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Saturday, June 9, 2012

Medications, Diet, and Treatment

I have been on several medications for gastroparesis, but none of them really help. I cannot sleep because I stay up vomiting all night. I vomit at least 8 times a day, so keeping medication down is a real challenge.

So, the medications that I'm on right now are as follows:

Zofran 8mg - three times daily under the tongue. Zofran is used to treat nausea and vomiting caused by chemotherapy. It is also used to prevent or treat nausea and vomiting after surgery.

My problem with this medication is that even though it dissolves under the tongue, it's very hit or miss. It doesn't always work to control the nausea. It also has a VERY strong mint taste and when you're nauseated, that doesn't really help.

Phenergan 25mg - four times daily. Phenergan is an antihistamine. It is used to treat allergic reactions and to treat or prevent nausea and vomiting from illness or motion sickness. It is also used to make you sleep before surgery, and to help treat pain or nausea after surgery.

My problem with this medication is that it's hard to keep down. However, it works the best out of all of the antinausea medications. If you get it through an IV, make sure your nurse pushes it slowly. If not, it will burn like hell and blow your vein. Trust me on that one.

Bentyl 20 mg - once per day. Bentyl is used to treat bowel problems including irritable bowel syndrome.

Again, it's hard to keep down tablets. This was given to me to control the spasms in my stomach. It does help, but not enough.

Dexilant 60mg - once per day. Dexilant prevents the production of acid in the stomach. It is used to treat gastroesophageal reflux disease (GERD) and inflammation of the esophagus.

The problem with this medication is that it interacts and effects the absorption of the Levsin. So, I haven't been taking it. Also, it's hard to keep down, even though it's a small capsule.

Levsin 0.125 - four times daily under the tongue. Levsin is used to treat stomach and bladder problems. This medicine is also used for rhinitis, to reduce some problems caused by Parkinson's disease, and for the treatment of poisoning with drugs that are usually used to treat myasthenia gravis.

I have been on this medication for only a few days, so I can't really offer an opinion.

As for diet, I follow this plan:

I cannot have fruits or vegetables, high fat, high fiber, or gluten. That limits my diet greatly. When I eat, it burns in my stomach. Imagine having heartburn inside of your stomach ... and then multiply that by 20. My stomach is pretty much conditioning me NOT to eat. If I do manage to keep food down, it's usually bland. I try to drink Ensure so that I can have vitamins, but that doesn't really stay down either.

The Mayo Clinic says:
Eat smaller meals more frequently.
Eat low-fiber forms of high-fiber foods, such as well-cooked fruits and vegetables rather than raw fruits and vegetables.
Choose mostly low-fat foods, but if you can tolerate them, add small servings of fatty foods to your diet.
Avoid fibrous fruits and vegetables, such as oranges and broccoli, that may cause bezoars.
If liquids are easier for you to ingest, try soups and pureed foods.
Drink water throughout each meal.
Try gentle exercise after you eat, such as going for a walk.

Some people with gastroparesis may be unable to tolerate any food or liquids. In these situations, doctors may recommend a feeding tube (jejunostomy tube) be placed in the small intestine.

Feeding tubes can be passed through your nose or mouth or directly into your small intestine through your skin. The tube is usually temporary and is only used when gastroparesis is severe or when blood sugar levels can't be controlled by any other method.

And believe me, I DO NOT want a feeding tube! An infected feeding tube does not sound like fun.

The Mayo Clinic says that treatments are:

Injecting a nerve toxin to allow the stomach to release food. Botulinum toxin type A (Botox) is a nerve toxin most commonly known for its use in treating skin wrinkles. Researchers have found that Botox injections relax the pyloric muscle in some people, thereby allowing the stomach to release more food into the small intestine. The benefits are temporary, however, and more studies are needed to determine the overall usefulness of this treatment.

Implanting an electrical device to control the stomach muscles. Electrical gastric stimulation uses an electric current to cause stomach contractions. Working much like a heart pacemaker, this stomach pacemaker, consisting of a tiny generator and two electrodes, is placed in a pocket that surgeons create on the stomach's outer edge. Stomach pacemakers have been shown to improve stomach emptying and reduce nausea and vomiting in some people with gastroparesis, but more studies are needed.

BUT, there is no cure. Each of the treatments have serious side effects. I haven't tried either one yet, but I've read about them. The Botox injections are temporary and I've read that the pain comes back a hundred times worse after it wears off. The pacemaker in your stomach, well, that could cause a whole lot of problems, not to mention that you can never get an MRI again.

I'll keep you updated on what works for me but everyone is different.

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