Vitamin Deficiencies; Causes, Signs, and Symptoms

What Causes Vitamin Deficiencies?

According to Right Diagnosis, vitamin deficiencies are caused when you are not able to have the nutrients your body needs to thrive. With Gastroparesis, our diet is strict and we cannot eat certain foods to replenish those vitamins. For me personally, I vomit up almost everything I eat, so I am unable to get the vitamins I need. A lot of GPers are the same way. I am going to list each vitamin deficiency and the signs and symptoms of each.

How to Test for Vitamin Deficiencies and What to Look Out For.

If you suspect or identify with any of the vitamin deficiency symptoms below, please make an appointment with your doctor to be tested. Dr. Oz has a video that you can view by clicking HERE that contains four easy steps to self test for vitamin deficiencies.

According to Fox News, there are five unusual warning signs that you may be vitamin-deficient. The good news: Most are fixable with dietary tweaks. However, if that doesn't work, please make an appointment with your doctor to discuss other options. The warning signs are:

Body Clue No. 1: Cracks at the corners of your mouth.

Body Clue No. 2: A red, scaly rash on your face (and sometimes elsewhere) and hair loss. (For more information on hair loss in relation to vitamin deficiencies, please visit: https://www.hairlossrevolution.com/vitamin-d-deficiency/)

Body Clue No. 3: Red or white acne-like bumps, typically on the cheeks, arms, thighs, and butt.

Body Clue No. 4: Tingling, prickling, and numbness in hands, feet, or elsewhere.

Body Clue No. 5: Crazy muscle cramps in the form of stabbing pains in toes, calves, arches of feet, and backs of legs.

Additionally, I am going to walk through each vitamin deficiency so that you know what the signs and symptoms are to watch out for.



Vitamin A Deficiency; What Causes It?

Vitamin A can be deficient due to dietary issues. According to Wikipedia, iron deficiency can affect vitamin A uptake. Excess alcohol consumption can deplete vitamin A, and a stressed liver may be more susceptible to vitamin A toxicity. People who consume large amounts of alcohol should seek medical advice before taking vitamin A supplements. In general, people should also seek medical advice before taking vitamin A supplements if they have any condition associated with fat malabsorption such as pancreatitis, cystic fibrosis, tropical sprue & biliary obstruction.

Infection is very draining on vitamin A reserves and this vitamin A deficit leaves the individual more susceptible to infection (Combs, 1991, Wikipedia).

According to Right Diagnosis, other causes for a vitamin A deficiency are:

Malabsorption

Inadequate diet

Malnutrition

Certain lipid-lowering medications



Vitamin A Deficiency; Signs and Symptoms.


The symptoms of a vitamin A deficiency are:


Reduced night vision

Night blindness

Dry eyes (the inability to produce tears)

Eye inflammation

Corneal inflammation

Rough skin

Dry skin

Vulnerability to respiratory infection

Vulnerability to urinary infection

Growth retardation in children

What Causes a Vitamin B1 (Thiamine) Deficiency?

According to article writer, Paul Simms, a vitamin B1 deficiency can occur because of many different causes. The most basic form of thiamine deficiency results simply because the individual does not consume enough of the vitamin in the food sources they eat. Vitamin B1 deficiency can also be caused by a problem absorbing the nutrient in the small intestines. There are several disease states that can cause this, but the most usual cause is over consumption of alcohol, which inhibits vitamin B1 absorption. Because vitamin B1 is necessary for energy production in cells, the most notable symptoms are related to low energy levels. These can be very striking when involving the brain because brain cells require large amounts of energy to function properly, and when functioning improperly, the effects are quite visible and dramatic.

There are three general causes of vitamin B1 deficiency. The first is caused when not enough thiamine is consumed in the foods eaten by the individual. The can be because of poor food choices, or because the food is prepared improperly. It is very easy to accidentally destroy or remove vitamin B1 during cooking and boiling. Diseases that effect the small intestines can also greatly reduce the amount of vitamin B1 that is absorbed from the foods that are eaten. Finally, the most common cause of vitamin B1 deficiency in the western world is the over consumption of alcohol. Alcohol prevents thiamine and many other nutrients from ever being absorbed by the small intestines.

Here is what vitamin B1 does for your body:

Vitamin B1 (Thiamine) Signs and Symptoms.

There are many basic symptoms that are associated with vitamin B1 deficiency. In most cases, these symptoms can be reversed easily if nutritional levels of vitamin B1 are increased or if supplements are given. Most of these symptoms result from the beginning stages of cellular starvation. Simply put, the cells do not have the energy to function any longer. In the brain, these symptoms include depression, irritability and memory loss. In muscle cells, a short term vitamin B1 deficiency will result in muscle fatigue, tenderness and weakness. The peripheral nervous system can also be effected, with symptoms such as pins-and-needles, poor coordination and slowed reflexes.

In more severe and long term cases of vitamin B1 deficiency, a disease called Beriberi will result. This is a severe condition that can lead to death. Symptoms of Beriberi disease caused by vitamin B1 deficiency include extreme weight loss, emotional imbalances (anger,depression),muscle weakness, and pain in the extremities. The individual will also often lose control of the use of arms and legs temporarily. The most dangerous aspect of Beriberi disease is it's effect on the heart. congestive heart failure and death is a real possibility when vitamin B1 deficiency has reached this level of severity.

Another condition that can develop either individually, or in association with Beriberi disease is Wernicke's encephalopathy and/or Korsakoff syndrome. These are severe mental conditions that result in amnesia, impaired sensory perception, mental confusion and loss of control of motor skills. These conditions usually result in the patient being deranged and uncontrollable. When the vitamin B1 deficiency reaches the stages where it causes these symptoms and disorders, much of the damage is no longer reversible. It is also important to note that the major cause of the severe of a case of thiamine deficiency is chronic alcohol abuse.

The symptoms include:

Vomiting

Involuntary eye movements (nystagmus)

Mental confusion

Speech difficulties

Pain

Weight loss

Difficulty walking (loss of balance and coordination)

Emotional disturbances

Impaired sensory perception

Loss of muscle function or paralysis of the lower legs

Weakness and pain in the limbs

Tingling or loss of feeling (sensation) in hands and feet (numbness)

Periods of irregular heart rate

Edema (swelling of bodily tissues)

It may increase the amount of lactic acid and pyruvic acid within the blood. In advanced cases, the disease may cause high output cardiac failure and death (other symptoms are described in Wernicke's encephalopathy in Wikipedia).

What Causes a Vitamin B3 (Niacin) Deficiency?

According to Web MD, Niacin deficiency is a condition that occurs when a person doesn't get enough or can't absorb niacin or tryptophan (the ingredient that makes you sleepy found in turkeys). Tryptophan is one of the amino acids that makes up protein. Your liver can convert tryptophan from high-protein foods like meats and milk into niacin.

Also known as vitamin B3 or nicotinic acid, niacin is one of eight B vitamins. Like all B vitamins, niacin plays a role in converting carbohydrates into glucose, metabolizing fats and proteins, and keeping the nervous system working properly. Niacin also helps the body make sex- and stress-related hormones and improves circulation and cholesterol levels.

In the 1800s, pellagra was common among poor Americans whose diets consisted mostly of corn, molasses, and salt pork -- all poor sources of niacin. Today, most people in the developed world get plenty of niacin in their diets. Niacin deficiency is more likely to be caused by problems that affect absorption of niacin or tryptophan. The most common cause is alcoholism. Other possible causes include disorders of the digestive system and prolonged treatment with the tuberculosis drug isoniazid (Laniazid, Nydrazid).




Vitamin B3 (Niacin) Signs and Symptoms.

Symptoms of mild niacin deficiency include:

Indigestion

Fatigue

Canker sores

Vomiting

Depression

Severe deficiency, called pellagra, can cause symptoms related to the skin, digestive system, and nervous system. They include:

Thick, scaly pigmented rash on skin exposed to sunlight

Swollen mouth and bright red tongue

Vomiting and diarrhea

Headache

Apathy

Fatigue

Depression

Disorientation

Memory loss

If not treated, pellagra can lead to death.

If you don't eat a lot of niacin-rich foods or if you have a medical condition that affects the absorption of niacin or tryptophan, speak to your doctor. Niacin supplements or multivitamin/mineral supplements, which usually contain at least 20 milligrams of niacin, can help prevent niacin deficiency.

What Causes a Vitamin B12 Deficiency?

