Issue link: https://www.epageflip.net/i/53866
Saturday, January 28, 2012 – Daily News 5A Changes in medication can relieve gastro paresis Q: My mother has Type 1 dia- betes. She was recently diagnosed with gastroparesis, which gives her severe abdominal pain and leaves her with very little appetite. She is suffering terribly with this disease. Are there spe- cial diet changes that would help make the condition more man- ageable? What are her other treat- ment options? wonder drug, and surgery is not an answer. A: Gastroparesis is the term used for sluggish emptying of food from the stomach into the small intestine. This condition is not caused by a physical blockage. Instead, the stom- ach muscles do not contract properly, reducing the stomach's ability to empty its contents. This causes fluid and food to linger far longer than normal. Gastroparesis can be an extremely troubling complication of diabetes. The chief culprit is damage to the nerves that control flow of food from the stomach into the intestine. Elevated blood glucose levels can also contribute to the problem. A normal stomach moves about half of an average meal into the small intes- tine within two hours after you eat. With- in four hours, about 90 percent of the meal has been emptied into the small intestine. In a person with gastroparesis, like your mother, food stays in the stom- ach much longer. Nausea and upper abdominal pain are common symptoms. It may become difficult to keep a full meal down. People with serious cases may eat so little they become dangerous- ly thin and malnourished. Although diabetes is the leading cause of gastroparesis, other problems can also interfere with normal stomach function. A wide variety of medications can slow stomach evacuation, including anti- histamines, tricyclic antidepressants, cal- cium-channel blockers and opioid painkillers (codeine, oxycodone and oth- ers). Some people suffer from gastropare- sis after they recover from a gastroin- testinal viral infection. Neurological dis- eases such as multiple sclerosis and Parkinson's disease can also affect how well the stomach does its job. Treating gastroparesis is a challenge for patients and their doctors. There's no Dr. K by Anthony L. Komaroff, M.D. One of the first things people can do is to limit — or even avoid — fatty and fiber-rich foods that are known to linger in the stomach. Eating frequent small meals rather than three large ones is recommended. If diabetes is the presumed cause, then optimal blood sugar control should be a goal. A number of medications have been used to try to improve gastric emptying. One of them, cisapride (Propulsid), looked promising, but it was pulled off the market over 10 years ago because of cardiac side effects. Domperi- done (Motilium), a drug that increases contractions of the small intestine and stomach, is sometimes helpful. But it hasn't been approved for sale in the Unit- ed States. Metoclopramide (Maxolon, Reglan) is available in this country and can be effective. However, one serious but rare side effect makes doctors reluctant to prescribe it at full dosage or for extended periods. This possible — but unlikely — side effect is tardive dyskinesia, an invol- untary movement disorder that is often irreversible. Some doctors prescribe very low doses of erythromycin, an antibiotic. Erythromycin can speed up movement of the stomach. However, its long-term suc- cess rate is mediocre, at best. If gastroparesis doesn't respond to medication or dietary changes, and the person is becoming seriously malnour- ished, other interventions may be neces- sary. One option is a feeding tube. There are also devices called gastric pacemak- ers. These devices stimulate the stomach to contract and have shown some benefit in research studies. But they are a last- ditch measure. The same goes for surgi- cal approaches, which are rarely used these days. There is no fast fix for a sluggish stomach. But with careful attention to detail, your mother may be able to get some relief from gastroparesis. Submit questions to harvard_adviser@hms.harvard.edu. The office of Dr. Theresa Asato, local Optometrist and Associate of Dr. Jack Fennel is dutifully and respectfully announcing that after 35 years of practicing and serving the eyecare needs of Red Bluff and surrounding communities Dr. H. Jack Fennel has retired. We are so thankful for Dr. Fennel and his service to the Red Bluff community and wish him and his family the best for many retirement years to come. Dr. Asato has been an associate of Dr. Fennel for 24 years. Now she is proud to announce the addition of Dr. Mitch Martin to the practice. Dr Mitch Martin was born and raised in Sitka, Alaska. He attended both California Lutheran University and Pacific University and received his Bachelor of Science from Pacific University in 1992. In 1996, he received his Optometric Physician Degree from Pacific University College of Optometry. Dr. Martin then served a one-year residency at the Portland Veterans Administration Medical Center where he specialized in diabetic eye disease, geriatrics, and primary eye care. He was an adjunct clinical professor for Pacific University, a member of the American Optometric Association, and served as a liaison to the U.S. Congress. He has been in family private optometric practice for the last fifteen years. Dr. Martin and his wife Jill have a son Xavier, and daughter Sofia. Dr. Martin is active in many community, church, and outdoor activities, including: coaching youth sports, Boy Scouts of America, Rotary and Lion's club, golf, hunting, and fishing. Dr. Martin is thankful for the warm welcome and trust that he has received from Tehama County and the surrounding areas. We look forward to continuing the tradition of providing comprehensive vision care for the families of the greater Red Bluff region. We are always accepting new patients and welcome your call to set up an appointment with Dr. Asato or Dr. Martin at 530-527-2211. Our office is located at 1031 Washington St., Red Bluff CA. 96080 Donate your non-perishable food items February 1st through 14th The perfect time to show just how much you care! Food Banks are depleted after the Holiday Season...last year this campaign brought dona- tions of 8,000 lbs of food-this year the project is City Wide aiming for 20,000. There will be a drawing from among food donors and 8 gift certificates valued at $25 each will be awarded to individual food donors. Only one donation per family per location, please! Look for the specially marked boxes and make your heartfelt donation at any of our participating merchants Adobe Road Chevron Amundson Physical Therapy Antelope Veterinary Hospital Balloons & More Bob's Tire Center Bud's Jolly Kone BR Growing Supplies Cabernet Apartments California Kitchen & Co Care Net Pregnancy Center Carmona's Appliance Catherine Salas Allstate Insurance Co Compassionate Health Center Cornerstone Community Bank Countryside Cafe Corp Cozy Diner Crossroads Feed & Ranch Dale's Carpet & Design Discover Earth Dolling Insurance Durango RV Resort Edward Jones – Susie Mustaine Edward Jones –Tyler Smail Ehorn's Antiques Elmore Pharmacy Express Employment Professionals Finders Keepers Thrift & Antiques First Love Tattoo Flower Boutique Francisco's Taqueria Gary Ramsey Jewelers Gregg R. 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All families are welcome including C.C.R.E. and Cal Works families! CPR certified/instructor Affordable rates/ very flexible hours (here we understand that no one works 9-5 anymore) Please give us a call; we look forward to hearing from you and your family! 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