Delayed gastric emptying or slow digestion (gastroparesis)

[modelarz71]

I just wanted to add that the scary thing is the ignorance of psychiatrists about the fact that SSRI withdrawal can cause damage to these serotonin pathways in the gut , one said it's my age and another said it heals the gut (!) or that it's my depression that manifests itself that way. Perhaps not many  MEDS pretend they don't see the connection. 
Waiting for the intestines themselves to repair themselves is difficult if it's going to take years and that alone can trigger depressive states. Someone wrote here that he passed after3 years but everyone has differently. Sorry only thinking because diet not helps

[modelarz71]

1 hour ago, modelarz71 said:

I just wanted to add that the scary thing is the ignorance of psychiatrists about the fact that SSRI withdrawal can cause damage to these serotonin pathways in the gut , one said it's my age and another said it heals the gut (!) or that it's my depression that manifests itself that way. Perhaps not many  MEDS pretend they don't see the connection. 
Waiting for the intestines themselves to repair themselves is difficult if it's going to take years and that alone can trigger depressive states. Someone wrote here that he passed after3 years but everyone has differently. Sorry only thinking because diet not helps

PS sorry I mean someone wrote that this intestinal ailment passed him after 3 years

[Prozack]

@modelarz71 I agree. I don't think it's your age, because everyone here has similar problem. And yes, diet in genera doesn't help. I saw by myself that it doesn't matter much what you eat - the gut is moving improperly this way or another way.

 

What do you mean by reinstatement? To start taking meds again or what? The problem is that once you start taking SSIRs you will be constipated if you take them or if you stop taking them. If you are taking them they work antiholinergic. Acetylcholine is important for releasing **** out of gut. On the other hand if you stop taking them, your serotonin receptors are missing and the gut is not moving again.

 

Sorry for mixing gastroparesis with shitting, but I feel that there is the same condition. My whole gastrointestinal tract in cramped - the stomach and the gut are not emptyng correctly...

[modelarz71]

37 minutes ago, Prozack said:

@modelarz71Zgadzam się. Chyba nie jest to Twój wiek, bo wszyscy tutaj mają podobny problem. I tak, dieta ogólnie nie pomaga. Sama przekonałam się, że nie ma większego znaczenia, co jesz – jelita poruszają się nieprawidłowo w tę czy w inną stronę.

 

Co masz na myśli pisząc o przywróceniu? Znowu zacząć brać leki czy co? Problem polega na tym, że gdy zaczniesz brać leki SSIR, będziesz cierpiał na zaparcia, jeśli je zażyjesz lub jeśli je przestaniesz. Jeśli je bierzesz, działają antyholinergicznie. Acetylocholina jest ważna dla uwalniania **** z jelit. Z drugiej strony, jeśli przestaniesz je brać, zabraknie receptorów serotoninowych i jelita już nie będą mogły się poruszać.

 

Przepraszam, że mieszam gastroparezę ze sraniem, ale wydaje mi się, że mamy do czynienia z tym samym schorzeniem. Cały mój przewód pokarmowy jest zaciśnięty - żołądek i jelita nie są prawidłowo opróżniane...

My bowels are moving a bit for now because I go to the bathroom every third day, I try to eat potatoes because they are such a filler. I don't know about doing next I am waiting for some miracle , internist suggests PPI. Also, there is some soreness in the stomach or intestines such symptoms of IBS Maybe taking the drug again will cause constipation but I would fight it with e.g. plums and kefir and with this lack of serotonin pathways you wrote about I don't know how to fight unless with St. John's wort.  I am afraid of taking escitalpram again, Thanks for your answer

[Prozack]

Every 3 day to the bathroom... This can't be acceptable...

 

I really don't recommend PPI. Because in the stomach there must be acid environment. In less acid environment in the stomach you can get yeast and bacteria overgrowth and consequently fermentation and (more) gas. If your GI track is slow, maybe your stomach is emptying slowly -this condition also can cause fermentation in the stomach.

 

Try SSRI can also trigger more constipation as I wrote. I don't recommend.

 

What about bloating? Are you gassy just after a meal?

[modelarz71]

19 minutes ago, Prozack said:

Co 3 dzień do łazienki... To nie może być akceptowane...