According to Web MD, vitamin B12 has many important functions in the body. It works with the B vitamin folate to make our body's genetic material. It helps keep levels of the amino acid homocysteine in check, which may help decrease heart disease risk, and it is essential to the production of red blood cells, which carry oxygen through the blood to the body's tissues.

But many people are deficient in this important vitamin.

Vitamin B12 deficiency can have a number of possible causes. Typically it occurs in people whose digestive systems do not adequately absorb the vitamin from the foods they eat.

This can be caused by:

Pernicious anemia, a condition in which there is a lack of a protein called intrinsic factor. The protein, which is made in the stomach, is necessary for vitamin B12 absorption.

Atrophic gastritis, a thinning of the stomach lining that affects up to 30% of people aged 50 and older.

Surgery in which part of the stomach and/or small intestine is removed.

Conditions affecting the small intestine, such as Crohn's disease, celiac disease, bacterial growth, or a parasite.

Excessive alcohol consumption.

Autoimmune disorders, such as Graves' disease or systemic lupus erythematosus.

Long-term use of acid-reducing drugs.

Gastroparesis (which I'm going to add because it affects absorption).


Vitamin B12 deficiency can also occur in vegetarians, because the best food sources of the vitamin are animal products. Strict vegans (people who don't eat any animal products, including meat, eggs, or milk) are at greatest risk. Vegetarians who eat eggs and milk products are also at risk, because, on average, they consume less than half the adult Recommended Dietary Allowance (RDA) of vitamin B12. Babies born to mothers who are vegetarians may also be deficient in vitamin B12.

Vitamin B12 Deficiency; Signs and Symptoms.

A deficiency of vitamin B12 can lead to vitamin B12 deficiency anemia. A mild deficiency may cause only mild, if any, symptoms. But as the anemia worsens it may causes symptoms such as:

Weakness, tiredness or light-headedness

Rapid heartbeat and breathing

Pale skin

Sore tongue

Easy bruising or bleeding, including bleeding gums

Stomach upset and weight loss

Diarrhea or constipation

Anemia

If the deficiency is not corrected, it can damage the nerve cells. If this happens, according to Harvard, vitamin B12 deficiency effects may include:

Tingling or numbness in fingers and toes

Difficulty walking

Mood changes or depression

Memory loss

Disorientation

Dementia

Yellowed skin (jaundice)

Difficulty thinking and reasoning (cognitive difficulties), or memory loss

Paranoia or hallucinations

What Causes a Vitamin C Deficiency?

The essential vitamin known as vitamin C is one of the most important elements in an individual’s daily diet, according to Discovery Health. We need Vitamin C to help contribute to good cellular growth, promote function of the circulatory system, and generally help our bodies to develop and maintain themselves. A vitamin C deficiency is a serious issue, and should be caught early and treated with natural foods or dietary supplements that contain plenty of this critical ingredient.

Vitamin C is destroyed by the process of pasteurization, so babies fed with ordinary bottled milk sometimes suffer from scurvy (which is a disease resulting from a vitamin C deficiency)if they are not provided with adequate vitamin supplements. Virtually all commercially available baby formulas contain added vitamin C for this reason, but heat and storage destroy vitamin C.

With Gastroparesis, it is hard for us to eat citrus or other foods that are high in vitamin C, so we become deficient. However, if you juice and can tolerate it, try and incorporate as much vitamin C as you can.

Vitamin C Deficiency; Signs and Symptoms.

According to Fit Day, a variety of symptoms will show that an individual is suffering from a vitamin C deficiency. Here are some of the top signs of this kind of shortage in the system.

Fatigue – Early on, someone with a vitamin C deficiency will tend to get tired easily and experience reduced energy. Because chronic fatigue is a symptom of so many illnesses, it can be hard to catch a specific condition based on this symptom.

Mood Changes – Individuals with a vitamin C deficiency may become irritable or short tempered.

Weight Loss – As with other “wasting conditions” someone with a vitamin C deficiency may experience sudden weight loss.

Joint and Muscle Aches – Chronic pain in the limbs or joints can be a symptom of a vitamin deficiency.

Bruising – Individuals with a vitamin C deficiency will tend to bruise easily. Excessive bruising is a sign that the body’s chemistry needs to be improved.

Dental Conditions – Just as a healthy daily dose of vitamin C contributes to healthy teeth and gums, a deficiency can cause deterioration of the gums. Periodontal problems are a symptom of a vitamin C deficiency that has been allowed to develop to a hazardous level. This kind of deficiency was classically called "scurvy" when it happened to mariners who had no access to nutrients (or sometimes even fresh water) on long trips at sea. In today’s world, it is a rare but frightening condition.

Dry Hair and Skin – A change in hair and skin conditions can also signal that the body is not getting enough of vitamin C and other essential vitamins and minerals.

Infections – When an individual does not have enough vitamin C over time, this can have a negative impact on general healing of wounds and the fighting of infections. Generally, the body’s immune system will be compromised.

A shortage of vitamin C in the system can be treated with dietary supplements. However, it’s important to seek professional medical help, rather than self-medicating with natural medicine. Vitamin C supplements are generally not known to have side effects, although at extremely high levels, they can cause nausea or indigestion. Those who experience any of the above negative symptoms should see qualified family practice doctors to talk about what may be the issue and whether a dietary deficiency may be the root cause.

What Causes a Vitamin D Deficiency?

According to Web MD, Vitamin D deficiency can occur for a number of reasons:

You don't consume the recommended levels of the vitamin over time. This is likely if you follow a strict vegetarian diet, because most of the natural sources are animal-based, including fish and fish oils, egg yolks, cheese, fortified milk, and beef liver.

Your exposure to sunlight is limited. Because the body makes vitamin D when your skin is exposed to sunlight, you may be at risk of deficiency if you are homebound, live in northern latitudes, wear long robes or head coverings for religious reasons, or have an occupation that prevents sun exposure.

You have dark skin. The pigment melanin reduces the skin's ability to make vitamin D in response to sunlight exposure. Some studies show that older adults with darker skin are at high risk of vitamin D deficiency.

Your kidneys cannot convert vitamin D to its active form. As people age their kidneys are less able to convert vitamin D to its active form, thus increasing their risk of vitamin D deficiency.

Your digestive tract cannot adequately absorb vitamin D. Certain medical problems, including Crohn's disease, cystic fibrosis, gastroparesis, and celiac disease, can affect your intestine's ability to absorb vitamin D from the food you eat.

You are obese. Vitamin D is extracted from the blood by fat cells, altering its release into the circulation. People with a body mass index of 30 or greater often have low blood levels of vitamin D.

Vitamin D Deficiency; Signs and Symptoms.

The best way to discover vitamin D deficiency is to take a blood test that will measure the level of the vitamin in your blood. You can either ask your doctor to administer the test or buy a home test kit do the test yourself. However, you are certainly vitamin D deficient if you have any of the following ailments, and you need to consult with your doctor regarding your preventive, as well as curative, options as soon as possible, according to Natural News.


Symptoms of bone pain and muscle weakness can mean you have a vitamin D deficiency. However, for many people, the symptoms are subtle. Yet even without symptoms, too little vitamin D can pose health risks. Natural News says the following,

1.) The flu - In a study published in the Cambridge Journals, it was discovered that vitamin D deficiency predisposes children to respiratory diseases. An intervention study conducted showed that vitamin D reduces the incidence of respiratory infections in children.

2.) Muscle weakness - According to Michael F. Holick, a leading vitamin D expert, muscle weakness is usually caused by vitamin D deficiency because for skeletal muscles to function properly, their vitamin D receptors must be sustained by vitamin D.

3.) Psoriasis - In a study published by the UK PubMed central, it was discovered that synthetic vitamin D analogues were found useful in the treatment of psoriasis.

4.) Chronic kidney disease - According to Holick, patients with advanced chronic kidney diseases (especially those requiring dialysis) are unable to make the active form of vitamin D. These individuals need to take 1,25-dihydroxyvitamin D3 or one of its calcemic analogues to support calcium metabolism, decrease the risk of renal bone disease and regulate parathyroid hormone levels.

5.) Diabetes - A study conducted in Finland was featured in Lancet.com in which 10,366 children were given 2000 international units (IU)/day of vitamin D3 per day during their first day of life. The children were monitored for 31 years and in all of them, the risk of type 1 diabetes was reduced by 80 percent.

6.) Asthma - Vitamin D may reduce the severity of asthma attacks. Research conducted in Japan revealed that asthma attacks in school children were significantly lowered in those subjects taking a daily vitamin D supplement of 1200 IU a day.

