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flowergirl2day 09-11-2008 09:06 PM

Answering questions about gastroparesis
 
I am having to use this thread to answer the question regarding gastroparesis (slow stomach emptying) etc. I would like to give the glycemic index way of eating a try. It helps those who follow it lower their blood pressure and blood glucose levels, and for some diabetics is all that is needed for blood glucose control. The foods are rated according to their immediate effect on blood glucose levels. The longer the food remains in the stomach, the slower the absorption of nutrients. This is desirable. The body can metabolize slowly digested food better, thus avoiding flooding of the system with glucose. My fasting insulin level indicates I should watch the glucose levels. My dilemma-the drug I take for gastroparesis-Reglan. It speeds up the stomach emptying. I wonder if I can somehow make things work without discontinuing this drug. It has taken care of my nausea, making me feel normal again. What a huge relief!

My blood pressure is well controlled with medication, the readings perfect. They can get quite low (90/60) at night. I guess that is still normal and preferrable to the high blood pressure readings I used to get at bedtime. I feel fine, except for problems with the new hernia. They have been driving me crazy! I can't wait to have it repaired. I should soon learn the date of the hernia surgery. I have another (minor) surgery scheduled for the beginning of next month. I am having tests done next week to determine if I'll be needing yet another surgery. I hope all goes well and that I won't. I am so glad my blood pressure is good and won't be a problem in the OR. It has taken long enough to get it to behave! I will be off work for a while. I had to let them know, as I'd done last year. I think from now on I'll only communicate with them by phone. I find going there too upsetting.

I suspect my stomach problems are a direct consequence of my drug therapy. I had a perfect, well behaved stomach prior to being started on medication. It's too bad so many medications have GI side effects. Some take longer to develop than others.
I am getting to the bottom of the medical issues, as you put it. I only wish I could speed it up a little! :) Thank you for the tip regarding a drink of water prior to a meal. I'll try that. I usually take the stomach pill with a sip of water before a meal, so will combine it with a whole glass of water and have it a few minutes earlier.

flowergirl

midi77 09-12-2008 01:13 PM

Re: Answering questions about gastroparesis
 
Hi FlowerGirl,

I am interesnted to know, were/are you on a BetaBlocker? They seem to mess up the whole GI tract, cause heartburn, a perpetual sense of fullness, not to mention what they do to the LES and other involuntary GI responses. My stomach has been a mess since 2002, shortly after I started on the BB.

flowergirl2day 09-12-2008 02:43 PM

Re: Answering questions about gastroparesis
 
Midi,

that's it exactly! Right on!
Heartburn (really bad) and all its symptoms, LPR and symptoms, gastroparesis, bloating...nausea from the food sitting in the stomach too long....I guess you know the feeling! :(

I take antihypertensive medication from all drug classes, except the ARBs, to control my blood pressure. My initial alpha/beta blocker was Labetalol. Along with the other drugs I had been taking, it turned my life into a nightmare of intolerable side effects. I quit this drug with considerable difficulty after about six months of misery. It was replaced with Bisoprolol, which I take to this day.

Many people are not aware of the GI damage the antihypertensives/heart meds can cause. Calcium channel blockers (and beta blockers), for instance, can cause GERD, which I now also have. The drugs relax the smooth muscle ([U]everywhere[/U], not just in the arteries), which, unfortunately, results in the LES malfunction and causes other structures and mechanisms (such as the stomach and intestine) not to contract or work properly.

Given the circumstances, there's little we can do, short of stopping the medication. I wonder if discontinuing the medication would be enough to set things right again, since the damage has been done. Unless you are extremely lucky, you know that the gastric side effects are not the only ones we are stuck with. What do you do to counter some of the GI side effects of the beta blockers? Do you take PPIs? I do. I am not sure whether or not they do anything, besides costing a lot of money every month. I'd describe my stomach the same way you have described yours. It's a mess.

flowergirl

flowergirl2day 09-13-2008 10:57 AM

Re: Answering questions about gastroparesis
 
The medications that cause delayed gastric emptying are narcotic pain medications, progesterone containing meds, nicotine, lithium, tricyclic antidepressants, dopamine agonists, clonidine and calcium channel blockers. The narcotics and antidepressants are said to be the most common drugs causing delayed gastric emptying.

The above information might prove useful to someone on medication with stomach problems. Sometimes, a correlation between medication and stomach problems can be difficult to establish. Most people on medication would not think of looking for one.

