Gastroparesis Series - Part IV: Nutrition Helpers

During a flare (or if you have a consistent case of severe GP) your body may become depleted of essential nutrients.  Adequate nutrition is a fundamental component of healing, and I've found some of these products to help me meet my needs:

• Coconut Milk - this is the base for my smoothies.  My nutritionist recommended the coconut milk because it has a bit of fat in it (about 5g) and she said that would help "carry me longer".  If you can't tolerate fat, rice milk and almond milk are healthy alternatives.
• Organic Rice Protein Powder - this is a necessary addition to my morning smoothie.  I am generally too nauseated to eat solids in the morning, so this helps add protein to my morning meal which helps give me the fuel I need to start my day.
• Fish Oil or Flax Oil - while this might sound strange, these oils do contain small amounts of fat (about 2-5 g) and can help get some "healthy fat" in you without having to eat a large portion that'll make you feel overly full.  There are certain kinds out there (ex. lemon flavored by Metagenics) that reduce the yucky "fish burp" side effect.  The flax oil by Barleans comes in a delicious strawberry banana flavor and can be easily added into a smoothie.
• Nano Greens - I have yet to be able to eat and/or digest green vegetables, so I've found this product to be a life saver in getting nutrition from veggies without actually having to eat them.
• Coconut Water - this is a great thing to have on hand if you can't keep much down or if you're dehydrated.  It contains 5 essential electrolytes, making it an excellent source for hydration purposes.  Additionally, it contains more potassium than a banana and is 100% natural- not to mention it tastes very refreshing!
• Sublingual Vitamin B Complex and D - these vitamins are essential for proper immune and neurological function.  They're extra easy to keep down since they're sublingual.

You might be wondering why I didn't add Boost or any of the more commonly known nutritional shakes out there to my list.... The primary reason for this is that I have an inflammatory condition that demands that I follow a dairy-free, sugar-free, low gluten, all-natural diet.  While it is a very diet to follow, I believe it has allowed my body to improve it's healing abilities.  Many of the commercially available drinks are very necessary for some people so I am not suggesting you shouldn't use them, but I avoid them because they have ingredients that are not consistent with my diet (ex. sugar, dairy, artificial colors and flavors, etc.).  

I'm sure I'll make more discoveries as time goes on and add more to this list- check back for updates!

*Just a reminder - I am NOT a doctor and this is not intended to be medical advice.  This information is based solely on my own personal experience and the information I have come across while dealing with my GP. *

Gastroparesis Series - Part III: Resources

Books:
Sadly, there are not many helpful books out there for the GP community.  Of the few that exist, these are the only two that had consistent good reviews.

• Eating for Gastroparesis: Guidelines, Tips, and Recipes by Crystal Zaborowski Saltrelli
• Living (Well!) with Gastroparesis by Crystal Zaborowski Saltrelli

Websites:
Websites for more information, resources, Q & A, and videos.

• G-PACT
• UVA Nutrition Series: Diet Intervention for Gastroparesis
• GICare
• Living Well With Gastroparesis

Online Support Groups and Communities:
Share your story and get feedback from others.

• MDJunction Gastroparesis Support Group
• Inspire (type in "gastroparesis" or "GI motility disorders"
• G-Pact on Facebook
• Living with Gastroparesis Community on Facebook

Diet Log for Tracking Possible Food Intolerance:

This can be a helpful step in figuring out "trigger foods" or subtle intolerances.  It could also be helpful to fill out this form if you are planning to see a dietician or nutritionist in the near future.  

• Food Diary from SheperdWorks

Gastroparesis Series - Part II: Natural Remedies

For my GP, I use a combination of the following herbs, supplements, and lifestyle changes to get me through the day.  On tough days, pharmaceuticals are sometimes the only thing that help, and on really tough days even they don't do the trick.  Luckily, my GP is usually pretty well behaved and I can manage it with only minimal discomfort when I use the natural methods listed below.