7.) Periodontal disease - Those suffering from this chronic gum disease that causes swelling and bleeding gums should consider raising their vitamin D levels to produce defensins and cathelicidin, compounds that contain microbial properties and lower the number of bacteria in the mouth.

8.) Cardiovascular disease - Congestive heart failure is associated with vitamin D deficiency. Research conducted at Harvard University among nurses found that women with low vitamin D levels (17 ng/m [42 nmol/L]) had a 67 percent increased risk of developing hypertension.

9.) Schizophrenia and Depression - These disorders have been linked to vitamin D deficiency. In a study, it was discovered that maintaining sufficient vitamin D among pregnant women and during childhood was necessary to satisfy the vitamin D receptor in the brain integral for brain development and mental function maintenance in later life.

10.) Cancer - Researchers at Georgetown University Medical Center in Washington DC discovered a connection between high vitamin D intake and reduced risk of breast cancer. These findings, presented at the American Association for Cancer Research, revealed that increased doses of the sunshine vitamin were linked to a 75 percent reduction in overall cancer growth and 50 percent reduction in tumor cases among those already having the disease. Of interest was the capacity of vitamin supplementation to help control the development and growth of breast cancer specially estrogen-sensitive breast cancer.

Low blood levels of the vitamin have been associated with the following:

Increased risk of death from cardiovascular disease

Cognitive impairment in older adults

Severe asthma in children

Cancer

Research suggests that vitamin D could play a role in the prevention and treatment of a number of different conditions, including type1 and type 2 diabetes, hypertension, glucose intolerance, and multiple sclerosis.

These various health conditions associated with vitamin D deficiency need not be something to fear. A proactive approach to prevention can assist in the avoidance of the many chronic diseases associated with vitamin D deficiency. For one, thousands of dollars can be saved, not to mention the peace of mind, simply at the cost of taking a walk under the sun. Save the umbrellas for the rainy days.

What Causes a Vitamin K Deficiency?

According to Paul Simms, a writer on the subject, vitamin K deficiency is rarely seen on its own, it is usually the result of another problem within the body. Not only is Vitamin K found in a large variety of easily obtainable foods such as vegetables and dairy products, it is also synthesized by bacteria in the small intestines where it is absorbed into the body. The body is also very efficient at recycling Vitamin K; each molecule can be used multiple times before degrading.

The most frequent cause of Vitamin K deficiency is the long term use of antibiotics. Since about half of the Vitamin K in the body is produced by bacteria in the small intestines, the use of antibiotics, which kill that bacteria will lead to a drastic decrease in the amount of Vitamin K available for absorption. For this reason, individuals taking antibiotics are often given Vitamin K supplements. Related to this, often times newborn infants will have a Vitamin K deficiency, not because of antibiotics destroying the beneficial bacteria, but because the bacteria has not had time to properly populate the small intestines.

Another reason an individual might develop a Vitamin K deficiency is because of an illness, injury or disease that affects the small intestines and prevents the absorption of the nutrient. Inflammatory bowel disease or other chronic diseases of the intestines often result in deficiencies of many different vitamins and minerals because the cells lining the intestines are unable to extract the nutrients before they pass through the body.

The final reason for the appearance of many symptoms of Vitamin K deficiency is because of liver damage or disease. After being absorbed by the small intestines, Vitamin K is processed into it's functioning forms in the liver. When there is damage to the liver, like is seen in cases of alcoholism or Hepatitis, sometimes the processing of the Vitamin K is diminished to the extent that it cannot perform its functions.

Vitamin K Deficiency; Signs and Symptoms.

According to Newsmax, deficiency of vitamin K results in serious complications such as prolonged blood clotting time and an increased risk to haemorrhages. Inadequate intake of vitamin K can lead to a deficiency. The best way to counter the symptoms of vitamin K deficiency would be to add foods like soybeans, leafy vegetables (spinach and broccoli), wheat bran, berries, etc. in the diet.

Signs of vitamin K deficiency:

Deficiency of vitamin K causes delayed blood coagulation, gum bleeding, nose bleeding, easy bruising, and tendencies toward nose-bleeding and gum-bleeding. Symptoms and signs of vitamin K deficiency further include bleeding within the digestive tract

Appearance of blood in urine or stool and experiencing heavy bleeding during menstrual cycle are also signs of vitamin K deficiency.

Deficiencies of vitamin K are not very common among adults, but newborns are found to be at a higher risk as breast milk is typically low in vitamin K and the infant’s natural vitamin K cycle may not be fully developed.

Signs of vitamin K deficiency include weakening of bones, osteoporosis, and fractures.

Other symptoms of vitamin K deficiency are hardening of heart valves, owing to calcification, purpurea, and neural tube defects.

A deficiency of vitamin K can affect a new-born baby or fetus as well. Vitamin K deficiency may result in internal bleeding (in the skull), malformed fingers, and under-developed facial features like ears, nose, and chin. Vitamin K helps in the overall development of the fetus. This explains why a pregnant woman is usually given vitamin K in the form of food supplements.

Hemorrhages are also among the signs and symptoms of a vitamin K deficiency. Deficiency of vitamin K leads to a reduction in the prothrobin content of blood. If you are deficient in vitamin K, you will suffer from blood clotting. Deficiency of vitamin K can also lead to Alzheimer’s disease.

Other prominent signs and symptoms of vitamin K deficiency are prolonged clotting times, hemorrhaging, and anemia.

Vitamin K deficiency-related symptoms lead to excessive deposition of calcium in soft tissues. Hardening of the arteries or calcium-related problems are the other common signs of vitamin K deficiency. So are biliary obstruction, malabsorption, cystic fibrosis, and resection of the small intestine.

Here are some charts that go along with vitamin deficiencies that I wanted to include:

List of Sources:

http://listverse.com/2012/03/16/top-10-vitamin-deficiencies/

http://www.dummies.com/how-to/content/signs-of-vitamin-deficiencies-in-your-diet.html

http://www.doctoroz.com/videos/4-easy-self-tests-vitamin-deficiencies

http://en.wikipedia.org/wiki/Avitaminosis

http://www.mayoclinic.com/health/vitamin-deficiency-anemia/DS00325

http://www.webmd.com/diet/vitamin-d-deficiency

http://www.rightdiagnosis.com/v/vitamin/causes.htm

http://www.doctoroz.com/videos/4-easy-self-tests-vitamin-deficiencies

http://www.emilysstomach.com/2013/06/information-about-malnutrition.html

http://www.helium.com/items/1802449-vitamin-b1-thiamine-deficiency---causes-symptoms-side-effects

http://www.health.harvard.edu/blog/vitamin-b12-deficiency-can-be-sneaky-harmful-201301105780

Information about Malnutrition

What is Malnutrition?

What is Malnutrition? Malnutrition describes both the nutritional value and the amount of food a person consumes. While not eating enough food clearly causes malnutrition, bad nourishment can also leave you malnourished. According to the World Food Program, when a person is not getting enough food or not getting the right sort of food, malnutrition is just around the corner. Disease is often a factor, either as a result or contributing cause. Even if people get enough to eat, they will become malnourished if the food they eat does not provide the proper amounts of micronutrients - vitamins and minerals - to meet daily nutritional requirements.

Good nutrition is critical to overall health and well-being, but with Gastroparesis, it's even harder to get the vitamins and minerals that your body needs in order to sustain yourself. When you cannot keep food that contains nutrients your body needs down, it becomes a huge problem - almost a hole that you cannot dig yourself out of.

How Does Malnutrition Start?

According to the Mayo Clinic, the causes of malnutrition might seem straightforward: too little food or a diet lacking in nutrients. Malnutrition can occur as a result of inadequate food intake, digestive disorders, problems with absorption and other medical conditions, according to Medline Plus. Excess consumption of alcohol can also lead to malnutrition and vitamin deficiencies. Malnutrition is often caused by a combination of physical, social and psychological issues. For example:

Health concerns. Adults often have health issues (in our case, Gastroparesis) that can lead to decreased appetite or trouble eating, such as chronic illness, use of certain medications, difficulty swallowing or absorbing nutrients, or trouble chewing due to dental issues. A recent hospitalization might be accompanied by loss of appetite or other nutrition problems. In other cases, a diminished sense of taste or smell decreases appetite. Dementia also can contribute to malnutrition.

Restricted diets. Dietary restrictions — such as limits on salt, fat, protein or sugar — can help manage certain medical conditions, but might also contribute to inadequate eating.

Limited income. People might have trouble affording groceries, especially if they're taking expensive medications. Also, gluten free products tend to be more expensive than food that contains gluten. Additionally, when you are on a specific diet like the Gastroparesis diet from Mayo or FOODMAP, those foods tend to be a bit more expensive.

