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No one knows nausea better than those who suffer from or months of school are not taken as seriously as adults How does a dysmotility of the stomach cause
digestive motility diseases such as gastroparesis since it who lose time from work. For this age group, many chronic nausea? Why do I have nausea?
is their most common complaint and can occur to a doctors are quick to ascribe this symptom to stress. debilitating degree. Gastroparesis represents a more (To understand gastroparesis and the term, severe form of digestive motility problems. Variability between test results and the patient's report “dysmotility”, please see our pamphlet, regarding symptom severity can increase everyone's Some gastroenterologists who specialize in motility frustration. More research is needed to understand better disorders speculate that nausea may be generated by the underlying causes of nausea. Our patient community Your stomach, like your heart, has a rhythm of altered stomach rhythms (dysrhythmias). These is in need of more medical treatments tailored www.digestivedistress.com
activity. Your stomach even has a “pacemaker” disrupted rhythms are relayed to your central nervous specifically for us. Don't allow your suffering to be region to help modulate its rhythmic, muscular, system (CNS) by the major nerve of the gut the vagus minimized, but also understand that, because this area of pumping action. This overall pumping action nerve. The brain interprets these signals as nausea. medicine has been underfunded, specialists lack tools (peristalsis) of your stomach and digestive tract is called Besides dysrhythms, overall stomach action may be and training to provide you with better medical motility.
hampered in a number of different ways, making for a guidance. A good patient-doctor relationship is essential complex motor malfunction. Groups like the American for dealing with this unrelenting symptom. A Chronic Debilitating
With gastroparesis, for whatever reason, your stomach's Motility Society have scientists pursuing this area of compassionate medical team goes a long way in helping rhythm and motility may becomedisrupted and weakened. What was once functioning normally and outside your conscious awareness has now become “ill”.
There is Hope!
Suddenly, the dysfunctioning of your stomach comes to Motility tests -- what can they
the forefront of your thoughts with nausea! There is Help!
Control measures
Individuals do not have to have gastroparesis Physical
As the diagram shows, control measures are aimed at in order to suffer with nausea; but nausea is five primary areas; each one will be discussed.
the most frequent symptom of gastroparesis Surgical
a large role in helping to tame this symptom. For more detailed information on diet, please see our information pamphlet, “Gastroparesis”. Generally, a diet should be easily digestible as well as low in fat and fiber. Coffee, spices, and alcohol should be avoided, and if you Nausea is found in association with many Psychol-
smoke, you must stop! Small, frequent meals with thorough chewing are important. Late-evening snacks heartburn or acid reflux, bloating, belching, are generally to be avoided. An easy walk after eating and a feeling of fullness soon after eating. Doctors generally label this collection of symptoms as “motility- though the patient is debilitated with nausea! A further test can sometimes help to highlight what is going on; called electrogastrography (EGG), this study can detect General Tips
Nausea can also be found in association with other abnormal stomach rhythms just as electrocardiograms digestive and non-digestive diseases. It is important to reveal heart dysrhythms. Yet the EGG is more of a Ø When nausea is particularly intense, switch for have a thorough evaluation by a GI specialist; and this screening tool than a diagnostic tool and may help to specialist should include testing to look for abnormal motility in your stomach. Motility testing often includes: Watch out for some herbal remedies. They can actually increase nausea because they increase Nausea Relief
refluxing, which is the washing up of stomach acid into your throat that results in heartburn. The relief of nausea remains a big challenge. Chronic Peppermint can greatly increase refluxing. For nausea is often underestimated and under-treated by the some people, ginger, too, can increase nausea.
Canadian charitable number: 859541310RR0001 If one or more of the motility tests above have not been Caution:
medical community. The situation is even harder for Try chewing or sucking on a licorice root stick performed and you are dismissed by your specialist with an children who suffer with debilitating nausea. explanation that your symptoms are psychologically mediated, then you need to seek a second opinion. Unfortunately, children and adolescents who miss weeks Try tart flavors such as a slice of Granny Smith Pharmacological classes of drugs:
A popular combination of anti-nauseants used by some Examples of pharmacological drugs are given here; GI specialists who specialize in motility diseases like however, this is not an exhaustive list. Be aware that gastroparesis is “ZAP” (Zofran and Phenergan). Both Constant, chronic nausea has a major impact on your Try sucking on hard candies. Sweet flavors some of the older classes of drugs such as the tricyclic come in a liquid and intravenous preparation. life and can lead to debilitating spells of depression. anti-drepressants, phenothiazine agents, and Reglan, This depression is often the consequence of poor When nausea is very intense, some relief may may be associated with significant and frequent side Physical measures to help control nausea may be as nourishment, disrupted sleep patterns, added financial be found by sucking on ice cubes, or try ice effects. Be sure to discuss this with your doctor. Newer simple as avoiding hot rooms and opening a bedroom burden, and frequent and discouraging disruption of medications that are used to control chemotherapy- window for fresh air; the avoidance of hot baths is also If your nausea is actually improved after a induced nausea and vomiting are excellent choices; yet, suggested since they can often trigger a bout of nausea. small snack such as crackers, then it would be If possible, avoid strong emotions; your emotions do Nausea may leave individuals housebound for extended advised to have this before retiring in the night.
