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August Is Gastroparesis Awareness Month!

“One small crack does not mean you are broken. It means you were put to the test and you didn’t fall apart”


Linda Poindexter



Intro

Following up from last month’s FODMAP topic, I thought I’d take some time to talk about another stomach related condition called Gastroparesis. It’s not one that rolls off the tongue but it can be serious enough that it deserves the spotlight this month. Like most gastrointestinal conditions, the path to wellness can feel more like a pilgrimage to a new world where trial and error provides the best results...but don’t give up. As research continues and more resources become available for you, it is always important to arm yourself with the knowledge you need to feel confident in your condition. As I have said many times...you know yourself best and you are your first line of defense. Cozy up with your gastroparesis, it’s the best way to get to know it, and tackle it head on.


Gastro...what?

Gastroparesis can be referred to as a disease, disorder or condition that delays gastric emptying. This means that your stomach’s motility and ability to move food from your stomach to your lower intestines is slowed down or doesn’t work at all, despite not having any blockages present.

This condition can interfere with normal digestion and can cause early satiety, meaning you feel more full earlier on in your meal. You can also feel very full after a normal size meal, which can cause nausea and/or vomiting. Bloating is a common symptom which often leads to pain and discomfort. Changes in blood sugar levels and malnutrition also play a role in delayed gastric emptying and induce symptoms.

According to The National Institute of Medicine (NIH) this condition affects approximately 10 men and 40 women out of 100,000 adults. It is also important to note that not everyone receives the proper Gastric Emptying Test to officially diagnose the condition so although gastroparesis is not necessarily common, 1 out of 4 adults in the US report symptoms similar to gastroparesis.

All this can sound pretty bleak but rest assured, there are some helpful guidelines, tips and resources out there for you so you can feel your best, even if you are living with gastroparesis.

How Did I Get Gastroparesis?

Gastroparesis is not hereditary and not a contagious bacteria. There are many instances that could cause someone to develop this condition but the number one cause is due to uncontrolled diabetes.


Hyperglycemia or increased glucose levels can delay gastric emptying causing gastrointestinal discomfort and can damage the vagus nerve. This nerve helps the stomach muscles move food through the digestive tract so any injury to the vagus nerve can slow down digestion and potentially damage blood vessels. This could decrease the amount of oxygen and nutrients your nerves need for healthy functioning.

If you find yourself experiencing hyperglycemia when suffering from diabetes, it may be helpful to administer insulin shots before a meal rather than after, and check glucose levels more often. Always consult with your doctor before engaging in any new medical routine to make sure it is suited for you.

Other causes that may lead to the development of gastroparesis include some esophageal or upper abdominal surgeries that particularly involve the vagus nerve. Viral infection and autoimmune disease can also initiate gastroparesis. Parkinson and Multiple Sclerosis can also affect the rate at which food is digested as muscle function decreases. A lot of these cases that stem from other illnesses or just appear are referred to as “idiopathic” meaning the exact cause is unknown. Everything in the body is connected and everyone reacts to medications and day to day life with a different set of circumstances, so it’s hard to determine who is susceptible. Even if you suffer from one of the conditions mentioned above, it does not mean you are en route to develop gastroparesis.

Signs and Symptoms

  • Heartburn

  • Nausea

  • Vomiting undigested food

  • Abdominal pain

  • Poor appetite

  • Weight loss

  • Early satiety (Feeling full with just a small meal)

If you find yourself suffering from any of these symptoms on an increased basis you should consult your doctor to see if a Gastroparesis test is right for you. These are different tests that can lead to a diagnosis including: scanning your abdomen after a light meal, a breath test, as well as an endoscopy. You and your doctor can decide together what the best path forward looks like.

If you suffer from a few of the above mentioned signs and symptoms every so often but are concerned, I would recommend keeping a food journal and recording any instances of discomfort or pain. Perhaps it is just a simple case of eating spicy food before bedtime and nothing to sound the alarm about. In any event, it’s always good to know how your body reacts to certain foods. Food journals are not always convenient but I think you’ll glean some interesting and surprising information about yourself along the way. If you do find yourself visiting your doctor, that information can be invaluable to starting a treatment plan.

