Slow digestion or Gastroparesis is a condition in which food stays in the stomach for longer than it should. It may also be called delayed gastric emptying. Peristalsis is the normal movement of muscles of GIT, mainly stomach & intestine which helps in the movement of food bolus from mouth downwards to the rectum while digestion & absorption occur. Speed of peristalsis should be rhythmic & normal for proper absorption & assimilation. Digestion will be disturbed when the movement of the intestines are very slow. This may lead to chronic malnutrition, deficiency disorders and other complications. Water and electrolyte balance also get impaired in such a condition. Medications and lifestyle changes are needed to manage the disease.
Signs and symptoms
- Heartburn
- Gastroesophageal reflux disease (GERD)
- Stomach upset
- Throwing up undigested food
- A feeling of fullness after first few bolus of food while eating
- Bloating & belching
- Lack of appetite and weight loss
- Abnormal values of blood sugar
- Abdominal pain
Causes
Diabetes
Injury to vagus nerve, mostly from surgery
Hypothyroidism
Gastroenteritis
Medications such as narcotics and some antidepressants
Parkinson’s disease
Multiple sclerosis
Rare conditions such as amyloidosis and scleroderma
Pathophysiology
The pathogenesis of primary intestinal motility disorders probably is multifactorial, but neither biochemical abnormality nor structural abnormality has been demonstrated commonly, except in some forms of intestinal pseudo-obstruction. More recently, there is evidence that low-grade mucosal inflammation and immune activation (particularly with mast cell involvement) in association with impaired epithelial barrier function and aberrant neuronal sensitivity may play a role in functional GI disorders.
Diagnosis
Clinical examination
Blood tests
Barium X-Ray
Gastric scintigraphy
13C-GEBTs
Gastric manometry
Electrogastrography
Ultrasound
Upper endoscopy
Treatments
Treatment highly depends upon the cause.
Changes in diet and habits
Eating six small meals each day rather than three larger ones.
Have more liquids and low-residue foods,
Drink plenty of water and fluids like broths, soups, juices, and sports drinks. Avoid high-fat foods, which can slow digestion, and high-fibre foods, which are harder to digest.
Make sure to take nutritious, yet light & easy to digest food items
Try walking after eating a main course. Do not lie down immediately after taking food.
Medications
Medicines like Metoclopramide, Erythromycin and antiemetics can help improve the situation for a while. It is not recommended to take long term medications which cause remarkable adverse reactions.
Other treatments
Botox injections to relax the valve, keeping it open for longer sothat the stomach can empty.
Electrical stimulation uses electrodes attached to the stomach wall to trigger stomach contractions.
In a procedure called per-oral pyloromyotomy (POP), an endoscope is used to cut the pylorus valve so it’s easier for the stomach to empty.
Patients with obesity and diabetes can have gastric bypass surgery. A small pouch is created from the top part of the stomach and attaches it to the lower end of the small intestine. This limits the quantity of food the patient can eat.
In severe cases, intravenous nutrition or parenteral nutrition will be needed in which nutrients go straight into the bloodstream through a catheter in a vein.
Prognosis
Primary intestinal motility disorders which are not associated with malignancy or debilitating pathology have a good prognosis.
Complications
Dehydration
Malnourishment
Deficiency disorders
Formation of bezoars and obstruction in GIT
Disease & Ayurveda
Ajeerna
Nidana
Intake of excess food or food which is not familiar or with different/opposite potency
Intake of food before the previously had meals get digested
Untimely food intake
Heavy, cold and heavy foods
Drinking large quantity of cold water
Day sleep and keeping awake at night
Suppression of natural urges
Other chronic systemic diseases
Emotions like envy, anxiety and anger
Food intake with worry, fear, anger, jealousy
Stress
Grief
Food and habits causing vitiation of Kapha
Purvaaroopa
Not mentioned
Samprapti
When the causative factors vitiate kapha, it gets smeared on the walls of intestines and all channels into and out of it gets obstructed. This causes a loss in the digestive fire. Proper digestion and absorption will not happen in this case. Due to this weakened Agni, undigested and partially digested food retained in the stomach and is called Ama. It contains many toxic produscts to the body and entering into the channels & circulatory system, Ama causes many diseases. This is why Loss of appetite (Agnimaandya) is considered as the root cause of all the diseases in Ayurveda.
Lakshana
Indigestion
Decreased appetite
Loss of taste & salivation
Sour belching/heartburn
Heaviness and distension of abdomen
General malaise
Headache
Giddiness/fainting
Stiffness in the back/hip
Yawning
Body aches
Fever
Vomiting
Divisions
Ama
Vidagdha
Vishtabdha
Rasasesha
Prognosis
Sukhasadhya
Chikithsa
The Ayurveda treatment of Ajeerna is normalising the Agni. It is done by two steps. One is to remove any Aama (mixture of digested and undigested food particles in stomach which turns toxic to the body) or obstruction in the channels. The next step is to enhance the Agni (digestive fire) and bring it into normal.
Samana
Upavasam
Langhanam
Aamapachana oushadhas
Agnideepana oushadhas
Sodhana
Sodhana therapies other than Sadyovamana (Therapeutic vomiting) are not indicated in a person with Loss of appetite/indigestion in the initial stage. Once the undigested food is cleared and the person is devoid of Ama, medicines and procedures to improve the Agni can be administered. The panachakarma therapies include:
Vamanam
Virechanam
Asthapanavasti
Anuvasanavasti
Sneha-sweada
Commonly used medicines
Amritottaram kashayam
Dhanwantaram gulika
Abhayarishtam
Dasamoolarishtam
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
People may find it easier to eat several smaller meals a day instead of three bigger ones.
Aim to make these meals high in calories and protein to make sure the body is getting plenty of nutrients and energy. People may also find having liquid meals, such as smoothies and protein drinks, easier to take.
Adding herbs, spices, or other flavourings to meals may also encourage people to eat more easily. Eating meals in relaxing or social settings may make eating more enjoyable.
Gentle exercise, such as a short walk, will increase appetite & digestion.
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening agni (digestive fire)
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, buttermilk boiled with turmeric, ginger and curry leaves
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Avoid day sleeping
Avoid sedentary lifestyle. Be active.
Avoid stress and emotional hurricanes.
Better to avoid exposure to excessive sunlight wind rain or dust.
Avoid lifting heavy weights and other vigorous physical activities.
Maintain a regular food and sleep schedule.
Avoid sitting continuously for a long time and avoid squatting.
Yoga
Regular stretching exercises, cardio work out, and following a specific Yogacharya with yoga asanas like pavanamuktasana, vajrasana, etc are recommended for improving digestion.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within and with surroundings.
In fever conditions, no exercises are recommended.
Pavanamuktasana
Vajrasana
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
https://pubmed.ncbi.nlm.nih.gov/12121888/
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
Dr. Rajesh Nair,
Expert,
Ayurveda Medicine, India
Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.
Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.
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