not cause your nausea, but they certainly modulate the periods, affecting their interaction with others. Fear of The anti-histamines:
symptom. Excitement can actually diminish your food may also be a problem since overwhelming waves symptoms, only to have your nausea rebound with even of nausea triggered an hour or more after eating may greater intensity hours after all the excitment. This build to an episode of vomiting, or the patient may be holds true for physical activity as well. Try slow, deep left in intense nausea limbo just wishing for the some gastroparesis poses a real challenge. Medications may breathing in cycles of 10 breaths with normal breathing relief an episode of vomiting would bring. have mixed results. Prolonged use of some medicines interspersed. This can help you get through a severe may show a waning of effectiveness. Altering Doxylamine (Diclectin) only available in wave of nausea with impending vomiting. Try raising Vomiting is recognizable as a serious problem. medication regimes, then revisiting old regimes may be the head of your bed six inches with books placed under However, it is the exhaustion of unrelenting, “hidden” the bed legs, and only wear loose-fitting clothing.
nausea that takes its toll emotionally and spiritually. The severity of such debilitating nausea is underestimated Promotility medications that help to re-establish the Serotonin (5HT3) antagonists:
Autonomic Retraining is biofeedback with guided
by the public at large since it is hard for even family and motility of the stomach may help to combat nausea since imagery is a method used to treat motion sickness friends to comprehend this endless cycle. some promotility drugs are also anti-nauseants. experienced by astronauts in space. This approach is However, these are usually only partially effective.
now being applied to help control severe nausea in Psychological treatments are varied and can be an upper digestive motility diseases like gastroparesis.
adjunct to the medical management of nausea. Acid-suppression medication may also play a very Techniques such as visual imagery, deep breathing and helpful role in nausea control and preclude the need for (NK1) antagonist:
relaxation, or biofeedback can be of benefit.
prescription anti-nauseant medications. Discuss this with device is revolutionizing the treatment of severe nausea Finding the right psychologist is valuable and Dopamine antagonists:
and vomiting of gastroparesis. Called “Enterra
(s)heshould be an integral part of your medical care For more severe nausea, specific medications called Therapy”, this device (similar in appearance to a heart
anti-nauseants may be required, and often two different pacemaker) for many patients, significantly reduces or pharmacological classes of anti-nauseants may need to halts nausea and vomiting. Your specialist can Your psychologist should play a supportive role. But be prescribed. Taken in combination, these drugs help to Side effects are frequently reported. determine if you are a candidate for Enterra Therapy. caution: if you find yourself uncomfortable or perceive combat episodes of debilitating nausea or nausea that Also, a method of temporary gastric electrical that the psychologist has adopted an exclusive approach can build to a crescendo of vomiting. Your doctor may Phenothiazine class:
stimulation is used by some centers to help evaluate of “fixing the problem in your head” to fix your nausea, actually advise you to take your anti-nauseant who is a good candidate for a permanent device. you may need to find another psychologist. medications on a regular schedule instead of on an as- Botox injections into the lower valve (pylorus) of the
Finally, patient-support groups help tremendously. Ask Cannabinoid agent:
stomach may provide temporary relief of nausea for a your doctor’s nurse for assistance to see if (s)he can When possible, try to get medications in either a liquid period of from three to nine months. Another method or sub-lingual (under the tongue) preparation since these that works on the same principle is a dilation of the
are absorbed better by people with delayed gastric Anti-anxiety agent:
pylorus with a balloon. A few specialized centers
Also, on-line support groups are available. See: http://groups.yahoo.com/search?query=gastroparesis
Have a back-up of medications for use rectally if Low dose, Tricyclic Antidepressants (TCA)
As well, an on-line forum is available on our
for controlling nausea. Pressure or massage applied to GPDA web site.
key points on the wrist can help with short-term Some medications can also be taken by Sub-Q injection (like a diabetic needle), which helps to regain control of * (Also act as pro-motility medications)

Source: http://www.digestivedistress.com/sites/default/files/pdf/chronic_nausea.pdf

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Sodium Cromoglycate in the Management of Chronic or Recurrent Enterocolitis in Patients With Hirschsprung’s Disease Background/Purpose: Chronic or recurring enterocolitis is a Results: The follow-up of the patients ranges from 8 months rare but perplexing complication of Hirschsprung’s diseaseto 26 months. Three of the 5 patients with chronic enteroco-affecting especially patient

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