The Gastroparesis Friendly Lifestyle Living (Well!) with - PowerPoint PPT Presentation

The Gastroparesis Friendly Lifestyle Living (Well!) with Gastroparesis Program Class 3

The GP-Friendly Lifestyle Often overlooked or underestimated, but has the potential to significantly improve symptom management.  Physical Activity  Shifting Priorities  Adequate Sleep  Respecting Limitations  Relaxation Practices  Fun & Laughter  Habits & Behaviors  Stress Management* *Covered in-depth in Class 2

Physical Activity: Benefits  Improves gastric emptying (moderate aerobic exercise increases blood flow to the organs, including the gut, which stimulates contractions; intense aerobic exercise actually decreases gastric emptying)  Helps maintain bowel regularity  Reduces anxiety up to 20% in patients with chronic medical conditions  Improves appetite  Reduces stress  Increases energy and reduces fatigue, even among those with chronic illness  Improves ability to fall asleep  Lowers blood pressure  Boosts immunity  Decreases risk of heart disease, type-2 diabetes, and breast cancer

Physical Activity: Tips  Intensity should be mild to moderate; strenuous exercise can exacerbate symptoms (what “mild to moderate” means for you is individual)  May be different from pre-diagnosis exercise habits  Walking tends to be well-tolerated, versatile, and easy to modify  Yoga is also a great choice, as it combines physical activity with relaxation  Several short activity bursts throughout the day are often better than one long workout in terms of symptom management  If you are currently inactive, start with a walk around the block or a gentle yoga practice  May feel best if you wait about an hour after eating or walk before meals  Avoid activities that “crunch” the abdomen (sit up, crunches, Pilates)  Exercise does not automatically equal weight loss; can actually help with weight maintenance  Other ideas: Leslie Sansone “In Home Walking;” swimming; biking; Wii Fit

Adequate Sleep Most adults need 7-9 hours per night.  Time when organs rest/repair May Interfere with Sleep  When the GI tract cleanses itself  Chronic stress  Depression Lack of adequate sleep can lead to…  Pain  Irritability  Acid reflux  Decreased immune function  Nausea/other digestive symptoms  Cold, allergy, and asthma medication  Increased stress hormones  High blood pressure medication  Overeating/weight gain  Thyroid disease medication  Anxiety/depression  Birth control pills  Increased risk of heart disease  Narcotic pain medications  Increased digestive symptoms  SSRI antidepressants

General Tips for Better Sleep  Limit caffeine consumption, especially after noon.  Avoid nicotine, especially in the evening.  Avoid alcohol, especially in the evening.  Avoid intense exercise. Mild to moderate exercise is helpful.  Take a brief nap in the afternoon.  Practice relaxation techniques at bedtimes, such as deep abdominal breathing, mantram, or progressive muscle relaxation.  Establish a regular, relaxing bedtime routine. Avoid using electronics or participating in stressful activities.  Eat an evening snack containing both carbohydrates and protein about 2-3 hours before bed.  If you can’t get to sleep after 30 minutes, get out of bed.

GP-Specific Tips for Better Sleep  Sleep on your left side to alleviate digestive symptoms like pain and reflux (consider getting a wedge or body pillow).  Elevate your head by 6 to 9 inches to alleviate reflux symptoms.  Magnesium can help relax you and may also help with limb cramps or restless leg syndrome.  Approximately 1,000 mg of ginger before bed (2 capsules) may help alleviate middle of the night or morning nausea.  Placing a heating pad over the abdomen may help relieve abdominal/chest pain.  Consider a small snack about two hours before bed if you wake up in the middle of the night with low blood sugar symptoms.  If you can’t sleep, try not to fixate on the GP. Instead do something relaxing and distracting.

Treatments for Sleep Problems  OTC sleep medications should not be used long-term  If trouble sleeping persists, see your doctor  A variety of meds are available to help with sleep, if necessary  Some prescription sleep aids may exacerbate nausea, abdominal pain and/or constipation  Magnesium and calcium both enhance sleep. Try taking them before bed (400mg magnesium to 800mg calcium)  Melatonin: hormone that controls sleep. Available as a supplement, but evidence is mixed as to whether or not it’s effective. Typical dose is 0.3 to 0.5 milligrams before bed.  Valerian: herb that’s been found to improve deep sleep, speed of falling asleep and overall quality of sleep. Most effective when used over a period of time. Typical recommendation is 200 to 800 milligrams before bed.

To Best Support GP Management… Quit Smoking Limit Alcohol Consumption  Nicotine delays gastric emptying.  Alcohol slows digestion of meals.  Smoking decreases the strength of  Impairs quality of sleep. the esophageal sphincter, allowing  Weakens the LES allowing stomach contents to reflux back contents of the stomach to reflux into the esophagus. back into the esophagus.  Smoking promotes the movement  Can cause gastritis (inflammation of bile salts from the intestine to the of the lining of the stomach). stomach, which makes the stomach  Alcohol inhibits the breakdown of acids more harmful.  Smoking increases the risk of nutrients into usable molecules by decreasing secretion of digestive Crohn's disease, gallbladder enzymes from the pancreas. diseases, and liver damage.

Establish a Relaxation Practice While this fall under Stress Management, it’s also an important part of the overall GP-friendly lifestyle. Doing breathing exercises, meditation, yoga, Tai Chi, EFT…  Alleviates stress  Enhances digestion  Reduces abdominal pain  Calms nervous system  Lessens anxiety and depression  Improves sleep  Improves mood

Shifting Your Priorities  Priorities may be different now than prior to diagnosis  Resources (time, money, attention) must be devoted to what’s most important  What’s your goal? What’s the one thing that would change everything else in your life? Is it better managing GP? If so, you must make that a priority.  May mean making changes to responsibilities at work/home  Do your actions reflect your priorities?

Respecting Limitations  Your limitations are different now than before diagnosis  Dietary choices  Scheduling meals/meds/etc.  Activity requirements  Sleep/rest needs  Energy level  Must consistently acknowledge and respect limitations in order to consistently manage symptoms  Make deliberate choices about pushing limits

Socialize, Have Fun & Laugh “Laughter is the best medicine.”  Important for quality of life.  You need support; avoid isolating yourself.  Make an effort to laugh/have fun every single day.  Laughter alleviates stress, releases feel good hormones, and is a natural pain reliever.  Continue to participate in activities that bring you joy.

Action Steps 1. Review all handouts/worksheets. 2. Consider whether your lifestyle choices currently reflect your priorities. If not, what needs to change? 3. Identify any habits or behaviors that are impairing GP management. What steps will you take to address them? 4. Start incorporating appropriate (for you) physical activity into your daily routine, if it’s not already.

Class 3 Notes: ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ Questions for Office Hours: ____________________________________________________________ ____________________________________________________________ ____________________________________________________________