Gastroparesis is when muscles inside the stomach decrease their movement, which causes the stomach to delay emptying its contents. Food stays in the stomach longer than it should.
Many conditions can cause this, especially those that affect the nerves serving the stomach, including multiple sclerosis and Parkinson鈥檚 disease. Diabetes probably is the most common cause now diagnosed, as longstanding diabetes affects all the nerves of the body. Very often, no specific cause is found.
The most common symptoms are nausea, abdominal discomfort, early satiety (feeling full after eating little food) and vomiting. These symptoms also are common in blockages of the stomach, so it frequently takes time to make the diagnosis.
If the gastroparesis is due to another condition, treating that condition may help. For example, in a diabetic, keeping diabetes under control makes sense. You mentioned diet: low-fat and low-fibre diets tend to be best, since fat normally slows the emptying of the stomach and fibre is hard for the stomach to clear. Smaller, more frequent meals are better tolerated.
Many medications, such as metoclopramide, can be helpful in treating gastroparesis. In severe cases, there is a medication that has been severely restricted in the U.S., cisapride, which is very effective but unfortunately associated with serious heart-rhythm problems.
Dear Dr. Roach: Can you please shed some light on compulsive lying and why a person would do it? My brother, 63, is developmentally disabled, and he makes up stories and/or lies nearly all the time. I truly believe he is a compulsive liar. Other than that, he鈥檚 a good-natured person.
J.B.
Compulsive lying is a very complicated issue. In your brother鈥檚 case, it is likely the cause is neurological, resulting from whatever issues cause his developmental delay. In fact, it鈥檚 entirely possible he doesn鈥檛 always know what is true and what is a lie.
In other cases, the problem is psychiatric. Personality disorders 鈥� especially borderline, narcissistic and histrionic 鈥� are associated with an increased prevalence of lying.
The most extreme case is pseudologia fantastica, in which the patient essentially lies continuously in a self-aggrandizing fashion, often with small amounts of truth.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Email questions to [email protected]
