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Have you ever wondered what happens in your digestive system after you finish eating that yummy pack of Nasi Lemak?
Under normal circumstances, the food you ingested goes through a journey that starts at your mouth, takes a good stroll at your food tract and makes its way to the stomach for digestion. Then, the food must enter the small intestine for further digestion and a thorough absorption of nutrition. Eventually, it reaches the large intestine, where water and electrolytes absorption take place and waste is formed to be expelled as ‘poop’.
Now, all of us would agree that eating is a pleasurable experience, and the entire digestive process seems pretty straightforward. However, the truth is, the movement of our digestive system (called gastrointestinal motor function) is a complex sequence of events controlled by the nervous system resides in our brain, spinal cords, the walls of the stomach and intestines; as well as the collection of transmitters constantly released by the cells that controls the contraction and relaxation of smooth muscles in our intestines. These events are crucial to push the food we eat from our mouth to the large intestine.
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When there is a problem with the nerves and muscles that control how the stomach empties, it may result in a condition called gastroparesis. Gastroparesis is a long-term condition where the stomach cannot empty in the normal way. Food passes through the stomach slower than usual.
The most common cause of gastroparesis is diabetes. Individuals with type 1 diabetes generally have more severe symptoms of gastroparesis compared to those who suffer from type 2 diabetes. Obesity in diabetes can worsen gastroparesis.
Some medications can result in side effects which are similar to the symptoms of gastroparesis too. For instance:
Narcotics or opioid-based painkillers such as morphine and oxycodone
Glucagon-like peptide 1, a treatment for diabetes. Examples that belong to this group are exenatide and liraglutide
Cyclosporine, an immunosuppressant that is commonly used in autoimmune diseases and kidney transplant. However, tacrolimus, another similar medication to cyclosporine, does not cause such side effects.
Amitriptyline, a type of antidepressant (belongs to the tricyclic group) and also a treatment for neuropathic pain.
Other causes include medical conditions (such as Parkinson’s disease) and complications from surgery (such as weight loss surgery or surgeries involving the stomach).
Symptoms of gastroparesis may include:
Feeling full very quickly when eating (early satiety)
Feeling sick (nausea) and vomiting. The vomit substances may even contain food ingested several hours previously.
Loss of appetite
Bloating
Heartburn
In very severe cases, gastroparesis can lead to weight loss.
Before your doctor confirms that you have gastroparesis, he or she would arrange a blood test and run a relevant medical examination to rule out other causes of gastrointestinal disorders. The tests can include X-ray, endoscopy and gastric emptying scan.
To relieve the stomach discomfort caused by gastroparesis, your doctor may prescribe the following medications:
Metoclopramide — It’s a medication commonly given for nausea and vomiting. It improves gastric emptying. However, long-term treatment of metoclopramide may cause some side effects, such as drowsiness and dizziness. Rare but severe side effects may include hyperprolactinemia (breast enlargement or breast milk production) and abnormal muscle movements that occur on the face or limbs (called extrapyramidal effect).
Erythromycin — Although most people know erythromycin as an antibiotic, it actually has a function that has nothing to do with treating an infection, which is to treat gastroparesis. Erythromycin can also stimulate the contraction of the stomach, which helps to promote stomach movement. It can be given as a pill, liquid or injection.
Beside these medications,you may also adopt the following suggestions to improve symptoms of gastroparesis:
Avoid foods that are high in fat, acidic and spicy (say goodbye to that nasi lemak). This is because fatty food slows down gastric emptying, especially so if insoluble fibre is ingested too. Keep your diet low in fat and have less insoluble fibre. You may instead take in soluble fibre or fibre that has been cooked or made into juice so that it’s easier for digestion.
Take homogenized food (such as porridge) if cannot tolerate solid food
Avoid alcohol and carbonated drinks that can aggravate stomach pain
If you have frequent vomiting and/or diarrhoea due to gastroparesis, make sure that you stay hydrated and replenish your electrolytes well. This can be done by purchasing an oral rehydration salt (ORS) sachet from any pharmacy, dissolving it in water and drinking it as per the instruction from your healthcare provider.
Gastroparesis patients also tend to develop nutritional deficiencies in the long-run. Make sure you consult your doctor for a blood test and get recommendations on the types of supplements you should take for optimal health. If you have diabetes, make sure you adhere to your diabetes treatment and keep your blood sugar optimal.
If you have any questions related to stomach discomfort, you can consult our professional doctors and healthcare professionals on DOC2US. DOC2US is a mobile application that allows you to talk to a doctor or any healthcare professionals via text chat at any time and from anywhere. For better communication, you can even send our online doctor images or voice messages related to your medical inquiry.
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Disclaimer: As a service to our users and general public, DOC2US provides health education contents. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
Specific references have been linked in its relevant part of the article.
Cover image credit: https://www.scientificanimations.com, CC BY-SA 4.0 , via Wikimedia Commons
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