Gastric Bypass, the Sleeve, and Gastroparesis

I have seen, recently, in the support groups questions about the gastric bypass, sleeve, etc. I wanted to share with you the year's worth of research that I have been doing so that if you are considering a gastric bypass or a sleeve, you can be well informed. My doctor keeps trying to push a gastric bypass on me, but that is not going to fix the nerve damage to my vagus nerve. Personally, I don't want it because I'm scared it will cause more problems than it's worth. I've had friends pass away from complications due to gastric bypasses. In fact, three days ago when I was in the emergency room, a lady came in who had a gastric bypass done and was vomiting up blood. This is a decision that you will have to make for yourself but I wanted to share the information I've gathered so that you can decide if this is for you. Sources are included below. There are a lot of hoops to jump through in order to get a gastric bypass or sleeve. Each doctor is different on their requirements.

The information below will also go into detail the differences between the bypass and the sleeve. Before you make the decision to have surgery (and I know a lot of you are desperate for relief), make time to talk to support groups with other gastroparesis patients so that they can give you advice. I would also recommend writing down any questions/concerns that you may have for the doctor, lest you forget or the doctor is in such a hurry that you don't have time to think of questions while you're in the doctor's exam room. Be your own advocate. Additionally, I would get a second opinion, just to be on the safe side. You should meet with a nutritionist too, since your diet may be a bit different from others getting a gastric bypass. You and the nutritionist should work together to come up with a plan if you choose to have this surgery. There is also a new Facebook support group for those who have had it done, and also combat Gastroparesis: GASTROPARESIS AFTER BARIATRIC SURGERY.

Roux-en-Y Gastric Bypass:http://www.saintlukeshospitals.com/roux-en-y-gastric-bypass.php


This surgery is not for everyone, and I've already decided it's not for me...but I hope this research will help you make the right decision for you. Again, if your gastroparesis is caused by vagus nerve damage, removing parts of your stomach may not help. It also will not stop the vomiting.

Gastric Endoscopic Myotomy Showing Promise for Gastroparesis

This is an article copied from: http://www.medscape.com/viewarticle/863847#vp_1. I like to go back and read interesting breakthroughs when it comes back to gastroparesis treatment. Also, if you have had this procedure done, please email me your story: emilysstomach[at[gmail.com and I will include your story in this article, and whether it did or didn't work for you to let other GPers know. So far, the only clinic I know that does this procedure is Emory in Atlanta, GA.

Gastric Endoscopic Myotomy Showing Promise for Gastroparesis
By: Caroline Helwick
May 25, 2016

FDA Approves Gastroparesis Test for Any Clinical Setting
Nortriptyline Minimal Benefit in Gastroparesis
Ghrelin Receptor Agonist Improves Diabetic Gastroparesis
RELATED DRUGS & DISEASES
Kidney-Pancreas Transplantation
All nine of the study patients were refractory to conventional treatment — including gastric electrical stimulation in two patients — for at least 6 months, had severe symptoms, had been hospitalized at least twice in the previous 6 months, and had disturbed gastric emptying.

Mean procedural time was 48 minutes. There were no peri- or postoperative complications, and all patients could eat 2 days after surgery and were discharged by day 5.

Clinical efficacy was very high; 85% of the patients had improved significantly after 1 month. One of the failures was a recurrence at 2 months in a diabetic patient with renal insufficiency.

