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Sunday, April 8, 2018

Gastroparesis: The Different Ways it Effects the Body

This idea and article dedicated to: Laurie Jayne

Her story, "After 14 years of being diagnosed with gastroparesis, a nurse practitioner told me this morning, that I don't have gastroparesis because I am not thin enough and don't vomit."

There are many kinds of Gastroparesis, many faces of Gastroparesis, and because everyone is different, it is hard to diagnose and treat. I, myself, have had Gastroparesis since about 2000 after an appendix surgery but was officially diagnosed in 2012. I do vomit, but that doesn't make my Gastroparesis more than someone who does not vomit, or my Gastroparesis less than someone who may have a feeding tube. There are also people who gain weight with Gastroparesis. However, Gastroparesis is Gastroparesis. It does not matter how much you weigh, because that does not mean that you are not malnourished or that you are not vitamin deficient. The Vagus Nerve is still damaged.

First of all, let's go into what Gastroparesis actually is and what causes it before we go into the different types of Gastroparesis.



Sources from GPACT and Imgur from years ago for the above images.


According to Gastroparesis Clinic,

"What is gastroparesis?

Gastroparesis is a gastric motility disorder in which the function of the stomach is impaired. The stomach is an important organ in our digestive system, which uses a series of muscular contractions to store meals after they have been eaten, grind up any solid food and pump this liquid into our small intestine at the right rate, so that the next steps in the digestive process can take place. In the case of gastroparesis, the muscular contractions of the stomach are defective, and as a result the contents of the stomach are emptied too slowly leading to symptoms.



Source from Imgur.



While gastroparesis is a relatively uncommon disorder, it can be very debilitating for those who suffer from it. Gastroparesis can have a significant impact on quality of life including the physical, emotional, and financial aspects of life. Sufferers may find that the nausea, discomfort, and pain associated with gastroparesis interfere with their ability to work, socialise, and maintain normal eating patterns. In severe cases, the inability to properly digest food can result in hospitalisation for fluid and nutrition supplementation, or sometimes the need for extra nutritional supplementation by a tube.

Gastroparesis is considered to be a motility disorder because there is no evidence of physical obstruction of the stomach, meaning that the primary issue is in the movement of the stomach. Impaired movement of the musculature of the stomach can be related to many underlying health problems, including diabetes, infection, neurological disorders, side-effects of medication, and following gastric surgery. However, in a large percentage of cases, gastroparesis is idiopathic – there is no known cause. In addition to the abnormalities of movement, there are also abnormalities of sensory function, so that the stomach becomes oversensitive and the sensations arising from the stomach are perceived as different or abnormally intense.

There are a variety of treatment options available to help gastroparesis sufferers manage their symptoms, though there is currently no cure. Health professionals are likely to recommend dietary changes, medications to minimise symptoms, psychological support, or hospital-based interventions depending on the severity of the symptoms and their response to treatment.







How many people are affected?

There are very few statistics on the prevalence of gastroparesis. It has been estimated that up to 4% of the population may experience gastroparesis-like symptoms, but it is uncertain how many of these people have the actual condition, as the sympotms and abnormalities of gastroparesis can be similar to other chronic functional gastrointestinal diseases such as functional dyspepsia or chronic idiopathic nausea. The lack of clarity around the incidence of gastroparesis is partially due to variation in the recognition of the condition by health professionals, as well as variation in the interpretation of test results.

As gastroparesis may be caused by diabetes, estimates about how many people are affected by gastroparesis are sometimes made based on diabetes statistics. These statistics suggest that more than 1.5 million Americans suffer from severe gastroparesis, and one estimate suggests that approximately 120,000 Australians are affected by the disorder. Women are more commonly affected than men, with approximately 80% of gastroparesis sufferers being female. The reason for this difference is not fully understood.









When does gastroparesis start?

Gastroparesis can begin at any age, although the average age of onset is 34 years.


Types of gastroparesis

In some cases, gastroparesis may be categorised as one of the following:

Idiopathic gastroparesis – there is no detectable abnormality responsible for the symptoms experienced, although sometimes the symptoms began following an infectious episode (gastroenteriltis with vomiting, nausea and diarrhea) – postinfectious gastroparesis

Diabetic gastroparesis – diabetes mellitus is the most common disease associated with gastroparesis, with 20-50% of longstanding diabetics experiencing gastroparesis, mostly in association with other complications of diabetes.

Post surgical gastroparesis – symptoms began following surgery to the upper gastrointestinal tract – the esophagus (gullet) or stomach.






Source from Imgur years ago.




Symptoms of gastroparesis

The symptoms associated with gastroparesis range in severity, but can be very debilitating. Common symptoms include: nausea, vomiting, bloating, early satiety, postprandial fullness, and abdominal pain. In extreme cases, the inability to digest foods and liquids properly can also lead to malnutrition, weight loss, and dehydration.



