Over the years I have talked with many parents whose babies have what they consider to be “slow stomach emptying” or “slow motility.” We found this to be true with one of our acid reflux babies as well. Until one of our daughters developed gastroparesis, we had no idea how bad it could really get
One winter my daughter Ava had a bout with a pretty nasty stomach bug that had been going around her school. It seemed like she was getting better until a weird phenomenon started. She began eating poorly and never got back to her pre-stomach bug appetite. Every three days or so she would throw up everything in her stomach. It would appear to be food from days before. The cycle repeated itself for weeks! Her pediatrician finally diagnosed her with post-viral gastroparesis.
Gastroparesis is a condition that reduces the ability of the stomach to empty stomach contents. Some of the symptoms of gastroparesis include nausea, vomiting, feeling full after very little food, bloating, increased acid reflux symptoms, low appetite and eventually weight loss. Post-viral gastroparesis, like Ava had, is a form of gastroparesis that occurs when the digestive tract is “shocked” by a virus. It isn’t always a stomach virus that does the damage; it can be a virus of any kind.
The stomach uses strong muscular contractions, called peristalsis, to move food through the digestive tract. In gastroparesis those muscles stop working correctly and food just sits in the stomach. When food sits in the stomach for longer than intended, stomach acid has more opportunity to bounce up into the esophagus. So when an adult or child already has acid reflux disease, the addition of gastroparesis can make the condition significantly worse.
In Ava’s case she was already very tiny (she is 9 years old and just now 50 pounds) so any additional weight loss was somewhat scary to consider. Her pediatrician recommended giving her easily digested foods, watching her closely, and waiting for the gastroparesis to subside. They warned us that if she was not able to keep food down soon she may need to be fed through a NG-tube. This kind of tube feeding is placed through the nose and into the stomach. Liquid nutrition would have been slowly fed into her stomach until she was able to eat and sustain those calories on her own. An NG tube had the added benefit of being able to slowly introduce calories overnight while she was sleeping as well.
Fortunately for us, Ava’s bout with post-viral gastroparesis resolved on its own after a total of about four to six weeks of symptoms. Thankfully, she never needed a tube feeding to make up for the calories lost, although it took her months to get back to her normal weight.
Tips to get through gastroparesis:
- If you or your child is diagnosed with gastroparesis, it is important to keep up with your acid reflux medications unless directed otherwise by your physician. Gastroparesis can increase the frequency of reflux episodes. If you are not taking your medication, then you could end up with more issues like esophagitis, a painful inflammation of the esophagus.
- Identify if you could be taking other medications that might be making the gastroparesis worse. Narcotic pain medications, muscle relaxants, certain cancer medications and some antidepressants can contribute to the problem. DO NOT stop taking these medications without your doctor’s permission but DO ask your physician if they could be making your condition worse and what steps to take.
- Discuss any other medical problems you have that could also be contributing to the gastroparesis with your physician. Diabetes, hypothyroid disease, scleroderma, Parkinson’s disease, bulimia or recent infections could be part of the problem. Sometimes your pre-existing conditions need to be monitored more closely or their treatments adjusted to deal with the gastroparesis.
- Try to eat smaller, more frequent meals of easily digested foods. Low-fiber foods, pureed foods and low-fat foods tend to be easier to digest. Smoothies made with low-fat yogurt can be good because they are easily digested and contain probiotics than can help the GI tract.
- Moderate exercise, like a short walk, can help the digestive tract move food along. Nothing too strenuous… or you may end up wearing your food.
- Ask your doctor about medications to help relieve the nausea like zofran, meclazine or phenergan. Medications to move the stomach contents through faster include Reglan and Erythromycin. These medications have side effects so they must be used after a risk vs. benefit analysis.
If you have tried all of these things and are still having problems with gastroparesis then it may be time to seek a specialist’s opinion. A gastroenterologist or GI doctor can help tailor additional treatments to your problem.