Input about gastroparesis

  1. I've been having what seems like an abundance of Pts lately with gastroparesis. I'm really trying to understand it. I *know* what it is but I'm feeling like I'm not doing my Pts any good.

    What do your er's do for treatment? Does anyone have it that can give me good nursing care tips?
    I don't understand why the recent Pts come in with blood curdling screaming until they are given multiple doses of pain medication, and start screaming again about 30 mins post dose.
    I'm wondering if there isn't a psych/psychological/behavioral component to these Pts. As I just don't understand their behaviors.

    Any input??
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    About Sassy5d

    Joined: Jun '06; Posts: 572; Likes: 701
    RN; from US
    Specialty: 11 year(s) of experience


  3. by   HH_RN13
    I have gastroparesis and ill tell you it's no fun. My gi dr was amazed to see food in my stomach after me being npo for 24 hrs. Your stomach feels full, there is so much pressure and the nausea on top of it. The only thing that helped me my last admission was dilaudid 2mg q3 hrs, and it wasn't enough because after about 1 hr the pain is back. The only thing that helps me is reglan, but I refuse to take it daily and take it only when I have too much pain because I do not want to get TD I'm too young for that. Have the drs try prescribing reglan?
  4. by   Sassy5d
    If I remember correctly, they were given IV Pepcid maybe.
    Nothing I read about describes this intractable pain that is being explained to me. I'm not trying to be heartless, I just genuinely don't understand and want to.
  5. by   HH_RN13
    Oh no I totally get it. It is hard for me to understand why there is so much pain and my gi dr doesn't do a very good job explaining other than it is what it is. I also had Pepcid iv and gi cocktail on top of it. I also get the gastritis frequently, which brings even more pain :-( I'm wondering if anyone else here can explain it to you as I would also want to know more.
  6. by   Calabria
    I have gastroparesis (and an extremely slow gut overall; for the record, Go-LYTEly doesn't work on me. At all. Doctors found out the hard way). I am stable now, my case is mild, and my treatment regimen is wonderful so I'm virtually asymptomatic 95% of the time, but I'll share my past experiences with you.

    Imagine having a dead weight just sitting in your stomach after you eat. And imagine your stomach/esophagus being perpetually irritated, whether from vomiting or from food just sitting there for hours longer than your body intends for it. It's like living with a stomach virus that doesn't end.

    I will say that I never screamed in pain from my gastroparesis. But I've been extremely uncomfortable, to the point where my quality of life has been adversely affected. I, like the previous poster, had gastritis as a result of my symptoms.

    When I've received dilaudid in the past for GI-related discomfort, I've been aware that my pain has still existed, but I simply haven't cared so much that it's there as I did when the medication wore off. If it were up to me, I'd take a medication that actually treated the cause of my pain (i.e., slow motility, GI irritation), instead of an opioid that's slowing down my gut and duping my mind.

    I wonder, like you, if some of the patients that you see have built up a tolerance as a result of their chronic pain. And I can't speak for all of them, but I wouldn't attribute all of their behaviors to psychologic causes. Gastroparesis can be truly miserable.
  7. by   Grandma16
    I'm not sure this is what you are looking for, but maybe this link will help: (I posted a short synopsis below. You must use the link to see the entire article.)Pain: the overlooked symptom in gastrop - PubMed Mobile Pain: the overlooked symptom in gastroparesis.Gut pain management: Visceral pain and gastroparesis"Excerpts from the presentation by: Robert Twillman, Ph.D. who spoke at the GPDA and ANMS organized consensus meeting on the Treatment of Gastroparesis, held in September 2004 at the Kahler Grand Hotel, Rochester, MN."....see link for full article. I was admitted via the ER last week with severe nausea, diahhrea and vomiting (at least several times in each 15 minute timeframe). I left at the end of my stay with 2 diagnoses, severe virus and gastro paresis. I can tell you that I have NEVER been so sick in my life, no exaggeration!Treatment consisted of pain meds, constant fluids and phenergan. The pain meds helped first, then the fluids and finally the phenergan. What helped the most, was the care and concern of all of the nurses that took care of me. They believed me when I asked for meds, and let me rest as much as possible,.I hope I've been able to help
  8. by   Sassy5d
    Thanks for the input.

    Presentation was just odd. Up running around in the room, screaming like a toddler tantrum that seemed she could turn on and off.

    This one comes in frequently. Guess I'm just confused at the presentation and behavior. I no doubt believe there's pain involved. I notice there's never any medication for pain given at home. Not exactly sure *what* is bringing them in. I've asked coworkers and they say they just give her a hearty dose of pain meds as ordered and let her sleep.
    I'm confident I will see her again. Was just looking for tips at how to help manage the symptoms.
  9. by   emtb2rn
    We have 2 gastroparesis regulars. If i get them, line, lab & big ns bolus (both young otherwise healthy) as soon as i'm bedside. Then it's trying to get them comfortable until d/c or admit.
  10. by   fitzfan82
    I have GP as a complication type 1 diabetes and I assure you, it is NOT psychological. The pain and nausea/vomiting is very real, and pain meds do very little to actually help the pain. Now, I don't run around the room screaming, it may be that this particular patient had unique issues, but it is very difficult to get the symptoms under control during a bad attack.
  11. by   thelema13
    Have any of the above posters tried high doses of high quality probiotics? Like 500 billion+ a day as a maintenance regimen?
  12. by   fitzfan82
    Yes, I take probiotics in addition to omeprazole and zofran. They do help, but my vagus nerve is pretty damaged (causing other non GI symptoms as well, such as palps) so some days are just really horrible. I basically eat a bland, soft, low roughage diet.

    I still can't see why a pt. would be running around screaming however...if anything my symptoms make me curl into the fetal position and lay very still otherwise I vomit if I move too much...
  13. by   fitzfan82
    Also, when I go to the ER for it, its usually because the n&v are effecting my blood sugars or I'm showing signs of DKA. Always dehydrated. I usually get tons of NS (or d5 if my bs are low), IV zofran, and something for pain if pain is an issue. Or IV insulin if DKA. Sometimes the admit me to get it under control, sometimes fluids and anti-emetics are enough to stabilize.
  14. by   emtb2rn
    Quote from fitzfan82
    I still can't see why a pt. would be running around screaming however...if anything my symptoms make me curl into the fetal position and lay very still otherwise I vomit if I move too much...
    The curled up presentation is what I usually see with our known gastro pts when they come in. Histrionics always make me suspicious, regardless of complaint.