• PEPPERMINT - peppermint is known to stimulate digestion and ease abdominal discomfort.  I usually drink a cup of Traditional Medicinals Organic Peppermint Tea each night after supper, and I generally take a few peppermint capsules between meals throughout the day.
• GINGER - ginger is a well known anti-nausea remedy and anti-inflammatory.  You can take this in the form of a tea, pill, or even a lozenge.  Personally, I like to drink a cup or so of Traditional Medicinals Ginger Aid Tea each day, and I also take a few Ginger/B6 Capsules (by Karuna).  There is some research that suggests that ginger in high doses (greater than 1200 mg) can help stimulate digestion.  Read more about ginger, here.
• DIGESTIVE ENZYMES - there are many to chose from, although I take a pretty basic chewable papaya enzyme.  Here is a similar formula, with a nice description of how the enzymes work.  
• DGL - this is licorice, with the glycyrrhizin component (that is known to raise blood pressure) removed.  It is said to be a great stomach soother and many people report great results for indigestion and upset stomach.  I use Enzymatic Therapy's unsweetened formula.  Read reviews of this formula on Vitacost.
• ALOE - I use the formula from Nutrametrix, in the strawberry-kiwi flavor and it is delicious!  This may be due to the fact that my first bottle of aloe juice from the Vitamin Shoppe tasted and smelled like a raw aloe plant, so I really had nowhere to go but up after that experience.  The formula from Nutrametrix is more like a juice and goes down quite easy.  I take a 2 oz "shot" on an empty stomach in the afternoon.  This product was recommended to me by my nutritionist.  I have not done an extensive amount of research on aloe, although she cautioned that many products have a laxative effect because they contain latex.  This product does NOT.  
• YOGA - there are several yoga poses that can help stimulate the digestive tract.  I love the Gaiam DVD, "Yoga Remedies for Natural Healing" because it contains an 8 minute chapter that includes yoga poses for indigestion.  Watch it for free on Hulu.  You can also check out the article "10 Yoga Poses to Improve Your Digestion" on Care2.  There are pictures and descriptions to help explain the poses.
• MEDITATION & RELAXATION - stress has a nasty effect on your GI function, so it is very important to try to find some balance in your life.  I know that chronic pain can cause a vicious cycle of stress and anxiety, but it is important to try to do what you can to lessen your stress.  In some scenarios, this may just mean accepting that there is nothing that you can do and going into survival mode until a flare comes to an end.  In other scenarios, this might mean doing daily guided relaxations or meditating daily to keep the stress levels low.  Do what's right for you at the time.  For a list of free podcasts that are great for helping with pain and providing nice guided relaxations, check out this old post. 
• WALKING - I try to take a walk at least once a day.  This is a great way to get a little exercise, some fresh air, and to get that digestive tract stimulated.

While I know it is far from a cure, I hope that this information is helpful for some of you suffering from GP!

Gastroparesis Series - Part I: The Basics

What is gastroparesis?
Gastroparesis is a condition that reduces the ability of the stomach to empty its contents, despite the fact that there is no mechanical blockage. (1)  When you have GP, the stomach muscles don't work properly so food is not propelled through your digestive tract like it should be. In many cases, it's assumed that this results from damage to the vagus nerve. (2)

How do you get gastroparesis?
The vagus nerve can be damaged by stomach surgery, or diabetes.  Other causes or risk factors for developing GP include infection, eating disorders, sclerodoma, Parkinson's, hypothyroidism, certain cancer treatments and certain medications.  In many cases people develop idiopathic gastroparesis, meaning that the cause is unknown.

What are the treatments for gastroparesis?
The most common treatment for GP is the use of motility drugs, such as Reglan or Motilium.  It is also often recommended that GP sufferers eat a low fat/low fiber diet and consume several small meals throughout the day.

There are more invasive options out there that are usually reserved for those with the more severe cases of GP.  These options include surgery, botox injections, or the use of a stomach pacemaker.  Many GP patients also need anti-emetic drugs (to help control the frequent nausea that often accompanies GP) and pain management drugs (to help control the pain that frequently is associated with GP). (2)
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In part II of this series, I will be discussing some natural alternatives that can help to manage symptoms of gastroparesis.

*Note: I am NOT a doctor.  I am sharing information that I've found from my own research and/or personal experience.  Nothing listed here is intended to be or replace medical advice from your doctor.


Sources:
1) http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001342/
2) http://www.mayoclinic.com/health/gastroparesis/DS00612

Healthy Shopping Online

I often use Vitacost as my site of choice for ordering vitamins & supplements.  Their prices are great and their free or low rate shipping is an added appeal.  In an effort to go "more organic" this year, I recently browsed their organic food selection.  I was pleasantly surprised to find some of my favorites, in addition to some new things I'd like to try out as well.

