How to Use Your Spacer Device Why use a spacer device? Using a spacer device (either a spacer or holding chamber) with your metered dose inhaler (“MDI”) can help reduce the amount of drug that sticks to the back of your throat. This can help you avoid hoarseness and a yeast infection in your throat called “thrush.” For this reason, spacers are sometimes recommended for use w
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Giassocandendocenter.comA registered dietitian can be very helpful in providing Gastroparesis Diet
The purpose of the gastroparesis diet is to reduce Medications
symptoms and maintain adequate nutrition and fluid intake. Step 1 is used when symptoms are more severe and The two most common types of drugs prescribed to you may advance to Steps 2 and 3 as symptoms improve.
treat gastroparesis are anti-emetics and prokinetics.
Step 1: Liquids
Anti-emetics – When nausea is a predominant symptom, an anti-nausea drug such as Liquids usually leave the stomach quickly by gravity prochlorperazine (Compazine) or ondansetron (Zofran) alone. Gatorade, soft drinks and broths prevent may be used to control nausea and vomiting.
dehydration and keep the body supplied with vital salts and minerals. Try to sip 1-2 ounces at a time with Prokinetics – These types of drugs are used to the goal of drinking at least 4 ounces an hour. You may also try plain saltine crackers. Avoid all citrus and • Metoclopramide (Reglan) – This prokinetic drug increases the strength and frequency of the Note: Step 1 is nutritionally inadequate and should stomach muscle contractions and relaxes the valve not be followed for more than three days without that controls the release of food from your stomach to your small intestine. Side effects are common and include drowsiness, depression and muscle spasms. Step 2: Soups & Breads
• Domperidone – This drug is similar to Try various soups with noodles, rice or crackers. This metoclopramide, but without many of its side step provides additional calories by adding small effects. It is available in Canada and Europe; it is not amounts of dietary fats. While fatty foods and oils can delay stomach emptying, you may be able to tolerate • Erythromycin – This drug is not a prokinetic; instead, small amounts of fats such as peanut butter and it’s a common antibiotic that produces short bursts cheese (less than 40 grams each day). Food should be of strong stomach contractions. However, most divided into at least six small meals per day. Avoid milk- people develop a tolerance to the drug fairly quickly so it is usually used only intermittently or when Step 3: Solid Foods
The goal of this step is to find a diet containing foods that you enjoy and can maintain long-term without significant nausea and vomiting. Add starches such as Gastroparesis is a common condition that may affect noodles, pasta, rice and potatoes back into your diet. anyone, but is most often seen as a complication Chicken breast is usually well-tolerated. Fat is limited to of insulin-dependent diabetes. Many cases have no 50 grams each day and raw, fibrous fruits and vegetables identifiable cause. Gastroparesis causes bloating, should also be restricted. Food should be divided into at nausea, vomiting, a feeling of being full and contributes least six small meals per day. Avoid red meat. to poor blood sugar control. In severe cases, it can A liquid multivitamin supplement is recommended in all affect nutrition. Treatment is available, but as yet there is no cure. Treatment consists of treating any underlying problem, diet and medications. By working with a physician, most patients are able to reach a satisfactory treatment program.
Tel: 715.847.2558 | Toll Free: 877.442.7762 Gastroparesis, (pronounced gas-tro-par-EES-is), also
satiety), bloating, excessive belching and nausea. There can be a vicious cycle. Gastroparesis doesn’t cause called delayed gastric emptying, is a disorder in which may be vomiting of undigested food (even several diabetes, but inconsistent food absorption can play the stomach takes too long to empty its contents. This hours after eating), heartburn, pain in the upper havoc with blood sugar levels, which makes diabetes condition is very common and can be the cause of a abdomen, lack of appetite, and weight loss due to poor worse. In turn, poor control of blood sugar levels number of abdominal complaints. It is usually not a calorie intake and poor absorption of nutrients. serious problem and there are effective treatments available.
Eating solid food, especially high-fiber foods such as raw fruits and vegetables, fatty foods, or drinks high in What is the treatment?
How the stomach works.
fat or carbonation may add to these symptoms.