What you really want to watch is how you feel after a meal and if you have lost more than 5lbs of your body weight unintentionally over a 1 month period. Unintentional weight loss is a reg flag that something is going on and needs professional attention. Seeking help early can mean the difference between a mild case with manageable resolutions as opposed too letting a condition go untreated for months and it turning into a severe case with malnutrition at the forefront.

Nutrition Intervention

There are several ways to navigate this tricky condition. What it ultimately comes down to is the severity of your case and what interventions work best for you. Some suggestions are:

  • Eating smaller meals throughout the day (5-6 light meals are recommended)

  • Chew your food well, in other words “Take your time and enjoy your meal.”

  • Consume all food and beverages sitting up and remain upright up to 1 hour after a meal

  • Avoid large meals with high fat content (fat is harder to digest and further delays gastric emptying)

  • A short 10 minute walk after eating could help improve stomach emptying

  • Avoid late night snacking

  • Avoid caffeine, alcohol and tobacco products (I know, it’s a big sacrifice but it may really help long term and then possibly add coffee/tea and one or two drinks back into your routine….I'm not giving you a pass on tobacco products though).

  • Control your blood sugar

  • Try a weight loss program if you are overweight

  • Do your best to manage stress

I fully understand that some of these are much easier to say than to do. Even something like “eat smaller and more frequent meals” can be confusing if you don’t know where to start or what foods to focus on.

Below I have included some materials from Cleveland Clinic that should help you get started. Click on this LINK to see the full Cleveland Clinic Gastroparesis Diet.


Cleveland Clinic Center for Human Nutrition, M17/ Digestive Disease Institute

Cleveland Clinic Center for Human Nutrition, M17/ Digestive Disease Institute


Although there's no exact cure for gastroparesis, simple modifications to your diet can offer some relief. I know life can also be really difficult if you don’t look sick but are in a lot of pain and discomfort just going about your day. People who don’t suffer from the same condition can have a hard time understanding where you are coming from and can be insensitive to what you are living with or how you are feeling. Try to stay positive and take things one meal at a time while charting your path to wellness, you are not alone. And Remember….Health starts from the inside out….but also from the ground up!


To discuss more detailed information regarding the topics within this blog, or to inquire about customized nutrition plans, please reach out to Cathleen Winter at cathleen@wellnesswithincw.com


A Little About Me

My name is Mary DeBlasio, and I live in Silver Spring, MD. I recently graduated Magna Cum Laude with a Bachelor of Science in Nutrition and Dietetics in May of 2021. I am very interested in mindful eating, and foods that correlate with the seasons. My goal after graduation is to pursue a dietetic internship with a focus on clinical dietetics. I would like to concentrate on patients suffering from gastrointestinal issues. All my information is backed by credible sources cited within the blog.


Sources

Diabetic gastroparesis. American Gastroenterological Association. (2020, December 14). https://gastro.org/practice-guidance/gi-patient-center/topic/diabetic-gastroparesis/#:~:text=Gastroparesis%2C%20or%20delayed%20gastric%20emptying,identified%20disease%20linked%20to%20gastroparesis.

Gastroparesis. Today's Dietitian. (n.d.). https://www.todaysdietitian.com/newarchives/070114p16.shtml.

Parrish, C. R., & Pastors, J. G. (2007). Nutritional management of gastroparesis in people with diabetes. Diabetes Spectrum, 20(4), 231–234. https://doi.org/10.2337/diaspect.20.4.231

Sawin-Johnson, K. N., & Packer, C. (2019). Norovirus-induced gastroparesis. Cureus. https://doi.org/10.7759/cureus.6283

U.S. Department of Health and Human Services. (n.d.). Symptoms & causes of gastroparesis. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/gastroparesis/symptoms-causes.

What is gastroparesis? About Gastroparesis. (2021, March 25). https://aboutgastroparesis.org/what-is-gastroparesis/.



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