Reduced social contact. Adults who eat alone might not enjoy meals, causing them to lose interest in cooking and eating. I found this interesting. I forget to eat if no one is home because I am usually not hungry. If someone does not remind me to eat, I don't.

Depression. Grief, loneliness, failing health, lack of mobility and other factors might contribute to depression — causing loss of appetite. When your social life is nonexistent due to Gastroparesis, it does make you depressed. I speak from personal experience. I have issues leaving my house because of vomiting and nausea, so that contributes to my lack of appetite.

Problems Caused By Malnutrition

According to the Mayo Clinic and Medicine Plus, malnutrition can cause:

A weak immune system, which increases the risk of infections

Poor wound healing

Muscle weakness, which can lead to falls and fractures

Lack of specific nutrients in your diet. Even the lack of one vitamin can lead to malnutrition.

An unbalanced diet

Certain medical problems, such as malabsorption syndromes and cancers

In addition, malnutrition can lead to further disinterest in eating or lack of appetite — which only makes the problem worse. Additionally, with Gastroparesis, you may not have an appetite to begin with.

Symptoms may include fatigue, dizziness and weight loss, low energy, easy bruising and slow wound healing, or you may have no symptoms. Your doctor will do tests, depending on the cause of your problem. Treatment may include replacing the missing nutrients and treating the underlying cause.

Signs of malnutrition can vary depending on which nutrients are lacking in the diet. Malnourishment can compromise the immune system and make people more vulnerable to illness. If left untreated, malnourishment can lead to illness, physical disability and even death.

What are the Signs and Symptoms of Malnutrition?

According to LiveStrong, malnutrition can affect every system in the body, depending upon the cause of the malnutrition. In mild to moderate cases of malnutrition, no symptoms or signs may be evident; however, as the condition persists, the signs and symptoms will become more pronounced.

The most common symptoms of malnutrition include significant weight loss, weight gain (distension of the belly), fatigue, dizziness, anemia, dry skin, edema, bone and joint pain, brittle nails, and loss of hair color, according to Lab Tests Online.

These can become apparent at any point after the lack of nutrients is realized by the body. When weight loss is the only symptom, doctors sometimes make a diagnosis based on the body mass index (BMI) of the patient, which takes into account age, gender, height and weight. Your doctor may order a series of blood tests that will determine if you are malnourished by your vitamin levels. However, there are symptoms that you can look out for below:

Oral Symptoms. Swollen and/or bleeding gums are the first oral symptoms of malnutrition. As the malnutrition continues, the teeth may begin to decay. When only the gums are affected, the oral effects of malnutrition can be reversed; however, once the teeth begin to decay, the damage is permanent.

Musculoskeletal Symptoms. Fragile bones, osteoporosis and muscle loss and/or weakness are symptoms of malnutrition. When calcium or vitamin D are the nutrients lacking, these symptoms may manifest shortly after the body becomes malnourished.

Mental Symptoms. Malnutrition can cause a slowed reaction time. However, in the elderly population, malnutrition may cause dementia and/or memory loss.

Decreased Organ Function. As malnutrition ravages the body, the organs may begin to function less efficiently. This can lead to heart problems, decreased liver function, kidney failure, decreased lung capacity, intestinal problems, stomach irregularities and abnormal menstrual cycles in females.

Abdominal Symptoms. Ascites, which manifests as a swollen or bloated abdomen, is a sign of malnutrition. This condition is exacerbated when the liver, kidneys or intestinal tract is affected.

Dry Skin. People with malnutrition may develop abnormally dry skin, despite the use of lotions and creams. In severe cases, the skin may begin to crack.

Treatment for Malnutrition

According to LiveStrong, treatment for malnutrition focuses on correcting the malnutrition and restoring normal weight. If malnutrition is caused by inadequate food consumption, an increase in food intake is recommended. If malnutrition occurs as a result of underlying medical conditions, it is necessary to correct the condition. Once the condition is corrected, the malnutrition usually corrects itself with a proper, balanced diet.

However, with Gastroparesis, it's hard to eat meals that replenish nutrients and vitamins because of our recommended diet. Talk with your doctor. They can prescribe vitamin injections to help with your malnourishment and send you to a nutritionist to go over a better, or more thorough diet plan. Below is the B-12 injection I take to bring up some of my vitamin levels because I'm malnourished.

List of Sources:

http://www.wfp.org/hunger/malnutrition

http://www.livestrong.com/article/18046-signs-symptoms-malnutrition/#ixzz2WDfJKTo

http://www.webmd.boots.com/a-to-z-guides/tc/malnutrition-symptoms-of-malnutrition

http://health.nytimes.com/health/guides/disease/malnutrition

http://www.livestrong.com/malnutrition-symptoms/

http://www.wfp.org/hunger/malnutrition

http://www.mayoclinic.com/health/senior-health/HA00066

http://www.nlm.nih.gov/medlineplus/malnutrition.html

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My First Botox Injection

As most of you probably already know, one of the experimental treatments for Gastroparesis is a Botox injection into the stomach through endoscopy.

According to the Mayo Clinic, Botulinum toxin A (BOTOX) is a powerful inhibitor of muscle contraction. Botox is a nerve toxin most commonly known for its use in treating skin wrinkles but is experimental for Gastroparesis. Botox can be injected through an endoscope to relax muscles in the GI tract, including the lower esophageal sphincter (end of the esophagus) in achalasia, and the pylorus (end of the stomach) in patients with Gastroparesis. Researchers have found that Botox injections relax the pyloric muscle in some people, thereby allowing the stomach to release more food into the small intestine. The benefits are temporary, however, and more studies are needed to determine the overall usefulness of this treatment.

I've read about it, did research on it, and asked people I knew who had it done questions about the procedure and if they would recommend it. Everyone I talked to had a great experience with it, so I decided that it couldn't hurt. Besides that, I was miserable and desperate.

So, I'm going to walk you through the botox injection procedure, step by step in what I went through today.

I have to admit I was nervous when I arrived at the hospital because I didn't know what to expect since I've never done this before. As soon as I walked in, I checked into the GI department. After I registered, I sat in the waiting room for a while.

The nurse called me back and put my fancy ID bracelet on. She gave me a gown and told me to put all of my stuff in a plastic bag. I had to strip down to my underwear for the hospital gown. After I was ready, she came back in and placed my plastic bag under my stretcher so that it could ride with me. She also logged all of my valuables.

She went ahead and applied the electrodes to monitor my heart rhythm, applied a blood pressure, and an oxygen sensor to take my vital signs. She tried to stick me for an IV, but missed the vein. So, they had to call in the IV team. Thankfully, the nurse on the IV team got me on the first try but had to use a really tiny needle for the IV because of my tiny veins. I was actually impressed because it usually takes them about six tries before they get it right.

The nurse gave me Zofran through the IV because I was extremely nauseated (since I couldn't eat or drink after midnight nor take my medications) while I was waiting.

I had a visit from the anesthesiologist and the doctor to make sure I didn't have any allergies, adverse reactions, etc.

Then, it was time to take me back for the endoscopy. If you've never had an endoscopy, the doctor uses an instrument to examine the interior of a hollow organ or cavity of the body. Unlike most other medical imaging devices, endoscopes are inserted directly into the organ and in this case, my stomach.

Below is an endoscope, image from Wikipedia:

Once I was in the room, the nurse had me lay on my side, facing away from the screen that the camera projects on to. She put oxygen in my nose and told me to open my mouth and bite down on a solid green circle, which would hold my mouth open for the camera to pass through.

The top picture is the bite block for an endoscope and the bottom picture is where the bite block goes. Source HERE.

The anesthesiologist then began to push the medications to put me to sleep for the endoscope. The first medication he pushed into my IV made my ears ring like crazy and made me a bit dizzy. The second one he told me would burn, and it did! It burned all of the way up my arm, so much so that I had tears in my eyes. It didn't hurt for very long because I woke up in recovery after that.

In recovery, the doctor visited my husband and myself. He said that if this doesn't help me, he would refer me to Augusta to a motility specialist there. After he left the room, the nurse came in, took my vital signs, and readied my discharge papers. She disconnected my IV, I got dressed, and she wheeled me out to my husband in our waiting car. That's all there was to it!

I was still groggy when I got home so I slept most of the day. I will tell you that I'm having stomach spasms because of the injection today. I was told it would take a few days to subside. So, I will keep you updated on my progress. In the meantime, check out some pictures my husband took of me in recovery. I look so thrilled!