 

Zdecydowanie nie polecam PPI. Bo w żołądku musi panować kwaśne środowisko. W mniej kwaśnym środowisku w żołądku może dojść do przerostu drożdży i bakterii, a co za tym idzie fermentacji i (więcej) gazów. Jeśli przewód pokarmowy jest powolny, być może żołądek opróżnia się powoli – ten stan może również powodować fermentację w żołądku.

 

Wypróbuj SSRI, może też wywołać więcej zaparć, jak pisałem. Nie polecam.

 

A co z wzdęciami? Czy masz wzdęcia tuż po posiłku?

I also have bloating after lunch for example, I used to not have that. Unfortunately those bowels and stomach slowed down after I stopped escitalopram and the problem started, now I take a minidose of esci 0.2 mg and it doesn't help anything. Of course, these ailments are something new for me until now there was only "depression" so I just sit and think I don't feel like doing anything because I'm worried. 

[Prozack]

I forgot to mention that PPI reduce stomach acid. That's why it's dangerous. In less acid environment you can develop yeast and pathogens, so you can make GI track issue worse. You can get more fermentation and consequently more gas and more bloating.

[Prozack]

@Altostrata I am sorry if I said the wrong thing. I said that just taking SSRI can make your digestion slower by anticholinergic effect. But you said in another topic that:

 

On 11/7/2023 at 12:04 AM, Altostrata said:

@Go2zero Fluoxetine is not antihistaminic. The SSRIs are not antihistamines, though citalopram and escitalopram might be mildly antihistaminic.

 

SSRIs and SNRIs act on serotonin (5-HT) receptors. Antihistamines act on histamine (H) receptors; some are also anticholinergic (sedating, drying). Paroxetine is the only SSRI that is anticholinergic. Tricyclic antidepressants (such as amitriptyline) are antihistaminic and anticholinergic to varying degrees.

 

 

But SSRI does have anticholinergic affect! Dry mouth and constipation are common side effect caused by this.

 

 

[SSRIHelp]

8 hours ago, Prozack said:

really don't recommend PPI

I'd like to add my experience with PPI use (specifically pantoprazole). After I stopped taking SSRI medications, I began to experience slow digestion and stomach pain. I didn't have an official diagnosis yet, but my doctors assumed I had GERD and prescribed pantoprazole, which I have taken for a couple months now. 

 

The medication seems to have helped somewhat with naseau and abdominal pain, but it didn't really fix the issue and in the end, I don't think it was the right answer to my problems. When I tried to discontinue use of the medication, I began to get horrible heartburn (which is not a symptom I ever had before). When I looked this issue up, many people have called this acid rebound. Although I'm not sure if acid rebound is a real thing doctors talk about, it is definitely difficult coming off of these medications. 

 

This isn't an attempt to scare people from trying PPIs if it is something you think you need. It can be a great benefit to people who actually have GERD and deal with acid that can damage the lining of the stomach and esophagus. However, I think it is a medicine that is overprescribed and the possible side effects are not talked about enough. 

[Altostrata]

1 hour ago, Prozack said:

@Altostrata I am sorry if I said the wrong thing. I said that just taking SSRI can make your digestion slower by anticholinergic effect. But you said in another topic that:

 

 

But SSRI does have anticholinergic affect! Dry mouth and constipation are common side effect caused by this.

 

 

 

Paroxetine is the only SSRI that is substantially anticholinergic. Types of antidepressants other than SSRIs, such as TCAs, may be anticholinergic.

[Prozack]

@SSRIHelp You get acid rebound and heartburn probably, because if you block PP, you body try to fix the lack of stomach acid simply just by creating more PPs. If you stop taking PPI, you get more acid than at the same "beginning". Similar story like prescribing antipsyhotics - you block dopamine receptor, your body create more of it. And then if you stop taking them, there is too much dopamine activity and you become more psychotic...

 

@Altostrata I believe you, you are an expert, but in practice fluoxetine also has anticholinergic activity. I had dry mouth and being constipated - it is typical anticholynergic reaction, isn't it?

[Altostrata]

On 11/11/2023 at 11:19 AM, Prozack said:

Dry mouth and constipation are common side effect caused by this.

