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Amitiza and Gastroparesis

Gastroparesis means delayed gastric emptying. If you think you may have gastroparesis and are wondering whether Amitiza will help you, this article will give you some clarity.

We’ll discuss what gastroparesis is, whether Amitiza helps with it, and what are some other ways that it can be treated. 

Let’s find out!

What is gastroparesis?

Gastroparesis literally means “weakness of the stomach”. Normally, your stomach contracts from time to time to move food along the intestinal tract. If these contractions fail for some reason, food stays inside the stomach for long periods, which can lead to uncomfortable symptoms.

Symptoms of gastroparesis include:

  • Heartburn, which refers to a burning sensation in the chest, especially after eating
  • Bloating
  • Vomiting, which may contain undigested food
  • Malnutrition
  • Feeling full after eating just a little
  • Lack of appetite
  • Weight loss

In most cases, doctors don’t know what caused gastroparesis in a patient. This is called idiopathic gastroparesis. However, anything that damages the nerve supplying the stomach — called the vagus nerve —  can lead to gastroparesis.

The most common known cause of vagus nerve damage (and thus gastroparesis) is diabetes. Diabetes leads to high glucose levels in the blood, and glucose damages a wide range of tissues in the body, including the vagus nerve.

Other causes of gastroparesis include:

  • Hypothyroidism, which means low thyroid hormone levels
  • Medications
  • Amyloidosis, where abnormal protein deposits in tissues and causes widespread dysfunction in the body
  • Stomach infections
  • Injury to the vagus nerve during surgery

Can Amitiza help with gastroparesis? 

No, Amitiza is not used to treat gastroparesis. In fact, it can make gastroparesis worse. That’s because it has been shown to delay gastric emptying and can cause food to stay in the stomach for longer periods.

Conditions that Amitiza has been approved for are irritable bowel syndrome, chronic idiopathic constipation, and opioid-induced constipation.

All of these conditions can lead to disabling bouts of long-term constipation that can be difficult to treat with other drugs. If you have any of these conditions and other therapies fail to improve your constipation, your doctor may resort to Amitiza.

The chemical name of Amitiza is lubiprostone, and it works by activating chloride channels in the gut. Activation of these channels leads to increased production of fluid inside the gut. This makes the stoof soft and the gut walls contract, and both of these mechanisms treat constipation.

You should be especially careful with Amitiza if you have gastroparesis due to diabetes. That’s because diabetes often occurs with high blood cholesterol and hypertension. And Amitiza can interact with both cholesterol-lowering drugs and antihypertensive medications.

A drug interaction occurs when one drug makes the other either ineffective or toxic inside the body, which can lead to a wide range of adverse effects.

What can you do for gastroparesis?

While Amitiza won’t help you with gastroparesis, there are many drugs that will.

But before you turn to drugs, it’s a good idea to make some lifestyle changes and see if they help.

Since one of the main problems in gastroparesis is a feeling of fullness and nausea due to excess food in the stomach, you can try reducing your meal size. But make sure to increase the number of meals to prevent malnutrition.

For example, instead of having three large meals, try six smaller meals.

You should also consider eating foods that your body finds easy to digest. Examples include: 

  • Low-fiber foods — cooking vegetables and fruits well is a good way to get rid of excess fiber
  • Low-fat foods
  • Liquid foods

Make sure to avoid fizzy drinks and alcohol as well as high-fiber foods, dairy products, and some types of meat. The best way to work out your diet is to see a dietitian, who is an integral part of gastroparesis treatment. 

Quitting cigarette smoking and eating well before you lie down to sleep are also good ways to combat gastroparesis.

If lifestyle changes don’t help you, your doctor may prescribe you drugs to improve stomach emptying. But be aware that many of these drugs cause uncomfortable side effects, so make sure to ask your doctor about this and decide whether they’re worth it.

Drugs used to treat gastroparesis include: 

  • Ondansetron, which treats nausea and vomiting but can cause headaches, constipation, diarrhea, abnormal heart rhythms, and liver damage
  • Promethazine, which is an antihistamine that also treats nausea. Side effects include drowsiness, dry mouth and eyes, dizziness, and headache
  • Metoclopramide, which in addition to treating nausea, causes increased stomach contractions and makes food exit the stomach faster. However, it’s associated with a wide range of side effects including diarrhea, high prolactin levels, abnormal movements, fatigue, and drowsiness.
  • Erythromycin, which is a macrolide antibiotic that can bind motilin receptors in the GI system. Activation of motilin receptors leads to increased gut contractions, which helps move food along the GI tract.
  • Domperidone, which works just like metoclopramide but has reduced neurological side effects.

If medications fail, then your doctor may advise you surgery. A device called gastric electrical stimulator can be implanted in the stomach, which makes it contract and improves the nausea and vomiting associated with gastroparesis.

Takeaway

Amitiza is an anti-constipation drug. It’s used to treat irritable bowel syndrome, chronic idiopathic constipation, and opioid-induced constipation.

Importantly, Amitiza does not help with gastroparesis, which is when the stomach becomes slow. The most common known cause of gastroparesis is diabetes but many cases occur without an identifiable cause. 

And there are a wide range of treatment options available for gastroparesis. Consider starting with dietary and lifestyle changes. It’s a good idea to see a dietitian to get a diet plan that can relieve the nausea and vomiting associated with gastroparesis. 

If that doesn’t work, drugs for treating both nausea and vomiting and reduced gastric contractility are available. But these drugs are associated with a wide range of side effects, so make sure to weigh the pros and cons before starting one.

Finally, if medications don’t improve gastroparesis, you can go for surgery where an electrical device can be implanted in the stomach to make it contract better. 

 

 Medically reviewed by Onikepe Adegbola, MD PhD

 


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