Gastrpirisis

aries

I’ve probably spelt it wrong.
I’ll get to the point.
I was diagnosed with  gastropirisis April, this year.

As my GP is terrified of having face to face consultations? I was told over the phone call not to have a conversation with her about anything she just wanted to see me.
obviously I asked her many questions about gastropirisis. She kept to her word and said your consultant will answer all your questions.

ive been waiting for that appt to come through for months and I’m still non the wiser?
I can google this which of course I have, but I’m becoming incontenant now?
I’m unsure if this is  part of the disease?
This has been going on for years, and to be able to function I live on Imodium but that doesn’t always work?

I can’t see  my appt being this year and would like to know if this is normal?

If you have any Comments or knowledge of this problem can you put my mind at rest. 

Thanks 

Aries 

Tori_Scope

Hi @aries  

As teddybear12 has said, many people are unfortunately experiencing long waits to get hospital appointments due to the pandemic, so you're not alone in your frustration.

Have you updated your GP to let them know that you're experiencing incontinence? I had a look on the NHS website, and it doesn't appear to be listed as one of the common symptoms, but it's important to get that checked out either way I think. 

Symptoms of gastroparesis may include:

• feeling full very quickly when eating

• feeling sick (nausea) and vomiting

• loss of appetite

• weight loss

• bloating

• tummy (abdominal) pain or discomfort

• heartburn

The following treatment options are listed on that same NHS page:

Treating gastroparesis

Gastroparesis cannot usually be cured, but dietary changes and medical treatment can help you control the condition.

Dietary changes

You may find these tips helpful:

• instead of 3 meals a day, try smaller, more frequent meals – this means there's less food in your stomach and it will be easier to pass through your system

• try soft and liquid foods – these are easier to digest

• chew food well before swallowing

• drink non-fizzy liquids with each meal

It may also help to avoid certain foods that are hard to digest, such as apples with their skin on or high-fibre foods like oranges and broccoli, plus foods that are high in fat, which can also slow down digestion.

Medicines

The following medicines may be prescribed to help improve your symptoms:

• domperidone – which is taken before eating to contract your stomach muscles and help move food along

• erythromycin – an antibiotic that also helps contract the stomach and may help move food along

• anti-emetics – medicines that can help to stop you from feeling or being sick

However, the evidence that these medicines relieve the symptoms of gastroparesis is relatively limited and they can cause side effects. Your doctor should discuss the potential risks and benefits with you.

Domperidone should only be taken at the lowest effective dose for the shortest possible time because of the small risk of potentially serious heart-related side effects.

Electrical stimulation

If dietary changes and medicine do not help your symptoms, a relatively new treatment called gastroelectrical stimulation may be recommended. However, this is currently not routinely funded by many NHS authorities.

Gastroelectrical stimulation involves surgically implanting a battery-operated device under the skin of your tummy.

Two leads attached to this device are fixed to the muscles of your lower stomach. They send electrical impulses to help stimulate the muscles involved in controlling the passage of food through your stomach. The device is turned on using a handheld external control.

The effectiveness of this treatment can vary considerably. Not everyone will respond to it, and for many people who do respond, the effect will largely wear off within 12 months. This means electrical stimulation is not suitable for everyone with gastroparesis.

There's also a small chance of this procedure leading to complications that would require removing the device, such as:

• infection

• the device dislodging and moving

• a hole forming in your stomach wall

Speak to your surgeon about the possible risks. You can also read the National Institute for Health and Care Excellence (NICE) guidelines on gastroelectrical stimulation for gastroparesis.

Botulinum toxin injections

More severe cases of gastroparesis may occasionally be treated by injecting botulinum toxin into the valve between your stomach and small intestine.

This relaxes the valve and keeps it open for a longer period of time so food can pass through.

The injection is given through a thin, flexible tube (endoscope) which is passed down your throat and into your stomach.

This is a fairly new treatment and some studies have found it may not be very effective, so it's not recommended by all doctors.

A feeding tube

If you have extremely severe gastroparesis that is not improved with dietary changes or medicine, a feeding tube may be recommended.

Many different types of temporary and permanent feeding tube are available.

A temporary feeding tube, called a nasojejunal tube, may be offered to you first. This is inserted into your digestive tract through your nose and delivers nutrients directly into your small intestine.

A feeding tube can also be inserted into your bowel through a cut (incision) made in your tummy. This is known as a jejunostomy.

Liquid food can be delivered through the tube, which goes straight to your bowel to be absorbed, bypassing your stomach.

Speak to your doctor about the risks and benefits of each type of feeding tube.

An alternative feeding method for severe gastroparesis is intravenous (parenteral) nutrition. This is where liquid nutrients are delivered into your bloodstream through a catheter inserted into a large vein.

Surgery

Some people may benefit from having an operation to insert a tube into the stomach through the tummy (abdomen). This tube can be periodically opened to release gas and relieve bloating.

A surgical procedure may be recommended as a last resort to either:

• create a new opening between your stomach and small intestine (gastroenterostomy)

• connect your stomach directly to the second part of your small intestine, called the jejunum (gastrojejunostomy)

These operations may reduce your symptoms by allowing food to move through your stomach more easily.

Your doctor can explain whether any procedures are suitable for you, and can discuss the possible risks involved.