First, controlling diabetes or any other underlying condition that may be causing gastroparesis, such Normally, muscles in the wall of the stomach work How is gastroparesis diagnosed?
as an underactive thyroid, is the first step in treating to grind the food into smaller pieces and then push the condition. Beyond this, treatment usually involves the churned and liquefied food into the duodenum, Doctors use several tests to help diagnose dietary changes and medications. In most cases, the first part of the small intestine. However, in gastroparesis. Some of these rule out conditions that treatment does not “cure” gastroparesis – it helps you gastroparesis, these stomach muscles work poorly cause similar symptoms; others check for specific signs manage the condition so you can be healthy and as or not at all, preventing your stomach from emptying properly. This can hold up digestion, cause increased • Gastric Emptying Study - This study is usually reflux, nausea and vomiting, and interfere with blood considered to be the most accurate way to diagnose Dietary Changes
gastroparesis. In this study, you eat a food item, most often egg salad, which contains a small Changing how and what foods are eaten is helpful. The What causes gastroparesis?
amount of “tracer”. After eating, you lie flat on a most common recommended dietary changes include: table while a scanner is placed over your stomach The most common known cause of gastroparesis is • Smaller, more frequent meals. Eat six small meals to monitor the rate at which the food (tracer) leaves diabetes. People with diabetes have high blood sugar, per day, instead of three large meals.
which causes chemical changes in nerves and damages • Avoid high-fiber foods. Foods high in fiber tend the blood vessels that carry oxygen and nutrients to • Upper GI Endoscopy (EGD) – Instead of helping to stay in the stomach longer, so they should be those nerves. Over time, these changes can damage diagnose gastroparesis, this procedure is used to restricted when symptoms are severe. Fibrous foods the vagus nerve – the nerve that controls the muscles rule out other conditions that can cause delayed are also more likely to form bezoars than softer gastric emptying. During the procedure, the doctor foods. Foods most likely to cause bezoars include passes a long, thin tube with a tiny camera through In addition, there are a number of other causes for dried figs, berries of all kinds, apples, coconut, corn, your mouth and down your throat, or esophagus, brussels sprouts, and potato and tomato peels.
into your stomach and the first part of your small • Cut back on high-fat foods or added fats. Foods intestine to check for any abnormalities.
high in fat naturally cause delay in emptying of the • Certain medications, such as calcium blockers and What are the complications?
• Nutritional supplements. Because gastroparesis narcotics that weaken stomach contractions • Weight loss and malnutrition - Problems can occur interferes with digestion and absorption of • Neurological conditions such as Parkinson’s disease, when slow emptying of the stomach affects your nutrients, people with gastroparesis may be body’s ability to digest and absorb nutrients. Also, deficient in important vitamins and minerals such • Metabolic disorders such as adrenal or thyroid gland if food stays in the stomach too long, it can cause as vitamin B-12, iron and calcium. A liquid vitamin bacterial overgrowth from the fermentation of the and mineral supplement may help supply missing food and disrupt the body’s normal balance of good • Pureed and liquid foods. Most people with In up to 40% of cases, people have what is called • Bezoars - Undigested food in the stomach can gastroparesis find that they do best with soups or idiopathic gastroparesis, meaning the cause is not harden into a bezoar (pronounced BEE-zawr), a solid pureed foods. Liquid always leaves the stomach known and cannot be found even after medical tests.
mass that’s similar to a hairball in a cat. Bezoars faster than solid food so liquid-type foods such as What are the symptoms?
may cause nausea and vomiting and may become dangerous if they prevent food from passing into • Avoid smoking, alcohol, coffee, spicy foods and The most common symptoms of gastroparesis are a mints. All of these things can irritate the lining of feeling of fullness after only a few bites of food (early • Blood sugar fluctuations – Diabetic gastroparesis the stomach and create more acid reflux.
DRUGS ASSOCIATED WITH QT INTERVAL PROLONGATION 2–65 Drugs by Class Associationa Torsadogenicb FDA Label ingc Comments Anesthetics Non-specific arrhythmias reported in PI. Anti-arrhythmics IV affects QTc less than oral; proarrhythmia infrequent. Rate appears lower than that of quinidine. Rate appears lower than that of quinidine. “Quinidine syncope” in 2–6% of patient