Sleep Deprivation's Effects on the Brain and Your Body

Sleep Deprivation



The immediate effects of skimping on sleep are obvious. You're groggy, unfocused, sluggish and dying for a nap (or a second cup of coffee). Then there are the sneakier signs you're overtired: You're overly emotional, starving and clumsier than usual. Most of the time, a solid night's sleep will solve all these problems.

The average adult needs about seven to nine hours of sleep each night, according to the National Sleep Foundation, but most of us don't even get that much. But getting too little sleep - generally understood to mean six hours or less a night - can be serious - enough to change your genes, even! Source HERE.

I have missed several nights of sleeps due to vomiting, nausea, and/or pain. I started to wonder, how will this affect my body long term? So, I started to do some research, curious as to why the doctors never address my sleeping issues. The articles I found were very enlightening.

First, let's address sleep deprivation. What is it? According to the National Heart, Lung, and Blood Institute, sleep deprivation is,

Sleep deprivation (DEP-rih-VA-shun) is a condition that occurs if you don't get enough sleep. Sleep deficiency is a broader concept. It occurs if you have one or more of the following:

You don't get enough sleep (sleep deprivation)

You sleep at the wrong time of day (that is, you're out of sync with your body's natural clock)

You don't sleep well or get all of the different types of sleep that your body needs

You have a sleep disorder that prevents you from getting enough sleep or causes poor quality sleep



Sleeping is a basic human need, like eating, drinking, and breathing. Like these other needs, sleeping is a vital part of the foundation for good health and well-being throughout your lifetime.

Sleep deficiency can lead to physical and mental health problems, injuries, loss of productivity, and even a greater risk of death. To understand sleep deficiency, it helps to understand how sleep works and why it's important. The two basic types of sleep are rapid eye movement (REM) and non-REM.

Non-REM sleep includes what is commonly known as deep sleep or slow wave sleep. Dreaming typically occurs during REM sleep. Generally, non-REM and REM sleep occur in a regular pattern of 3–5 cycles each night.



The sleep cycle



Your ability to function and feel well while you're awake depends on whether you're getting enough total sleep and enough of each type of sleep. It also depends on whether you're sleeping at a time when your body is prepared and ready to sleep.

You have an internal "body clock" that controls when you're awake and when your body is ready for sleep. This clock typically follows a 24-hour repeating rhythm (called the circadian rhythm). The rhythm affects every cell, tissue, and organ in your body and how they work.

If you aren't getting enough sleep, are sleeping at the wrong times, or have poor quality sleep, you'll likely feel very tired during the day. You may not feel refreshed and alert when you wake up.

Sleep deficiency can interfere with work, school, driving, and social functioning. You might have trouble learning, focusing, and reacting. Also, you might find it hard to judge other people's emotions and reactions. Sleep deficiency also can make you feel frustrated, cranky, or worried in social situations.

The signs and symptoms of sleep deficiency may differ between children and adults. Children who are sleep deficient might be overly active and have problems paying attention. They also might misbehave, and their school performance can suffer.

Sleep deficiency is a common public health problem in the United States. People in all age groups report not getting enough sleep.

As part of a health survey for the Centers for Disease Control and Prevention, about 7–19 percent of adults in the United States reported not getting enough rest or sleep every day.

Nearly 40 percent of adults report falling asleep during the day without meaning to at least once a month. Also, an estimated 50 to 70 million Americans have chronic (ongoing) sleep disorders.

Sleep deficiency is linked to many chronic health problems, including heart disease, kidney disease, high blood pressure, diabetes, stroke, obesity, and depression [and let's go ahead and add in Gastroparesis].

Sleep deficiency also is associated with an increased risk of injury in adults, teens, and children. For example, driver sleepiness (not related to alcohol) is responsible for serious car crash injuries and death. In the elderly, sleep deficiency might be linked to an increased risk of falls and broken bones.

In addition, sleep deficiency has played a role in human errors linked to tragic accidents, such as nuclear reactor meltdowns, grounding of large ships, and aviation accidents.

A common myth is that people can learn to get by on little sleep with no negative effects. However, research shows that getting enough quality sleep at the right times is vital for mental health, physical health, quality of life, and safety.

The Source is HERE.




How much sleep is enough?


The amount of sleep you need each day will change over the course of your life. Although sleep needs vary from person to person, the chart below shows general recommendations for different age groups.



Age Recommended Amount of Sleep
Newborns 16–18 hours a day
Preschool-aged children 11–12 hours a day
School-aged children At least 10 hours a day
Teens 9–10 hours a day
Adults (including the elderly) 7–8 hours a day

If you routinely lose sleep or choose to sleep less than needed, the sleep loss adds up. The total sleep lost is called your sleep debt. For example, if you lose 2 hours of sleep each night, you'll have a sleep debt of 14 hours after a week.

Some people nap as a way to deal with sleepiness. Naps may provide a short-term boost in alertness and performance. However, napping doesn't provide all of the other benefits of night-time sleep. Thus, you can't really make up for lost sleep.

Some people sleep more on their days off than on work days. They also may go to bed later and get up later on days off.

Sleeping more on days off might be a sign that you aren't getting enough sleep. Although extra sleep on days off might help you feel better, it can upset your body's sleep–wake rhythm.

Bad sleep habits and long-term sleep loss will affect your health. If you're worried about whether you're getting enough sleep, try using a sleep diary for a couple of weeks.

Write down how much you sleep each night, how alert and rested you feel in the morning, and how sleepy you feel during the day. Show the results to your doctor and talk about how you can improve your sleep. You can find a sample sleep diary in the National Heart, Lung, and Blood Institute's "Your Guide to Healthy Sleep."

Sleeping when your body is ready to sleep also is very important. Sleep deficiency can affect people even when they sleep the total number of hours recommended for their age group.

For example, people whose sleep is out of sync with their body clocks (such as shift workers) or routinely interrupted (such as caregivers or emergency responders) might need to pay special attention to their sleep needs.

If your job or daily routine limits your ability to get enough sleep or sleep at the right times, talk with your doctor. You also should talk with your doctor if you sleep more than 8 hours a night, but don't feel well rested. You may have a sleep disorder or other health problem.




How does Sleep Deprivation Affect the Brain?



The effect of sleep deprivation.




According to Serendip Studio,

"Sleep deprivation is a commonplace occurrence in modern culture. Every day there seems to be twice as much work and half as much time to complete it in. This results in either extended periods of wakefulness or a decrease in sleep over an extended period of time. While some people may like to believe that they can train their bodies to not require as much sleep as they once did this belief is false. Sleep is needed to regenerate certain parts of the body, especially the brain, so that it may continue to function optimally. After periods of extended wakefulness or reduced sleep neurons may begin to malfunction, visibly effecting a person's behavior. Some organs, such as muscles, are able to regenerate even when a person is not sleeping so long as they are resting. This could involve lying awake but relaxed within a quite environment. Even though cognitive functions might not seem necessary in this scenario the brain, especially the cerebral cortex, is not able to rest but rather remains semi-alert in a state of "quiet readiness." Certain stages of sleep are needed for the regeneration of neurons within the cerebral cortex while other stages of sleep seem to be used for forming new memories and generating new synaptic connections. The effects of sleep deprivation on behavior have been tested with relation to the presence of activity in different sections of the cerebral cortex.








The temporal lobe of the cerebral cortex is associated with the processing of language. During verbal learning tests on subjects who are fully rested functional magnetic resonance imaging scans show that this area of the brain is very active. However, in sleep deprived subjects there is no activity within this region. The effects of this inactivity can be observed by the slurred speech in subjects who have gone for prolonged periods with no sleep.

Even severely sleep deprived people are still able to perform to some degree on a verbal learning test. This implies that some other area of the brain must become active to compensate for the loss of temporal lobe functioning. In fact, activity can be seen in the parietal lobe that is not present during verbal learning tests using rested subjects. Greater activity within this region corresponded to better performance by subjects in research studies. Still, sleep deprived people do not perform as well on these tests as do fully rested subjects. One possible reason for the poorer performance after missing sleep, aside from unregenerated neurons, could be the fact that since the parietal lobe is not usually used to performing tasks such as these it is not as adept at carrying them out. Therefore, when control switches from the temporal lobe to the parietal lobe some speed and accuracy is naturally lost. Interestingly, sleep deprived subjects have been shown to have better short-term memory abilities than their well-rested counterparts (6). Since memory is associated with this region of the cerebral cortex the fact that it is already active in sleep deprived people could make it easier for new synapses to be created, thus forming new short-term memories more easily.