• Organicville Barbeque Sauce - naturally sweetened with agave (not sugar), you'd never even know this was a natural product.  The sweet and tangy flavor is delicious!
  
• Annie's Organic Dijon Mustard - add some zip to your favorite dish with organic mustard.  Our recipe of choice is mustard & maple glazed salmon.
  
• Organic Dried Apricots - Apricots are a great source of fiber and iron.  They're a great addition to any stir fry, or tasty on their own as an afternoon snack.  
  
• Eden Organic Juice-Sweetened Cranberries - Cranberries are a great addition to salads, snack mixes, and chicken or turkey dishes.  The great thing about these cranberries are that they're naturally sweetened with juice, so they don't have any added sugar.  
  
• Organic Sundried Tomatoes - are a great addition to any pasta dish. 
  
• Lavender & Lemon Scented Natural Hand Sanitizer (regular & travel size) - made with 62% organic ingredients and a blend of essential oils.  According to Women's Voices for the Earth, many commercial hand sanitizers contain hormone disrupting chemicals.  This is a great way to kill germs, while ensuring that you're using the purest formula to do so.
  

For Healthcare Workers: Vaccinations & Your Rights

For many healthcare workers it is now "required" that you receive the flu shot.  I personally believe that it should be one's right to choose what they put in their body and that no employer should require vaccination.  That said, here are some links that can help you object to the annual flu vaccine requirement:

• If you work in a healthcare facility, this page on the CDC website will tell you whether you are able to use a medical, philosophical, or religious exemption.  For Marylanders, the site lists the following info:
• For Maryland, for religious exemptions to the immunization requirements of MD. Regs. Code tit. 10, § 06.01.12 (regarding rubella) and MD. Regs. Code tit. 10, § 06.01.15 (regarding rubella), see MD. Regs. Code tit. 10, § 06.01.12 and MD. Regs. Code tit. 10, § 06.01.15. MD. Regs. Code tit. 10, § 06.01.12 and MD. Regs. Code tit. 10, § 06.01.15 provide that if a worker objects to the immunization on the grounds that it conflicts with the worker’s bona fide religious beliefs and practices, the hospital shall grant a religious exemption. 
• Source: http://www.vaccinerights.com/healthcareworkers.html

• According to the U.S. Equal Employment Opportunity Commission (EEOC), under the heading "Reasonable Accommodation & Religion", it indicates:
• The law requires an employer to reasonably accommodate an employee's religious beliefs or practices, unless doing so would cause difficulty or expense for the employer. This means an employer may have to make reasonable adjustments at work that will allow the employee to practice his or her religion, such as allowing an employee to voluntarily swap shifts with a co- worker so that he or she can attend religious services.
• Source: http://www.eeoc.gov/laws/practices/index.cfm

• Title VII
• Title VII of the 1964 Civil Rights Act requires employers to reasonably accommodate their employees' religious beliefs, as long as it does not cause undue hardship.
• Source: http://answers.flu.gov/questions/4766

• MD Health General  Code Ann. § 18-403:
• HEALTH-GENERAL 

                   TITLE 18. DISEASE PREVENTION                    SUBTITLE 4. MISCELLANEOUS PROVISIONS
                   Md. HEALTH-GENERAL Code Ann. § 18-403 (2007)
                   § 18-403. Religious exemption

• (a) In general. -- Unless the Secretary declares an emergency or disease epidemic, the Department may not require the immunization of an individual if:
• (1) The individual objects to immunization because it conflicts with the individual's bona fide religious beliefs and practices; or
• (2) The individual is a minor and the individual's parent or guardian objects to immunization because it conflicts with the parent or guardian's bona fide religious beliefs and practices.
• (b) Rules and regulations. -- The Secretary shall adopt rules and regulations for religious exemptions under this section.
• Source: http://www.nvic.org/Vaccine-Laws/state-vaccine-requirements/maryland.aspx

Additional Resources:

• For additional information, see Maryland Immunization Exemption Information.
• For a doctor that will not judge you for choosing to opt out of getting vaccinated, check out http://novaxdoctors.webs.com/
• National Vaccine Information Center
• The Canary Party
• Dr. Tempenny's Website