Posted 4/4/2014 11:15 AM (GMT 0)
Hi, I don't have Chrone's, but do have Gastroparesis caused by a lupus flare. Gastroparesis is a partial or total paralysis of the stomach, resulting in delayed gastric emptying or bo gastric emptying, and is poorly understood with few treatment options and no cure. symptoms can range from mild to severe, and include stomach pain, bloating, early satiety (dealing full after very little food intake), GERD, nausea, vomiting, belching, difficulty swallowing, diarrhea or constipation, bezoars, obstructions, dehydration and malnutrition. The number and severity of symptoms varies from mild to severe from person to person. It is classified as either diabetic Gastroparesis, or Idiopathic Gastroparesis, but known causes of IGP are damage to the vagus nerve caused by illness or gastric surgery, viral infections, autoimmune diseases/connective tissue diseases such as Lupus, Scleroderma and Ehlers Danlos Syndrome, Parkinson's Disease and MSand many people have other GI disorders along with GP such as GERD, IBS, Chrone's, etc and can have digestive tract paralysis affecting more than just the stomach. Some medications slow gastric wmptyong and can cause temporary or permanent GP, most notably Opiod medication due to it's constipating affects, tho bot all taking opiods experience issues, as well as anticholinergics Treatments include low fiber, low fat diet if you tolerate food orally or keep it down, anti nauseas and anti emetics, prokinetics (Reglan, Erythromycin, and Domperidone), and in severe cases, jejunostomy tubes (enteral nutrition) to bypass the stomach and feed the small bowel when nausea and vomiting prevent adequate or any oral intake leading to dehydration, malnutrition and weight loss can be used. NJ tubes, J tubes and GJ tubes are commonly used, though a g-j or g tube, the g isn't used for feeding as it goes into the stomach, but for venting air or draining the stomach, or meds that can't go into the j tube, and can be placed either percutaneously under fluoroscopy in IR, or via open surgery. Another options for severe cases needing nutritional support is Total Parenteral Nutrition (TPN) which goes through a central line (PICC line, tunneled catheter or Port). Surgical options include Entera Gastric Stimulator (also known as a gastric pacer or pacemaker), gastric bypass such as a roux en y, or partial, sleeve gastrectomy or complete gastrectomy.
I have 2 surgical G-J tubes, 2 surgical J tubes, g tube replaced numerous times until tubes were no longer an option due to massive scar tissue and nerve damage and pain, an NJ tube that irritated esophageal lesions and due to gag reflux, induced further vomiting, and been on TPN and IV meds through 5 PICC lines (some temp or replacements after septic line infections) a Hickman, a port, a groshong, then a temporary improvement in symptoms allowing me to keep food down, and now awaiting another port placement on Tuesday to restart TPN/IV meds until I am cleared and have insurance approval for a roux en y, pyloroplasty and gall bladder removal where they will also clip abdominal adhesions from scar tissue from previous surgeries causing a partial obstruction hopefully before it becomes a total obstruction. Anyways, probably more than you wanted to know, but hope all went well and it ended up not being GP!