Gastroparesis, or delayed gastric emptying that causes bloating, regurgitation, and early satiety, can be a problem in the neurodegenerative disorders in our group, especially in MSA and LBD. Gastroparesis can lead to weight loss and dehydration.
One gentleman in our local support group with a clinical diagnosis of MSA but a pathologically confirmed diagnosis of LBD had gastroparesis. It was the worst symptom he had.
Online friend Vera James posted to an MSA-related Yahoo!Group a link to a terrific article on gastroparesis. Here’s a link to the article, available at no charge:
www.practicalgastro.com/pdf/December06/WoArticle.pdf
Motility and Functional Disorders of the Stomach: Diagnosis and Management of Functional Dyspepsia and Gastroparesis
Practical Gastroenterology
December 2006
by John M. Wo and Henry P. Parkman
See pages 37-45 especially.
The section on “Treatment” is particularly good. These points are discussed in detail:
* eating smaller, more frequent meals
* relying on liquid nutrient
* limiting fatty foods
* avoid salads, raw foods, and red meat
* antiemetic medications. “The most commonly prescribed traditional antiemetic drugs include promethazine and prochlorperazine.”
* prokinetic medications such as metoclopramide, domperidone (not available in the US), and erythromycin.
* botulinum toxin injection
* gastric electrical stimulation
* jejunal feeding, rather than PEG feeding
I’ve copied below the “Gastroparesis Cardinal Symptom Index.”
Robin
—————————–
Table 4. The Gastroparesis Cardinal Symptom Index
1. Nausea (feeling sick to your stomach as if you were going to vomit or throw up)
2. Retching (heaving as if to vomit, but nothing comes up)
3. Vomiting
4. Stomach fullness
5. Not able to finish a normal-sized meal
6. Feeling excessively full after meals
7. Loss of appetite
8. Bloating (feeling like you need to loosen your clothes)
9. Stomach or belly visibly larger
Each symptom is graded by the patient on a 0 to 5 scale: 0=none; 1= very mild, 2=mild, 3=moderate, 4=severe, 5=very severe.
From Revicki DA, Rentz AM, Dubois D, Kahrilas P, Stanghellini V, Talley NJ, Tack J. Aliment Pharm Ther, 2003;18:141.