While activity is seen within the parietal lobes of rested people as they think through math problems no corresponding activity is visible within the brains of sleep-deprived subjects. Also, no new area of the brain becomes active while the sleep deprived people work on math problems. Since sleep deprived people can still complete math problems, albeit with less speed and accuracy than a well-rested individual, this data implies that a region of the brain already in use is used for this task.

The frontal lobe is the most fascinating section of the brain with relation to sleep deprivation. Its functions are associated with speech as well as novel and creative thinking. Sleep deprived test subjects have difficulties thinking of imaginative words or ideas. Instead, they tend to choose repetitious words or clichéd phrases. Also, a sleep-deprived individual is less able to deliver a statement well. The subject may show signs of slurred speech, stuttering, speaking in a monotone voice, or speaking at a slower pace than usual. Subjects in research studies also have a more difficult time reacting well to unpredicted rapid changes. Sleep deprived people do not have the speed or creative abilities to cope with making quick but logical decisions, nor do they have the ability to implement them well. Studies have demonstrated that a lack of sleep impairs one's ability to simultaneously focus on several different related tasks, reducing the speed as well as the efficiency of one's actions. A person may be able to react to a complex scenario when suddenly presented with it but, similar to the verbal tests, the subject will most likely pick an unoriginal solution. If presented with a similar situation multiple times with slight variations in the information presented the subject chooses the same solution, even though it might not be as applicable to the new scenario.

Part of the frontal lobe, the prefrontal cortex, has several functions specifically coupled with it. Judgment, impulse control, attention, and visual association have all been related to this region of the cerebral cortex. A recent study has shown that the prefrontal cortex, usually the most active area of the brain in rested individuals, becomes more active as a person remains awake for long periods of time. This region regenerates during the first stage of sleep, giving a person the ability to feel somewhat refreshed after only a short nap. The length of the first stage of sleep cycle is somewhat dependent upon how long the person had previously been awake. The longer the period of wakefulness, the longer the brain remains in the first stage of sleep. When the brain enters into the REM stage of sleep the prefrontal cortex is active once more.

The implications of this data seem to be fairly important in supporting the location of the I-function within the brain. The prefrontal cortex is active whenever a person is awake, no matter how little sleep they have had. Also, this area is active while dreaming. Since the individual is aware of him or herself during both of these instances, but is not aware during the stages of sleep when the prefrontal cortex is shut down, it seems logical that the I-function is located within this region. This indicates that the I-function is what is resting and regenerating during the first stage of sleep. It would be interesting to study prefrontal cortex activity while a person is conscious, but unaware of his or her actions, due to an influence such as drugs or alcohol. According to the results of the sleep deprivation studies little or no activity should be seen in the prefrontal cortex at anytime when the individual is unaware of his or herself.

One of the symptoms of prolonged sleep deprivation is hallucinations. This could also be related to the I-function since it is the system that integrates the input from all other areas of the brain. If the neurons composing the I-function become too taxed then the picture in the head that the I-function produces may be more dissimilar from reality than usual. The neurons, under pressure to continue functioning but unable to perform optimally, create an image useful enough for a person to see most of his or her surroundings. Metabolic activity in the prefrontal cortex can drop as much as eleven percent after a person has missed sleep for only twenty four hours. As a person loses more sleep or continues to receive less-than-adequate amounts of sleep the neurons become even more taxed and the I-function may begin to generate even less coherent images possibly resulting in temporary insanity.

Another piece of evidence supporting the location of the I-function is that mammals have REM sleep whereas cold-blooded animals do not and mammals have a neocortex, located within the prefrontal cortex, while cold-blooded animals do not. REM sleep stimulates areas of the brain used for learning and memory. When a person is taught a new skill his or her performance does not improve until he or she receives at least eight hours of sleep. An extended period of sleep ensures that the brain will be able to complete the full sleep cycle, including REM sleep. The necessity of sleep for learning could be due to the fact that sleep increases the production of proteins while reducing the rate at which they are broken down. Proteins are used to regenerate the neurons within the brain. Without them new synapses may not be able to be formed, thus limiting the amount of information a sleep-deprived individual can maintain.

One of the possible side effects of a continued lack of sleep is death. Usually this is the result of the fact that the immune system is weakened without sleep. The number of white blood cells within the body decreases, as does the activity of the remaining white blood cells. The body also decreases the amount of growth hormone produced. The ability of the body to metabolize sugar declines, turning sugar into fat. One study stated that people who sleep less than four hours per night are three times more likely to die within the next six years. Although the longest a human has remained awake was eleven days rats that are continually deprived of sleep die within two to five weeks, generally due to their severely weakened immune system.

In a way sleep deprivation studies help us to study the relationship between the brain and behavior in a very unique way by observing how a person's behavior changes as the brain shuts down. By taking images of the brain showing where activity is located it is possible to correlate the behavior exhibited by a subject with his or her brain patterns. Just like a person cannot jog for three continuous days a person's brain cannot operate without rest breaks. Since different regions of the brain rest during different stages of the sleep cycle, sleep cannot be cut short.

In fact, if the brain does not receive a break it will soon begin to shut down for periods of micro-sleep. This is essentially several seconds of actual sleep; delta waves that interrupt the regular EEG of an awake person thereby impairing his or her continuity of cognitive function. Micro-sleep generally happens directly before performance failure occurs. Without sleep our brains deteriorate, and if the argument that brain=behavior is true, then our behavior will also suffer accordingly."

What are the Signs/Symptoms of Sleep Deprivation?

Sleep deficiency can cause you to feel very tired during the day. You may not feel refreshed and alert when you wake up. Sleep deficiency also can interfere with work, school, driving, and social functioning.

How sleepy you feel during the day can help you figure out whether you're having symptoms of problem sleepiness. You might be sleep deficient if you often feel like you could doze off while:

Sitting and reading or watching TV

Sitting still in a public place, such as a movie theater, meeting, or classroom

Riding in a car for an hour without stopping

Sitting and talking to someone

Sitting quietly after lunch

Sitting in traffic for a few minutes

Sleep deficiency can cause problems with learning, focusing, and reacting. You may have trouble making decisions, solving problems, remembering things, controlling your emotions and behavior, and coping with change. You may take longer to finish tasks, have a slower reaction time, and make more mistakes.

The signs and symptoms of sleep deficiency may differ between children and adults. Children who are sleep deficient might be overly active and have problems paying attention. They also might misbehave, and their school performance can suffer.

Sleep-deficient children may feel angry and impulsive, have mood swings, feel sad or depressed, or lack motivation.

You may not notice how sleep deficiency affects your daily routine. A common myth is that people can learn to get by on little sleep with no negative effects. However, research shows that getting enough quality sleep at the right times is vital for mental health, physical health, quality of life, and safety.

To find out whether you're sleep deficient, try keeping a sleep diary for a couple of weeks. Write down how much you sleep each night, how alert and rested you feel in the morning, and how sleepy you feel during the day. Source is HERE.


There are ten top ten reasons for sleep deprivation check list if you're still skeptical that can be found HERE.



Top Ten Things Sleep Deprivation Will do to You

According to Web MD, lack of sleep will:

1. Sleepiness Causes Accidents
2. Sleep Loss Dumbs You Down
3. Sleep Deprivation Can Lead to Serious Health Problems
4. Lack of Sleep Kills Sex Drive
5. Sleepiness Is Depressing
6. Lack of Sleep Ages Your Skin
7. Sleepiness Makes You Forgetful
8. Losing Sleep Can Make You Gain Weight
9. Lack of Sleep May Increase Risk of Death
10. Sleep Loss Impairs Judgment, Especially About Sleep

Source is HERE.



According to Tuck, Advancing Better Sleep,

"GI Issues and Sleep
LAST UPDATED ON JANUARY 29, 2018

Anyone who’s living with IBD, GERD, or even the occasional bout of indigestion or heartburn knows that a poor night’s sleep only makes you feel worse.

In fact, GI issues and sleep are so interconnected that scientists have literally referred to the relationship as a chicken-and-egg problem.



Why Stomach Problems Cause Sleep Problems, and Vice Versa

It’s hard to sleep when you’re uncomfortable. Conditions like indigestion, constipation, heartburn, and nausea are all extremely uncomfortable, and even painful at times. If GI issues strike at night, it makes it difficult to sleep. Unfortunately, when we don’t get enough sleep, our stomach problems often persist into the next day and often get worse.

