Treatments for Gastroparesis

Treatment list for Gastroparesis:

The list of treatments mentioned in various sources for Gastroparesis includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.

• Diabetic blood sugar control
• Medications
  • Prokinetics
  • Metoclopramide (Reglan)
  • Erythromycin - although an antibiotic, it also helps digestion
  • Domperidone
  • Antiemetics - to avoid vomiting
• Diet changes
  • Smaller meals, liquid meals, low-fat diet, low-fiber diet
• Endoscopic injections - for bezoars
• Feeding tube (jejunostomy tube) - a tube directly into the intestine bypassing the stomach; severe cases only
• Intravenous feeding (Parenteral nutrition) - severe cases only; often for temporary relief in hospitalization

Treatments of Gastroparesis: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the treatments of Gastroparesis.

Intestinal obstruction: Treatment (Tx)
(Professional Guide to Diseases (Eighth Edition))

Surgery, nasogastric tube, total parenteral nutrition, supportive care (I.V. fluids, bed rest)

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Intestinal obstruction: Treatment
(Handbook of Diseases)

Initial therapy involves correcting fluid and electrolyte imbalances, resting the bowel by decompressing it to relieve vomiting and distention, maintaining nothing by mouth status, and treating shock and peritonitis. A strangulated obstruction usually necessitates blood replacement as well as I.V. fluid administration. Nasogastric tube suction is necessary to relieve vomiting and abdominal distention.

Close monitoring of the patient’s condition determines the duration of treatment; if the patient fails to improve or if his condition deteriorates, surgery is necessary. Surgery is performed on all patients with large-bowel obstruction.

Total parenteral nutrition may be appropriate if the patient suffers a protein deficit from chronic obstruction, postoperative or paralytic ileus, or infection.

Drug therapy includes an analgesic and a sedative. An antibiotic is given for peritonitis due to bowel strangulation or infarction. A broad-spectrum antibiotic should be given to provide anaerobic and gram-negative coverage.

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Medications used to treat Gastroparesis:

Note:You must always seek professional medical advice about any treatment or change in treatment plans.

Some of the different medications used in the treatment of Gastroparesis include:

• Metoclopramide - mainly used to treat gastroparesis in diabetics
• Apo-Metoclop - mainly used to treat gastroparesis in diabetics
• Clopra - mainly used to treat gastroparesis in diabetics
• Emex - mainly used to treat gastroparesis in diabetics
• Gatrobid - mainly used to treat gastroparesis in diabetics
• Maxeran - mainly used to treat gastroparesis in diabetics
• Maxolon - mainly used to treat gastroparesis in diabetics
• Octamide - mainly used to treat gastroparesis in diabetics
• Reclomaide - mainly used to treat gastroparesis in diabetics
• Reglan - mainly used to treat gastroparesis in diabetics
• Cisapride
• Entheropride
• Kinestase
• Prepulsid
• Unamol

Unlabelled alternative drug treatments include:

• Macrolide antibiotics - mainly used to treat gastroparesis in diabetics
• Azithromycin - mainly used to treat gastroparesis in diabetics
• Zithromax - mainly used to treat gastroparesis in diabetics
• Clarithromycin - mainly used to treat gastroparesis in diabetics
• Biaxin - mainly used to treat gastroparesis in diabetics
• Biaxin XL - mainly used to treat gastroparesis in diabetics
• Biaxin XL Pac - mainly used to treat gastroparesis in diabetics
• Erythromycin - mainly used to treat gastroparesis in diabetics
• Apo-Erythro Base - mainly used to treat gastroparesis in diabetics
• Apo-Erythro E-C - mainly used to treat gastroparesis in diabetics
• Apo-Erytrho-ES - mainly used to treat gastroparesis in diabetics
• Apo-Erythro-S - mainly used to treat gastroparesis in diabetics
• E.E.S - mainly used to treat gastroparesis in diabetics
• E.E.S. 200 - mainly used to treat gastroparesis in diabetics
• E.E.S. 400 - mainly used to treat gastroparesis in diabetics
• E-Mycin Controlled Release - mainly used to treat gastroparesis in diabetics
• E-MycinE - mainly used to treat gastroparesis in diabetics
• E-Mycin 333 - mainly used to treat gastroparesis in diabetics
• Eramycin - mainly used to treat gastroparesis in diabetics
• Erybid - mainly used to treat gastroparesis in diabetics
• ERYC - mainly used to treat gastroparesis in diabetics
• EryPed - mainly used to treat gastroparesis in diabetics
• Eryphar - mainly used to treat gastroparesis in diabetics
• Ery-Tab - mainly used to treat gastroparesis in diabetics
• Erythrocin - mainly used to treat gastroparesis in diabetics
• Erythromid - mainly used to treat gastroparesis in diabetics
• Ethril - mainly used to treat gastroparesis in diabetics
• ETS-2% - mainly used to treat gastroparesis in diabetics
• Ilosone - mainly used to treat gastroparesis in diabetics
• Ilotycin - mainly used to treat gastroparesis in diabetics
• Novo-Rythro - mainly used to treat gastroparesis in diabetics
• PCE - mainly used to treat gastroparesis in diabetics
• Pediamycin - mainly used to treat gastroparesis in diabetics
• Pediazole - mainly used to treat gastroparesis in diabetics
• PMS-Erythromycin - mainly used to treat gastroparesis in diabetics
• Robimycin - mainly used to treat gastroparesis in diabetics
• SK-Erythromycin - mainly used to treat gastroparesis in diabetics
• Wyamycin E - mainly used to treat gastroparesis in diabetics
• Wyamycin S - mainly used to treat gastroparesis in diabetics

