tests need to be performed, but if you’re suffering the side
effects it’s definitely worth trying out (with your physician’s blessing,
of course).

  







































































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Avoid foods rich in fiber if you have
gastroparesis.