While we sleep, our body keeps working – restoring and repairing our muscles so they can do their job the next day. Our body requires a remarkable amount of energy to function properly. One of those major functions is our digestive process – eating, chewing and processing food before eliminating what we don’t need. Without sufficient sleep, we don’t have enough energy to perform that process as smoothly and as painlessly as we should.

The problems don’t stop there. When we’re sleep deprived, our appetite increases, and we actually begin to crave the kinds of junk food that trigger GI problems. Tired brains release more ghrelin (the hunger hormone), while well-rested minds release more leptin (an appetite suppressant). The more sugary, fatty food we eat, the more we feel it in our waistline – as well as our digestive and bowel movements.

When you’re overweight, GI symptoms worsen. Obese people are much likelier to report waking up from sleep due to chest pain or acid reflux, and experience lower quality sleep overall.

It’s not just the hunger hormone working against us. It’s faulty logic, too. When we’re tired, we’ll do anything for a quick energy boost. As a result, we often turn to caffeine and sugar. Both of these are bad for our digestion and our sleep.

With all this discomfort and lack of sleep, it’s no surprise we end up feeling stressed. Unfortunately, stress itself contributes to insomnia, IBS, and heartburn.




GERD, Heartburn and Sleep

Gastroesophageal reflux disease (GERD) is a chronic condition affecting 10 to 20% of Americans, making it the third most common GI disorder in the U.S. Common symptoms include heartburn and acid reflux.

As many as 74% of sufferers experience nighttime heartburn, contributing to sleep-onset insomnia (difficulty falling asleep). When acid flows back into the esophagus from the stomach, individuals start choking or coughing, either waking them up or keeping them from falling asleep in the first place.



Heartburn and Disturbed Sleep

The same proinflammatory cytokines present with GI diseases like GERD also show up with sleep disorders. When you’re sleep deprived, those cytokine levels increase, worsening GERD symptoms.

GERD is often comorbid in children with autism spectrum disorder (ASD), and their risk increases if sleep issues are also present. Children with autism and sleep problems are twice as likely to experience frequent constipation and heartburn. Subsequent research says the relationship works both ways – autistic children with sleep issues are just as likely to have GI problems as autistic children with GI issues are to have sleep problems.

Children with ASD are also at high-risk for obstructive sleep apnea (OSA). OSA is a form of sleep-disordered breathing where the individual stops breathing during sleep due to a blockage of their airways. Even without autism, people with OSA are more likely to have GI tract conditions like gastric reflux and hiatal hernia, which stem from the spot in your diaphragm where your esophagus meets your stomach.

Although CPAP therapy is extremely effective for treating sleep apnea, there is one side effect that’s especially problematic for people with GERD. Occasionally air enters the esophagus and stomach instead of the lungs, which can worsen GERD symptoms.



IBS and Sleep

Irritable bowel syndrome (IBS) is a chronic disorder of the large intestine that affects between 7 to 21% of the global population, with a disproportionate amount of sufferers in the US and south Asia.

Sleep problems are one of the biggest non-intestinal complaints of IBS sufferers. Difficulty falling asleep, disturbed sleep, and daytime fatigue are commonly reported. Research has also confirmed a positive association between IBS and sleep apnea.

While people with IBS are just as likely to wake up during the night as someone without IBS, they’re more likely to require a bowel movement rather than urinate, and that bowel movement is often accompanied by abdominal pain. This discomfort makes it tougher to fall back asleep.

People with IBS also often have fibromyalgia, which is tied to sleep problems of its own.




Ulcerative Colitis and Sleep

Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) that affects the colon and rectum of 250,000 to 500,000 Americans. Onset typically occurs in adults between ages 15 and 40.

People living with ulcerative colitis deal with abdominal pain, diarrhea and bowel issues on a daily basis, along with the fatigue and stress that comes part and parcel with managing such recurring discomfort.

Recent research suggests that adequate, quality sleep is important for managing UC symptoms as well as preventing the disease in the first place. One study observed that both chronic oversleeping and sleep deprivation seem to be risk factors for ulcerative colitis. Participants who consistently slept fewer than 6 hours per day or more than 9 were much likelier to also have ulcerative colitis.




Crohn's Disease and Sleep

Over 2 million Americans have some form of IBD, whether it’s ulcerative colitis or Crohn’s disease. Crohn’s disease (CD) affects the lining of the digestive tract, with symptoms ranging from abdominal pain and diarrhea to anemia and fatigue. For many people with CD, fatigue persists when the disease is inactive as well.

People with insomnia have a three-fold increased risk of developing a bowel disorder like CD or UC. And, according to a study of over 1,200 patients, disturbed sleep and/or inadequate sleep doubles the risk of flare-ups for those living with Crohn’s disease.

Improving sleep is important not just for managing symptoms of Crohn’s disease, but also for preventing relapse during remission. A study of individuals in remission from Crohn’s disease found that the ones with sleep problems doubled their risk of it becoming active again.





How to Sleep Better When You Have IBD, IBS, or Heartburn

While most GI issues stem from chronic conditions, getting better quality sleep can alleviate the intensity of your symptoms. Try these behavioral strategies for improving sleep despite heartburn or IBD.

1. Follow a bedtime routine.
Develop a bedtime routine that calms your mind, body, and stomach. Take a warm bath or do some calming yoga poses.

Drink a nice cup of herbal tea. Chamomile, lemon balm, and passionflower have all been shown to promote sleep, reduce anxiety, and soothe indigestion.

Melatonin can also be an effective way to induce drowsiness. In one study, it reduced sleep latency (the amount of time it takes to fall asleep), and increased the overall total sleep time for individuals with IBS. Melatonin’s anti-inflammatory properties may also be helpful for sleep-deprived individuals living with colitis, according to another study.


2. Prepare for nighttime disruptions.
If you’re living with chronic heartburn, abdominal pain, or digestive issues, recognize now that you will expect some nighttime awakenings throughout your life. However, rather than getting frustrated, accept that these will happen and take steps to relax yourself back to sleep afterwards.

If you find yourself lying awake in bed for more than 20 minutes, get up and leave your room. Go do something calm somewhere else, like reading a book by a soft lamp, until you feel tired again. You don’t want your brain to come to associate your bed with sleeplessness.

Also clear your bedroom of electronics, especially clocks which build frustration as you watch the hours tick by.



3. Pay attention to your diet.

People with IBD and GERD are used to getting diet advice, so it’s no surprise that we’re including it as a tip here. Avoid heavy meals and spicy or sugary trigger foods late at night, at least 2 hours before bed.

Managing your diet will help keep your weight in check, too, minimizing your risk of heartburn. Never lay down after you eat, and wear clothes that are comfortable and loose, especially when going to bed. Too-tight clothing increases pressure on your stomach, leading to heartburn and GI issues.

Take care during the day to keep your blood sugar balanced, so as to avoid nocturnal hypoglycemia. Your blood sugar already lowers naturally while you sleep, but people with GI issues are more at risk. To keep your blood sugar steady, avoid overly sugary foods all day long, not just before bed. Instead, eat smaller meals throughout the day to stay in balance.


4. Change up your sleep position.
Stomach sleeping is terrible for acid reflux, since it places your esophagus in line with your stomach. Instead, sleep on your side or your back.

If you lie on your side, opt for your left side to reduce the pressure on your heart and other organs. If you sleep on your back, use a wedge pillow or raise the head of your bed with 6-inch risers to keep your esophagus above your stomach and reduce acid reflux.

Those with ulcerative colitis should lie on their back. If you’re more comfortable sleeping on your side, choose the side opposite to the side of your colon that gives you the most trouble. If you’re still feeling pain, avoid painkillers and use a heating pad instead. Painkillers like ibuprofen can actually irritate your colon, making you feel worse.


5. Reduce stress.
Stress builds anxiety and the kind of spiraling thoughts that keep insomniacs up at night, just as it makes your stomach feel like a spiral of its own.

To reduce stress, try incorporating one or more of the following into your life: yoga, meditation, or aromatherapy. Practice deep breathing or relaxation exercises before bed. If you can’t get the worries to stop, write them down in a journal to free them from your mind.


Additional resources:

Studies and research
“Sleep Dysfunction and Gastrointestinal Diseases”: This review details at-length the physiology of sleep and the immune system, and its connection with various GI diseases.

“Sleep disturbances and inflammatory bowel disease: a potential trigger for disease flare?”: Researchers provide an overview of the sleep problems related to IBD, and theorize whether circadian rhythm disorders may play a role in flare-ups of Crohn’s disease or ulcerative colitis.

“Association of irritable bowel syndrome and sleep apnea in patients referred to sleep laboratory”: This study examines the prevalence of IBS in patients with sleep apnea.

