In Western medicine gastroparesis is considered a disorder in which the stomach gastric motility is greatly delayed causing severe nausea, vomiting, heartburn, bloating, anxiety, pain and decreased appetite. In most people diagnosed with gastroparesis, the cause of the condition in unknown. The most common known cause is diabetes, however studies have also shown links to vagus nerve damage, which is the nerve responsible for digestion. Medications such as antacids, anticholinergics, atropine, Beta-agonists, calcitonin, calcium channel blockers, dexfenfluramine, diphenhydramine, ethanol, glucagon, Interleukin-1, L-DOPA, lithium, octreotide, ondansetron, narcotics, nicotine, potassium salts, progesterone, proton pump inhibitors, sucralfate and tricyclic antidepressants have also been found to delay gastric motility. Gastroparesis can also occur after stomach surgery.
During the past 10 years, I’ve been seeing more patients with the diagnosis of gastroparesis. Many of these patients have been treated with Reglan, a drug associated with severe side effects that limits its use. There are a number of other drugs that are being used to increase gastric motility; unfortunately, all have severe side effects and none of them cure the disease. In some cases dietary changes have been recommended, where patients have been told to consume only foods that are canned and to eat small amounts through the day in order to ease the pressure of the digestive system. Unfortunately these patients still have all the symptoms.
Research on the digestive system in recent years has found the gut consists of its own neural network called the enteric nervous system (ENS), which has been coined “the second brain.” The ENS is a complex system of about 100 million nerves that are found in the lining of the gut. The tissues that arise from the ENS are the same as what’s found in our central nervous system (CNS) during fetal development. There are many structural and chemical parallels to the brain. It has become clear that emotional and psychosocial factors can trigger symptoms in the gut due to the close interaction between the gut and the brain. Research has found that psychological factors can literally impact physical factors of the gut, like motility. So in other words those “butterflies” you feel in your stomach or the “nervous stomach” you get when you’re stressed is because of your ENS and its connection to the brain. The saying ‘“it’s all in your head” no longer has clout.
A new pilot study from Harvard University affiliates Benson-Henry Institute for Mind Body Medicine at Massachusetts General Hospital and Beth Israel Deaconess Medical Center found that meditation has a significant impact for those with gastrointestinal disorders. Forty-eight patients with gastrointestinal disorders took a nine-week meditation training. The results showed decreased stress, pain, improved symptoms and the change in expression of genes that contribute to inflammation. There’s also new research that shows depression as an inflammatory disorder mediated by poor gut health.
New research confirms previous studies finding that acupuncture is effective at treating gastroparesis. This particular study found that acupuncture is more effective than Reglan for improving gastroparesis after surgery. This randomized controlled trial of 63 patients took place at the Eastern Hepatobiliary Surgical Hospital, Second Military Medical University, Shanghai, China. Among the acupuncture patients, 29 were rated recovered and three were rated effective after 10 treatments. Among the Reglan patients, 10 were rated recovered, 12 were rated effective and nine were rated ineffective.
Our gut health is a complex system, and its health along with our brain health is dependent upon many lifestyle choices including stress and diet. The latest research shows utilizing meditation to allow for stress reduction, consuming a healthy “live” diet with the reduction of excess sugar and refined carbohydrates and having acupuncture treatments will allow for a healthy gut and brain thereby helping the body to heal gastroparesis.
In Chinese medicine, our digestive metabolism is called the “middle burner.” The middle burner is the heart of the digestive system. Next week I will talk about the importance of the middle burner and what you can do to keep it healthy and/or to achieve health for gastrointestinal disorders along with a multitude of other maladies.