Gastroperisis

[ckast]

my mother was recently diagnosed with gastroperisis. She had stomach cancer 2 years ago and part of her stomach was removed and she went through radiation & chemotherapy. she has been on reglan to try to get her stomach working, but at this point it isn't looking very hopeful. She has had x-rays, cat scans, GI scans, ultrasounds and is now left on PICC line and trying to gain weight to prepare for a total gastroectomy, which she will not be able to have until she gains at least 20 pounds (she is down to 110). There has been no sign that the cancer has returned. Is there any other option worth looking into with this condition? I just want to be sure that we have explored all the avenues before committing to removing her entire stomach.  Thank you for your advice.

[dd2482]

Hi there.  I just read your post.  This is my first time on this website and I thought I would try it out before I actually posted my question.  Can you tell me what type of symptoms your mom had prior to discovering the stomach cancer?

[Emperes]

I have a daughter with severe gastroparesis. There are so many causes and you may never find your mother's. But the best way to help her is educating yourself so that you may support her. To do this, I found two great web-sites for knowledge and support, please try them.  www.g-pact.org  and yahoo has a support group for gastroparesis-e-mail the moderator at ***@****  or just go to yahoo and find this group, you will be totally amazed at the info that is shared each and every day!  Best of luck, Tina

[Gastro_interest]

And, let's not forget the very helpful drug, domperidone to help with gastroparesis.  I have GP, and domperidone has helped me a great deal.  Your mother may want to try that, or Reglan, but Reglan is a bit scary with the side effects.

[surgeon]

Depending on which part of the stomach remains, it may be at least in part denervated, meaning the nerves to it which control muscular action could be cut. Radiation can contribute. Whatever the cause, the treatment options remain as stated.

[Kevin Pho, MD]

There are a variety of causes for gastroparesis.  These can include systemic diseases such as diabetes, scleroderma, amyloidosis, neurological diseases or damage to the spinal cord, multiple sclerosis, medications, or prior surgical procedures.  

As mentioned in the comments, erythromycin is an antibiotic that has been shown to have some effect in cases of gastroparesis.  Cisapride - which is severely restricted in the United States - is also a motility agent that may be considered.  

There are investigational studies using the injection of botulinum toxin.  Pilot studys suggest some beneficial effect.  Another investigational option would be gastric pacing where an implantable device is used to electrically stimulate the stomach.

Finally, there are the surgical options which has been discussed in the comments below.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[surgeon]

Here's a few comments while you wait for the official answer: first, people usually do quite well with total gastrectomy -- not always, of course, but the majority can eat lots of foods with not much or any difficulty. Second, while waiting, tube feeding might be a better option than IV feeding: food into the gut is better utilized and there are fewer complications than with TPN. It might be possible for a radiologist to pass a very thin tube; if not, a relatively minor open operation to place a tube into the intestine could be done. Third, erythromycin, an antibiotic, has properties of increasing gastric emptying, and is often used for gastroparesis. It has a chance of causing nausea.

[ckast]

I am also wondering how the gastroparesis could have been caused in the first place? Is this something that radiation could have done? Or more likely a result of the surgery that removed part of her stomach? My mom was also taking Wellbutrin-XL when this started, because she was feeling depressed b/c her husband passed away in March. Could this have contributed?