“Sleep and Emotional and Behavioral Symptoms in Adolescents with Inflammatory Bowel Disease”: Researchers noted that teens with IBD experienced sleep problems that correlated with other problematic behaviors such as aggression and depression or anxiety.


Advocacy groups and organizations:

The CDC’s portal on inflammatory bowel disease (IBD) provides up-to-date research and demographic analysis on Americans living with ulcerative colitis or Crohn’s disease.

The International Foundation for Functional Gastrointestinal Disorders is a non-profit focused on raising awareness, funding research, and providing helpful resources and treatment advice for people suffering from gastrointestinal and motility disorders.
The Crohn’s & Colitis Foundation provides educational resources online, and helps patients and caregivers find local support groups, doctors and other healthcare providers near them.


Blogs and social media:

Read the latest news in GI disorders and find healthy recipes on popular online blogs such as Living with Gastroparesis, Gutsy By Nature, IBD News Today, and My Gut Health Today.

Connect with others for support and share your advice for getting better sleep on online forums such as the Constipation and GERD forums on Treato; the GERD, Acid Reflux, IBD, and IBS subreddits; CPAPtalk forum; the Crohn’s & Colitis Foundation Community Forum; Crohn’s Forum; and the IBS Self Help and Support Group."

Their website, listed above, again is: https://www.tuck.com/gastrointestinal-issues-and-sleep/

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.

A Doctor's Advice to those with Chronic Illness

My friend Tanya recently shared an article that I wanted to re-post. It's a great read! I was actually sitting in the middle of my floor, in my bathroom, crying, because pain and nausea keep hitting me in waves. I woke up gagging and vomiting from horrible night terrors that continued when I went back to sleep to round out my four hours of sleep last night. I saw this article and read it.

I forget sometimes that sometimes, as our own advocates, that we can come on too strongly to doctors. I definitely don't want to intimidate anyone, I just want help - as I imagine many chronically ill people feel. I think as someone who is chronically ill, we tend to give up on doctors before we even meet them because of past experiences with other doctors, specialists, etc. If you're like me, you've seen too many doctors to count. But, this doctor's advice brought me back down to Earth. I'm probably guilty of doing some of this so I wanted to share this article with everyone.

"A Letter to Patients with Chronic Illness
by: Dr. Rob BLOG LINK: HERE

Dear Patients:

You have it very hard, much harder than most people understand. Having sat for 16 years listening to the stories, seeing the tiredness in your eyes, hearing you try to describe the indescribable, I have come to understand that I too can’t understand what your lives are like. How do you answer the question, “how do you feel?” when you’ve forgotten what “normal” feels like? How do you deal with all of the people who think you are exaggerating your pain, your emotions, your fatigue? How do you decide when to believe them or when to trust your own body? How do you cope with living a life that won’t let you forget about your frailty, your limits, your mortality?

I can’t imagine.

But I do bring something to the table that you may not know. I do have information that you can’t really understand because of your unique perspective, your battered world. There is something that you need to understand that, while it won’t undo your pain, make your fatigue go away, or lift your emotions, it will help you. It’s information without which you bring yourself more pain than you need suffer; it’s a truth that is a key to getting the help you need much easier than you have in the past. It may not seem important, but trust me, it is.

You scare doctors.

No, I am not talking about the fear of disease, pain, or death. I am not talking about doctors being afraid of the limits of their knowledge. I am talking about your understanding of a fact that everyone else seems to miss, a fact that many doctors hide from: we are normal, fallible people who happen to doctor for a job. We are not special. In fact, many of us are very insecure, wanting to feel the affirmation of people who get better, hearing the praise of those we help. We want to cure disease, to save lives, to be the helping hand, the right person in the right place at the right time.

But chronic unsolvable disease stands square in our way. You don’t get better, and it makes many of us frustrated, and it makes some of us mad at you. We don’t want to face things we can’t fix because it shows our limits. We want the miraculous, and you deny us that chance.

And since this is the perspective you have when you see doctors, your view of them is quite different. You see us getting frustrated. You see us when we feel like giving up. When we take care of you, we have to leave behind the illusion of control, of power over disease. We get angry, feel insecure, and want to move on to a patient who we can fix, save, or impress. You are the rock that proves how easily the ship can be sunk. So your view of doctors is quite different.

Then there is the fact that you also possess something that is usually our domain: knowledge. You know more about your disease than many of us do – most of us do. Your MS, rheumatoid arthritis, end-stage kidney disease, Cushing’s disease, bipolar disorder, chronic pain disorder, brittle diabetes, or disabling psychiatric disorder – your defining pain - is something most of us don’t regularly encounter. It’s something most of us try to avoid. So you possess deep understanding of something that many doctors don’t possess. Even doctors who specialize in your disorder don’t share the kind of knowledge you can only get through living with a disease. It’s like a parent’s knowledge of their child versus that of a pediatrician. They may have breadth of knowledge, but you have depth of knowledge that no doctor can possess.

So when you approach a doctor – especially one you’ve never met before – you come with a knowledge of your disease that they don’t have, and a knowledge of the doctor’s limitations that few other patients have. You see why you scare doctors? It’s not your fault that you do, but ignoring this fact will limit the help you can only get from them. I know this because, just like you know your disease better than any doctor, I know what being a doctor feels like more than any patient could ever understand. You encounter doctors intermittently (more than you wish, perhaps); I live as a doctor continuously.

So let me be so bold as to give you advice on dealing with doctors. There are some things you can do to make things easier, and others that can sabotage any hope of a good relationship:


Don’t come on too strong – yes, you have to advocate for yourself, but remember that doctors are used to being in control. All of the other patients come into the room with immediate respect, but your understanding has torn down the doctor-god illusion. That’s a good thing in the long-run, but few doctors want to be greeted with that reality from the start. Your goal with any doctor is to build a partnership of trust that goes both ways, and coming on too strong at the start can hurt your chances of ever having that.

Show respect – I say this one carefully, because there are certainly some doctors who don’t treat patients with respect – especially ones like you with chronic disease. These doctors should be avoided. But most of us are not like that; we really want to help people and try to treat them well. But we have worked very hard to earn our position; it was not bestowed by fiat or family tree. Just as you want to be listened to, so do we.

Keep your eggs in only a few baskets – find a good primary care doctor and a couple of specialists you trust. Don’t expect a new doctor to figure things out quickly. It takes me years of repeated visits to really understand many of my chronic disease patients. The best care happens when a doctor understands the patient and the patient understands the doctor. This can only happen over time. Heck, I struggle even seeing the chronically sick patients for other doctors in my practice. There is something very powerful in having understanding built over time.

Use the ER only when absolutely needed – Emergency room physicians will always struggle with you. Just expect that. Their job is to decide if you need to be hospitalized, if you need emergency treatment, or if you can go home. They might not fix your pain, and certainly won’t try to fully understand you. That’s not their job. They went into their specialty to fix problems quickly and move on, not manage chronic disease. The same goes for any doctor you see for a short time: they will try to get done with you as quickly as possible.

Don’t avoid doctors – one of the most frustrating things for me is when a complicated patient comes in after a long absence with a huge list of problems they want me to address. I can’t work that way, and I don’t think many doctors can. Each visit should address only a few problems at a time, otherwise things get confused and more mistakes are made. It’s OK to keep a list of your own problems so things don’t get left out – I actually like getting those lists, as long as people don’t expect me to handle all of the problems. It helps me to prioritize with them.

Don’t put up with the jerks – unless you have no choice (in the ER, for example), you should keep looking until you find the right doctor(s) for you. Some docs are not cut out for chronic disease, while some of us like the long-term relationship. Don’t feel you have to put up with docs who don’t listen or minimize your problems. At the minimum, you should be able to find a doctor who doesn’t totally suck.

Forgive us – Sometimes I forget about important things in my patients’ lives. Sometimes I don’t know you’ve had surgery or that your sister comes to see me as well. Sometimes I avoid people because I don’t want to admit my limitations. Be patient with me – I usually know when I’ve messed up, and if you know me well I don’t mind being reminded. Well, maybe I mind it a little.

You know better than anyone that we docs are just people – with all the stupidity, inconsistency, and fallibility that goes with that – who happen to doctor for a living. I hope this helps, and I really hope you get the help you need. It does suck that you have your problem; I just hope this perhaps decreases that suckishness a little bit.

Sincerely,

Dr. Rob"

I think this is amazing advice! I am guilty of putting up with jerks and avoiding doctors because of it. But, I hope this helps you in some way. It stopped me from crying earlier. <3