The Reality of Digestive Tract Paralysis
Cringing at the number on the scale, my weight continues its downward trend. I cannot fit into my clothes anymore. Bottoms are baggy in all of the wrong areas. Yet, the buttons will no longer clasp over the rounded protrusion of my stomach.
The distension is intense. The skin encompassing my bones, now fragile from years of malnutrition, stretches to its limit and causes a tight pinching, sensation. Competing for an already occupied space, my bloated intestine collides with surrounding organs. Breathing becomes increasingly difficult. I imagine this is what it means to feel claustrophobic in my own body. My gut concurs, and that irrational fear, that inability to escape enclosure, is undeniably real.
These progressive gastrointestinal manifestations I experience daily are the result of gastroparesis, translating to a paralyzed stomach, combined with chronic intestinal pseudo-obstruction. The muscle contractions that move food, air, and bile through the gastrointestinal tract are uncoordinated, causing the small and large bowel to respond as though there is an obstruction. That introduces the risk of malnutrition and bowel perforation.
From mild discomfort to excruciating agony, pain is ever-present. I awake to a ruthless, queasy ache in my upper and lower quadrants accompanied by sharp pangs occurring with movement. Daily activities are fragmentary, broken with many breaks for me to catch a reprieve. Dressing, completing chores, preparing for my online classes — nothing progresses smoothly, similar to my obstructed and sluggish digestive tract. And by evening, my nights are spent tossing and turning to find comfort that does not exist.
Every single X-ray since October depicts dilated loops of bowel with air levels indicative of a “partial or complete blockage of the small and/or large intestine either by functional (adynamic or paralytic ileus) or bowel obstruction…” Except mine never goes away. The scans leave medical professionals puzzled. If no physical mechanical obstruction is present, why is my body responding like there is?
Baseline symptoms take on a new identity as they evolve into an acute attack — a desperate attempt for my insides to claw their way out of my body. The pain escalates to an unfathomable scale. No position is comfortable: not sitting, not laying, nor leaning over in the fetal position crouched like a frog. Although the slightest activity exacerbates the intensity, I cannot remain still. I yearn to scream, but the energy to expel coherent language is beyond me. I silently pray for healing, to be sedated, for anything to lessen the torture.
Pain medication is counterproductive. It only slows my GI tract more. Even if that were not the case, a pain pill would not stay down… A heated wave surges through my very being, chasing my racing heart. Midway through the paralytic episode, I wretch, and pitying spectators run to fetch the garbage can.
Surgical tubes and a central line barely control nausea and pain. Intestinal bile from the duodenum, similar to the thick consistency of scrambled eggs, frequently travels back upward. My faulty GI tract struggles to digest my own air, saliva, and acid. The contents are then vented through a tube surgically placed into my abdomen… because having a bag of throw-up on me at all times is so attractive. I have even had the fun conversation of rectal tubes, which are inserted to relieve trapped air from the colon in hopes of preventing perforation.
The whole ordeal is often not even instigated by eating or drinking. On the rare chance of a decent day, just a single sip of water is enough to provoke the cascade. Symptoms go from manageable to appearing nine months pregnant and writhing in pain after a few milliliters of fluid. Thus, my nutrition is a special formula delivered through another tube directly into my small intestine and an IV line in my chest infuses all of my hydration needs.
I had accepted life with a failing stomach. However, I never expected my intestines to fail too. Because of digestive tract paralysis, I have had to adapt to a new normal that should not be my reality, but is.
Written in honor of Gastroparesis/Digestive Tract Paralysis Awareness Month in August. Original post featured on my blog).