Saturday, February 14, 2015

GP Awareness Day!!!

For all of you that thought today was Valentine's Day, you'd be mistaken. I know that's what Hallmark wants you to think,but in reality it's Gastroparesis Awareness Day!

So instead of wearing red and pink and eating heart shaped food, wear green and don't eat anything! Okay, just kidding about the not eating part =) But seriously, GP needs awareness. I hadn't heard of it until I started dealing with these medical issues, and I've met multiple doctors and who knows how many people who don't know what it is. It's hard to effectively treat something who no one knows what it is.

So here are some facts about GP to spread some awareness and share information about dealing with this condition.

Gastroparesis is caused by damage to or the miscommunication of the vagus nerve. The vagus nerve is the main nerve in the body responsible for the parasympathetic nervous system (PNS) response. The PNS is responsible for the "rest and digest" functions in the body, including digestion in the stomach and intestines. When this nerve and the smaller nerves that branch off from it are damaged or not working properly these processes don't work well or at all.

Normal digestion begins in the stomach and once the food has begun to break down, it is moved into the intestines to continue digestion. With GP, the vagus nerve may not stimulate the stomach to begin digestion, might not trigger peristalsis (contraction and relaxation of the gut muscles to move food along), and might not stimulate the pancreas and/or gall bladder to secrete the digestive enzymes and bile needed to help digestion. Every case of GP can presently slightly differently.

It can cause pain, nausea, vomiting, diarrhea, constipation, bloating, distension, and more. Again, every person is different and the symptoms can vary. One day can have more pain than nausea another day can be non-stop vomiting...there is no way to predict what each day will bring. I deal with all of these symptoms at one time or another. The biggest ones for me are pain and nausea. I take multiple medications every day right now to help keep them at manageable levels so I can function. On days when things are really bad, I have emergency medications to take that make me really sleepy or shakey. I can't drive or focus well when I take those so they are a last resort. Some days, my symptoms get so bad I cannot keep down any of my medications at home...that's when we end up in the ER so I can get IV medications. It's day-to-day how I am able to manage my symptoms.

There are two main diagnostic tests for GP. One is the Gastric Emptying Study. In this test, a small amount of radioactive material is injected into either eggs or oatmeal and the patient has to eat a certain amount of the food. The test is approximately 4 hours and every half hour the patient stands in front of a machine similar to a Geiger counter to measure how much of the radioactive material is still in the stomach. The other test is a SmartPill study which is what I had. This test can measure motility all the way through the digestive tract, not just the stomach. For this I had to swallow a pill that measures pH, temperature, and where it is in the GI system. The patient wears a wireless (obviously =P) recorder that collects the data as the pill moves through.

Unfortunately, just receiving a diagnosis of GP is not necessarily the end of digestive issues. There is no cure for GP. However, sometimes GP can be a symptom of an underlying condition. It is common in diabetes and dysautonomia, both of which effect the vagus nerve. When it is caused by an underlying condition, treating that condition typically results in improvement in GP symptoms. We are hoping this is the case for me.

MCAS is a systemic disorder meaning it can have effects throughout the body. Mast cells are located along the nerves so they can have effects on the nervous system and how the vagus nerve and enteric nervous system in the gut function. In addition, mast cells are located throughout the GI tract and can cause inflammation. The combination of these two effects can result in motility issues. By stabilizing the mast cells, both the inflammation and nerve responses can be calmed down which *hopefully* will resolve GP issues.

So that's a quick overview of GP and how it effects me and is related to MCAS. I hope that this is informative and hopefully can help someone else as they are dealing with GP and related issues.

Happy Valentine's Day! Happy Gastroparesis Awareness Day!

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