Discussion of treatments for Gastroparesis:

It is important to note that in most cases treatment does not cure gastroparesis--it is usually a chronic condition. Treatment helps you manage the condition so that you can be as healthy and comfortable as possible.

Insulin for blood glucose control in people with diabetes

If you have gastroparesis, your food is being absorbed more slowly and at unpredictable times. To control blood glucose, you may need to

• Take insulin more often.
• Take your insulin after you eat instead of before.
• Check your blood glucose levels frequently after you eat, administering insulin whenever necessary.

Some doctors recommend taking two injections of intermediate insulin every day and as many injections of a fast-acting insulin as needed according to blood glucose monitoring. The newest insulin, lispro insulin (Humalog), is a quick-acting insulin that might be advantageous for people with gastroparesis. It starts working within 5 to 15 minutes after injection and peaks after 1 to 2 hours, lowering blood glucose levels after a meal about twice as fast as the slower-acting regular insulin. Your doctor will give you specific instructions based on your particular needs.

Medication

Several drugs are used to treat gastroparesis. Your doctor may try different drugs or combinations of drugs to find the most effective treatment.

• Metoclopramide (Reglan). This drug stimulates stomach muscle contractions to help empty food. It also helps reduce nausea and vomiting. Metoclopramide is taken 20 to 30 minutes before meals and at bedtime. Side effects of this drug are fatigue, sleepiness, and sometimes depression, anxiety, and problems with physical movement.

• Erythromycin. This antibiotic also improves stomach emptying. It works by increasing the contractions that move food through the stomach. Side effects are nausea, vomiting, and abdominal cramps.

• Domperidone. The Food and Drug Administration is reviewing domperidone, which has been used elsewhere in the world to treat gastroparesis. It is a promotility agent like cisapride and metoclopramide. Domperidone also helps with nausea.

• Other medications.Other medications may be used to treat symptoms and problems related to gastroparesis. For example, an antiemetic can help with nausea and vomiting. Antibiotics will clear up a bacterial infection. If you have a bezoar, the doctor may use an endoscope to inject medication that will dissolve it.

Changing your eating habits can help control gastroparesis. Your doctor or dietitian will give you specific instructions, but you may be asked to eat six small meals a day instead of three large ones. If less food enters the stomach each time you eat, it may not become overly full. Or the doctor or dietitian may suggest that you try several liquid meals a day until your blood glucose levels are stable and the gastroparesis is corrected. Liquid meals provide all the nutrients found in solid foods, but can pass through the stomach more easily and quickly.

The doctor may also recommend that you avoid fatty and high-fiber foods. Fat naturally slows digestion--a problem you do not need if you have gastroparesis--and fiber is difficult to digest. Some high-fiber foods like oranges and broccoli contain material that cannot be digested. Avoid these foods because the indigestible part will remain in the stomach too long and possibly form bezoars.

Feeding tube

If other approaches do not work, you may need surgery to insert a feeding tube. The tube, called a jejunostomy tube, is inserted through the skin on your abdomen into the small intestine. The feeding tube allows you to put nutrients directly into the small intestine, bypassing the stomach altogether. You will receive special liquid food to use with the tube. A jejunostomy is particularly useful when gastroparesis prevents the nutrients and medication necessary to regulate blood glucose levels from reaching the bloodstream. By avoiding the source of the problem--the stomach--and putting nutrients and medication directly into the small intestine, you ensure that these products are digested and delivered to your bloodstream quickly. A jejunostomy tube can be temporary and is used only if necessary when gastroparesis is severe.

Parenteral nutrition

Parenteral nutrition refers to delivering nutrients directly into the bloodstream, bypassing the digestive system. The doctor places a thin tube called a catheter in a chest vein, leaving an opening to it outside the skin. For feeding, you attach a bag containing liquid nutrients or medication to the catheter. The fluid enters your bloodstream through the vein. Your doctor will tell you what type of liquid nutrition to use.

This approach is an alternative to the jejunostomy tube and is usually a temporary method to get you through a difficult spell of gastroparesis. Parenteral nutrition is used only when gastroparesis is severe and is not helped by other methods. (Source: excerpt from Gastroparesis and Diabetes: NIDDK)

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