Gastroparesis: Treatment Options

If you have Gastroparesis, or you know someone who has it, you should already know that treatments options for the disease do exist - but hardly any of them are dedicated to Gastroparesis itself, and they don't work for everyone who has the disease.

This can raise a few important questions - how can a drug like Domperidone work for so many people, yet have such little impact on others?     The same goes for all of the treatments that are out there for this condition (not that there are many).   You are pretty much playing a game of "flip the coin" with your health in trying to figure out if anything can work for you, personally.     Gastroparesis isn't completely unique in this regard, but that doesn't make it any less frustrating to the sufferer or to the loved ones.

My wife has tried many of the possible solutions.  The Domperidone didn't have much, if any, effect on her.   Erythomycin seemed to have some impact early on in her condition, but the relief didn't last.   She tried the Botox therapy, and that had no impact whatsoever on her condition. 

She hasn't tried some of the more radical approaches used to help the condition.  You may have read about the gastric pacemaker, which does what it implies:  Using a device implanted in your body that controls your stomach muscles.  The success rate on this technique varies, and it seemingly requires a lot of adjustments even when it does work.   I won't discourage anyone from trying it - it is just my personal belief that this would be more of a last resort than the first thing you run and try.  I liken it to a beta version of a video game - it works.  It is playable.   But, just as you are ready to capture the flag, a bug enters the picture and crashes your game.     By the same token, some people have instant success with the device and cannot live without it.

She has also not attempted to use Reglan, a controversial drug that I believe at one time was one of the gold standards for treatment of Gastroparesis.  The biggest problem with Reglan is that it comes with the dreaded Black Box Warning, as it can cause Tardive Dyskinesia, a serious movement disorder that is usually irreversible, especially if it isn't treated right away.    Some people do have success with this drug, however - though it is typically advised that one does not stay on it long term.  My wife has discussed the possibility of asking her doctor if she can give it a try, but naturally there is some hesitation there.   You can find many stories (good and bad) about the use of this drug online.  Some people consider it a savior; others say it was either ineffective or made their lives worse.

You may have heard of Cisapride in your research about the disease.    Cisapride has been banned due to the serious side of effect of cardiac arrhythmias.  Cisapride was once a wonder drug for many with this condition, but is no longer prescribed.  As an interesting side note, Cisapride is actually an approved medication for veterinary use.    

Beyond the typical treatments for the disease, you can try other remedies that control certain symptoms.  For example, ginger gum helped Colleen when she had a bad case of nausea.     

As a loved one, you have the responsibility to listen to the patient.  You can encourage and discourage, but remember that you are not the one feeling the pain every day (or most days).  If your loved one wants to try a more controversial/radical treatment for the disease, you have to do two things:  Gather all of the information you can about the treatment and support your loved one who is seeking it out.  By gathering the information, you are prepared to look for the signs of serious side effects.  You are prepared for the discussion your loved one will have with the doctor.   You are prepared to talk things through with your loved one as well to make sure this is the path they truly want to go in.    Just always remember that the person who is sick is desperate to get better, and sometimes radical approaches can help reach that goal.  It is your responsibility to be the "watchdog".   It may not always be easy - but nothing about this disease is easy for anyone.  But remember, nobody has it worse than the sufferer.