I was checking drug interactions in my new book, a companion to the 2007 PDR -"Guide to drug interactions, side effects and indications". What a great book! I find one feature particularly useful. One can look up any symptom or a side effect. All the drugs known to cause this side effect are listed alphabetically, along with the percentage of frequency of occurence.

flowergirl

famnd 09-13-2008 11:47 AM

Re: Answering questions about gastroparesis
 
That'a really interesting about Clonidine. As you know I was on the drug for about two yrs.

I wanted to mention the danger regarding having a hiatal hernia. One has to be very careful not to over fill the stomach & then try to bend over. If you have to pick up something, bend the knees & keep the back straight.

When I first got the hernia, I ended up having SEVERE abdominal pain from twisting etc. I probably should have gone to the hospital.
And it lasted several hours.

Thank you for the info. Sounds like a good book to buy.

Having one of those long handled dustpans is a great help to pick up anything that will fit in the pan. I try to do anything physical before I eat & take my meds. Fam

flowergirl2day 09-15-2008 09:55 PM

Re: Answering questions about gastroparesis
 
Thanks for the tips. :)

While reading through the side effects index in the book I'd mentioned earlier, I came across hernias - hiatal, inguinal and others. Surprisingly, -or not!!!! hernias can be caused by our medication! One of my medications is listed as having caused hernias in some people. This section of the book is a real eye opener and serves to remind the readers that there is no such thing as a drug without side effects. :dizzy:
Having one hernia was bad enough. Having two of them is turning out to be quite an experience-not one I'll soon forget! I am glad yours isn't causing any unpleasant symptoms at the moment.

flowergirl

SunLover90056 09-19-2008 10:16 PM

Re: Answering questions about gastroparesis
 
Flowergirl2day,

You have so much knowledge and everytime I come to the site I truly enjoy your information information.

I am now on Clondine, along with the Enaperil and the motropolol (sp), and I have had my stomach blow up like a balloon, and I seem to have a lot of gas which I never had before.I thought I was rapidly gaining weight but then I thought I was not eating that much LOL! I have never had my stomach this large in my life. Also I gained over 10 pounds in a month. Could gas make your weight that much?

Does your books say anything about how to control the bloating/gas?

I had to come off of the Narvasic because it mad my feet/legs swell up so much that I could not wear a shoe, so they put me on this new medication. I have been taking it for two months now.

I find I have problems going to sleep and when I do sleep I wake up after about 3-4 hours. I also feel my heart beating really fast when I lay down. This does not happen often, but enough. When I take my BP my pulse/heart rate is low. like 51. I sure do not want my heart to beat too slow Lol, lol.

Anyway, if anyone has advice I would appreciate it.

Thank you Flowergirl2day for all of your great, and helpful advice!

Have a nice week-end everyone~

flowergirl2day 09-20-2008 01:57 PM

Re: Answering questions about gastroparesis
 
SunLover,

thank you for your post. I am a curious person by nature. Unfortunately for me, there is a seemingly endless choice of topics I need to learn more about. :(

I am sorry to hear about your problems with medication. I take Norvasc (Felodipine before that). Enough said. I don't blame you for switching to another medication. Why Clonidine in addition to a beta blocker? Alpha blockers fell out of favor a long time ago and are not used often anymore. They are suitable for a difficult to control blood pressure and for other indications in addition to the hypertension. There is a drug that combines the alpha blocker with a beta blocker, Labetalol. It is used for treating people with severe hypertension. I am glad your doctor gave you a cardioselective beta blocker with the Clonidine. Try asking him about Labetalol. It is said to prevent or reduce rebound hypertension when people try to discontinue the drug(s). I had a tough time stopping Labetalol last year. On the plus side, there was no rebound hypertension. Clonidine could prove just as difficult to stop. If you ever decide to discontinue Clonidine and/or metoprolol, find out how to do it properly. It could be potentially very dangerous. Do not rely on your doctor helping you much, though I hope he will. Mine didn't. Caution must be exercised when discontinuing these types of medications. I think it is ironic that withdrawal from Clonidine itself has to be orchestrated so carefully, since it is also sometimes used to treat the withdrawal symptoms of alcohol, nicotine and some drugs.

Your heart palpitations and bradycardia are not surprising, given the combination of an alpha and a beta blocker. Combining certain drugs with alpha blockers (CCBs, beta blockers and digitalis) often results in additive effects. These in turn cause us problems - palpitations, bradycardia, tachycardia, AV blocks, ECG abnormalities, CHF, and other cardiac irregularities. Like you, I have been getting palpitations AFTER I lie down in bed. For me, they are something new. Lying on either side makes them worse. They make it impossible to lie still, never mind fall asleep. I find that sitting up (basically, changing one's position from supine to an upright one-sitting or standing) helps. Please make sure to inform your doctor about these side effects. He might want to cut back on the beta blocker - you don't want the heart rate dropping too much!