Source included in the image.



These symptoms can mimic a number of other health conditions (e.g., functional dyspepsia), and a medical history, physical examination and testing will help to discern if gastroparesis is the most likely explanation for the patient’s symptoms. Imaging tests and physiological measurements are used to determine the functioning of the stomach and the rate of gastric emptying. Some patients have severely delayed emptying but little in the way of symptoms, whereas other patients may have severe symptoms with only minor delays in emptying. In other words the severity of symptoms and the rate of emptying may not be closely correlated, which is why the abnormalities of sensation (which cannot be as easily measured) are likely to be important.










Further details about specific gastroparesis symptoms

Nausea: One of the main symptoms of gastroparesis is a feeling of nausea that may be accompanied by vomiting. Whilst dietary modification and prescribed medications can be helpful in addressing this symptom, there are also some other approaches that can lessen nausea. Using ginger to make a tea, as an ingredient in recipes, or taking ginger capsules, is known to ease nausea and speed up gastric emptying in some people. There is also evidence that stimulation of acupoints PC-6 and ST-36 can help relieve nausea and improve gastric emptying.

Bloating: Abdominal bloating is commonly associated with gastroparesis. Dietary modification may decrease abdominal bloating and discomfort. A discussion with your doctor can guide you in the necessary direction however, a specialised dietician’s advice is usually required in more severe cases

Abdominal pain: Many people with gastroparesis experience abdominal pain and discomfort. Gastroparesis generally does not cause sharp stabbing pains, but instead pain that is vague and crampy in nature. It is commonly made worse by eating, and may disrupt sleep at night.

Pain relief in the form of applying a hot pack to the abdomen for short periods may be helpful. The frequency and severity of pain episodes may also be reduced by treating gastroparesis with dietary modification, as well as natural, over the counter, and prescribed medications. Opiate based medications (eg morphine) are best avoided as they can lead to an increase in symptoms in the long term and are highly addictive.

Pain in gastroparesis can have a significant impact on quality of life. Learning techniques to cope with the symptoms is an effective strategy to make living with gastroparesis easier. Techniques that can be helpful in managing pain include those used by psychologists, for example cognitive behavioural therapy.

Depression and anxiety: It is common for gastroparesis sufferers to experience anxiety or depression. This may be due to the symptoms themselves, or to other issues such as family, relationships, financial stresses, or even to significant life changing events from the past.

The symptoms of gastroparesis may interfere with the normal activities of day-to-day life. This can lead to tiredness, low mood, low energy levels, and feelings of being out of control, tense, or anxious. This in itself will make the experience of living with gastroparesis more difficult and can create a vicious cycle of increasing symptoms leading to more anxiety and a further increase in symptoms, impacting on the overall condition of the person’s health and quality of life.

If any of the above feelings or events is pertinent to your care, then this should be discussed with your doctor, and if there are previously unresolved psychological issues then it would be the right time to address these as part of the treatment plan. Treating these issues can improve the ability of the mind and body to cope with gastroparesis. If your doctor feels that depression and/or anxiety is contributing to your symptoms, your doctor may suggest medication. It can often take some time to work out the right medication and dosage before it has a favourable outcome. Alternatively, a referral to a psychologist for further assessment and treatment may be appropriate."



Source: A friend made these images.


Just because people have Gastroparesis, does not mean that they vomit or have all of the symptoms listed. Everyone has different body chemistry and not everyone may have developed Gastroparesis from diabetes. I am here to talk about the different kinds of Gastroparesis people have because:

1. Gastroparesis is misunderstood.
2. Everyone is different (and that is why it is so hard to treat and find a cure).
3. Not everyone has the same symptoms (for instance, I vomit but my friend Kenny does not).
4. Not everyone with Gastroparesis is on a feeding tube.
5. Gastroparesis can range from mild to severe.
6. Just because people have a "mild" form of Gastroparesis, that does NOT make their Gastroparesis any less than someone who vomits or has a feeding tube with it. Vagus nerve damage is vagus nerve damage.





I wanted to upload this PDF from John Hopkin's because it explains everything regarding Gastroparesis, the different types and how a person could get them, as well as other useful information. This source comes from, which you can click on to make the images bigger if you have a hard time reading them below: https://www.hopkinsmedicine.org/gastroenterology_hepatology/_pdfs/esophagus_stomach/gastroparesis.pdf



In conclusion, Gastroparesis can effect each person who has it differently. It does not mean that the person is less sick if they have a milder form of Gastroparesis. In the end, it is a motility issue that will be with that person for the rest of their life. It is not fair to compare someone on a feeding tube with Gastroparesis to someone who vomits daily with Gastroparesis. That serves no purpose because those people are both very sick with a motility disorder and they deserve respect and understanding.

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