Gastroparesis Cardinal Symptom Index (CGSI) score decreased from 3.5 before the procedure to 0.9 at 1 month (P < .001) and 1.1 at 3 months (P < .001). Improvements were also significant for nausea, vomiting, abdominal pain, gastric fullness, and early satiety at 3 months (P <.001 for all), but not for anorexia. Time to half gastric emptying was significantly better after the procedure than before (133 vs 222 minutes; P < .001). Improved quality of life was reported by 63% of patients. Table. Gastric Emptying Mean Residual Percentage Before G-POEM, % After G-POEM, % P Value At 2 hours 76 40 <.001 At 4 hours 44 19 NS Dr Gonzalez acknowledged that long-term follow-up is needed for these patients, as are prospective studies, which his group has initiated. Dr Khashab said G-POEM can be considered not only for patients with recurrent hospitalizations, but also "for any patient with nausea and vomiting that significantly affects their quality of life, even without hospitalization." Although some patients respond to simple medical therapy, metoclopramide carries a black-box warning for tardive dyskinesia "and is only marginally effective," and antiemetics provide only symptomatic relief, Dr Khashab pointed out. Before attempting G-POEM, endoscopists should be skilled at esophageal POEM, he added. Dr Gonzalez offered a few procedural tips: "Start at the 5 o'clock position from the pylorus, keep checking your direction, and stop at the pyloric arch." Dr John Vargo These results come from small case series, but they show "intriguingly positive results" in terms of symptomatic response and gastric emptying tests, said John Vargo, MD, from the Cleveland Clinic's Digestive Disease and Surgery Institute. "G-POEM is definitely something we have to look at," Dr Vargo Medscape Medical News. "For these patients, pharmacologic treatments are imperfect; medications have many different side effects. We do have another avenue with gastric pacing, but again, this approach is in its infancy." "I'm hopeful G-POEM will help these very sick people who have a very challenged quality of life," he said. "It's good to see these results, and I look forward to longer follow-up and a larger series of patients." Dr Khashab, Dr Gonzalez, and Dr Vargo have disclosed no relevant financial relationships. Digestive Disease Week (DDW) 2016: Abstracts Mo2015 and 715. Presented May 23, 2016.

Drug Interactions and Gluten Intolerance

The doctors like to give people who suffer from Gastroparesis a drug called Erythromycin, but only if they feel like it's a last resort.









This drug will help motility as a SIDE EFFECT. You probably want to pay close attention to side effects because some of them can be sneaky. For instance, Phenergan (promethazine) has a keep out of direct sunlight side effect and can cause dizziness when you're exposed to heat (a big thanks goes out to Melony for pointing that out). To read more about Phenergan's side effects, please click HERE.

According to the Mayo Clinic, Erythromycin belongs to the class of medications known as macrolide antibiotics. It works by killing bacteria or preventing their growth. What you may NOT know about Erythromycin though, is that it's not always gluten free.

There is a particular brand (Abbot Labs) that is gluten free. If you have a gluten intolerance, you need to make sure that your pharmacy knows so that the pharmacist can catch gluten drug interactions on your behalf. If you are unsure of whether or not you have a gluten intolerance, please click HERE for more information.

If you want to advocate for yourself, in addition to letting your pharmacy know about a gluten allergy, here is a list of drugs that are gluten free. You can read the list by clicking HERE.

Drug interactions are important to catch, for your safety. What is a drug interaction, you ask? Simple. According to Wikipedia, a drug interaction is a situation in which a substance (usually another drug) affects the activity of a drug when both are administered together. This action can be synergistic (when the drug’s effect is increased) or antagonistic (when the drug’s effect is decreased) or a new effect can be produced that neither produces on its own. Typically, interactions between drugs come to mind (drug-drug interaction). However, interactions may also exist between drugs and foods (drug-food interactions), as well as drugs and medicinal plants or herbs (drug-plant interactions).

For instance, I was just placed on Cipro for an infection that I have right now. Cipro is a strong, broad spectrum antibiotic but it has a drug interaction with the muscle relaxer I take for stomach spasms (Zanaflex). The Cipro will make the Zanaflex build up in my blood stream, so I can't take them together at all. I have to finish the Cipro before I can start my Zanaflex again.

Your pharmacy will have their own drug interaction checkers online, depending on who you use. Walgreens and CVS both have one. In addition to those, you can also use this one, by clicking HERE or HERE, just to be on the safe side. You can never be too cautious and the pharmacy doesn't always catch everything. It's really important for you to advocate for yourself and to make sure that you use the same pharmacy with all medications as well as make sure that the doctors you see have the full list of medications you're on.