I think you should also have your stomach/abdomen checked. Any sudden weight gain, when accompanied by other symptoms, such as bloating, gas and abdominal distention should be investigated. You need certain screening tests run to rule out as many conditions as possible. I personally find the abdominal distention quite worrisome. I wish I could be certain that my hernia is the only cause. I can tell that my doctor is not completely sure himself (I asked). I've just had another test done because of an upcoming surgery but have to wait for the results. Generally, continuous distention is caused by either fluid, tumors, enlarged organs, or fat. Intermittent distention is caused by excessive intestinal gas or various physical or functional obstructions in the intestines.

Many of our medications interrupt the normal process of digestion. Some kill the good bacteria that we need for proper function of the digestive system, others inhibit digestive enzymes or reduce stomach acid. Some medications contain sugars that our system cannot digest. That is why we end up with so many gastrointestinal side effects. Your weight gain is NOT from the gas. Gas does not weigh anything. It is from your medication (providing you haven't changed your diet or exercise habits recently). Our hormones can also cause weight gain to some degree.
Insomnia is a well known side effect of both the beta blockers and Clonidine.

I hope that your blood pressure is well controlled. Please get yourself checked out and try to find the cause of your abdominal swelling. It takes a while. Don't let your doctor simply pass it off as fat, especially if there are other symptoms. There is always a slight chance it could be that though, due to our medication-altered metabolism. :)

flowergirl

SunLover90056 09-21-2008 03:07 PM

Re: Answering questions about gastroparesis
 
FlowerGirl2day,

THANK YOU ~ THANK YOU ~ THANK YOU!

You have helped to make the decision to ask my doctor to take me off of the Clondine.

In addition to all that you mentioned, and that I have experienced while taking it (2 months), I just do not "feel" it is right for me. Something is just not right and I can feel that it is not for me.

The gas/bloating seems to be temp, it is up and down. I have started walking 3 miles at least 3-4 time a week, and doing well with that. I have been doing everything I know to do to reduce my BP. Even with the meds the top number is a little high (136-146) and the low number is always in the 80's, but with this medication my heart rate seems low compared to what it used to be.

As someone else mentioned, I also experienced a feeling of not knowing where I was going when driving the other day. I actually had to pull over and "think" about where I was, where I was going and how to get there for a few seconds Lol, lol..

I will definately take your advice and ask my doctor about the "withdraw" procedure reagarding this drug, and I sincerely thank you for helping me to make a decision that I feel will be best for me.

Hang in there!

I hope we all can find natural solutions to our medical issues :)

famnd 09-21-2008 08:37 PM

Re: Answering questions about gastroparesis
 
Hi Sun,

I agree with FG re: Clonidine. I was on it for 2 yrs. It took me 2 months & two tries to get off of it. One day I was driving to my Dr's appointment & couldn't find her office even though I had been there at least 20 time & I live in a very small town so it is easy to find. The office nurse chewed me out for being late but I didn't want to tell her why because she might think I was getting dementia.

Clonidine definately affects the brain especially in the first two hrs of taking it. My husband used to get so mad because I couldn't do anything requiring brain function for the first two hrs after taking it. He was about ready to flush my pills down the toilet.

You can look up my other posts about Clonidine for the other symptoms I had if you need other ammunition to talk to the Dr. Be prepared for some opposition to going off Clonidine at least that's what I had with my DR. She wanted to increase my dose-another bad fact with Clonidine as it stops working & must for increased every now & then.

I've been taking Labetalol for 5 1/2 yrs. I've read that it does have the possibility of causing "rebound hypertension" if you stop it or decrease the dose. It happened to me when I just decreased my dose by 100mg. The big red flag with Labetalol is that it can damage the liver severely. So you have to get your lab work done on time & I would avoid alcohol.

Good luck. Fam

flowergirl2day 09-22-2008 10:34 PM

Re: Answering questions about gastroparesis
 
Just a quick note.

I did some reading about the palpitations in the morning. I think it is possible that ours could stem from too low a blood pressure and heart rate at night. Apparently (aside from all the other cardiac and non-cardiac possible causes), many arrhythmias, including any bradycardia (even when caused by a beta blocker or other blood pressure meds) or tachycardia, can cause palpitations. I hope they'll resolve on their own. Reducing the dose of the beta blocker might prove helpful.

flowergirl


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