 

Dry mouth and constipation may be caused by effects other than anticholinergic effects.

[Fairsome]

Because I saw this being discussed, serotonin can mediate the activity of acetylcholine. Neurotransmitters are interconnected, you change one, you dysregulate another.

[GGGG]

On 10/14/2023 at 3:23 PM, SSRIHelp said:

@GGGG

I try to avoid eating beef too much since it's harder to digest. I think chicken, turkey, and fish may be a little easier. In terms of fruits, I can tolerate them pretty well if they are blended into smoothies, but certain fruits I can't eat on their own like watermelons because it causes my stomach to hurt.

 

I have not tried probiotics or enzymes yet, but I was recommend the Renew Life brand of probiotics by my GI doctor. I might eventually give these things a try but since I've found some improvement on my own, I don't want to add anything else to my body right now.

 

I've lost track how long its been since I last took the antidepressant but I know it's been over five months.

I tried marshmallow root and it got me dizzy i also tried bone broth and it gave me anxiety because it contains glutamate ongoing to try dgl 

[modelarz71]

With me still slow digestion since June 23, I just wonder that so few posts about gastroparesis is it not common?

[modelarz71]

On 19.11.2023 at 17:31, modelarz71 said:

Przy moim wciąż powolnym trawieniu od 23 czerwca, zastanawiam się tylko, że tak mało postów o gastroparezie czy to nie jest częste?

Can the intestinal villi be mechanically damaged, I hurt all the time even when I'm calm and watching tv. it's not a food allergy or nervousness or shortness of digestion manifests like this?
I think I will decide to have an endo or a colono dig but many people it shows nothing.
It's hard to have a sore stomach all the time Of course, I'm not crying in pain, but for now I'm holding my stomach. 

[Riccardo]

I am not sure it's an intestinal villi damage,. I rather think it's drug withdrawal and I believe am experiencing the same. As I wrote in another topic (reinstatement) I will see today my GP and ask about it.

A small AD drug reinstatement has already been helpful, but I admit that reinstating "just" because of this, while feeling mentally stable is frustrating. Perhaps some alternative treatments (prokinetic medications combined with diet / lifestyle adjustments) can help! 

 

@modelarz71 are you experiencing "only" digestive issues or also sadness / lack of motivation?

 

[modelarz71]

4 minutes ago, Riccardo said:

Nie jestem pewien, czy to uszkodzenie kosmków jelitowych. Raczej myślę, że to odstawienie narkotyków i wydaje mi się, że doświadczam tego samego. Jak pisałem w innym temacie (przywrócenie) dzisiaj udam się do mojego lekarza rodzinnego i zapytam o to.

Niewielkie przywrócenie leku na AD już pomogło, ale przyznaję, że przywrócenie „tylko” z tego powodu, podczas gdy poczucie stabilności psychicznej jest frustrujące. Być może pomocne będą alternatywne metody leczenia (leki prokinetyczne w połączeniu z dietą/zmianą stylu życia)! 

 

@modelarz71 Czy odczuwasz „tylko” problemy trawienne, czy też smutek/brak motywacji?

 

thank you for your answer, I unfortunately have trouble sleeping, and anxiety about what is happening to me that's why I sit still. i read that you even ran it's out with me

[modelarz71]

11 minutes ago, modelarz71 said:

dziękuję za odpowiedź, niestety mam problemy ze snem i niepokój o to, co się ze mną dzieje, dlatego siedzę spokojnie. Czytałem, że nawet ze mną umówiłeś się

Sorry translator wrong I read about someone else that he practiced running for health. '
At the beginning I think in May I had symptoms of GERD rebounding.
Now this has disappeared but there are symptoms like IBS (also pains) and a quick feeling of satiety after a small amount of food.

[Riccardo]

@modelarz71 I am sorry you cannot run, I know very well that, if you are not feeling ok, running (and doing sport, in general) can feel almost impossible.

I used to run because honestly, while tapering, I did not feel any symptom / issue, neither mentally nor physically. And running made me feel even better. I even managed to become a father in the meantime, which was pretty much the main reason why I wanted (and still want) to quit AD. Embarassing as it may be, it is known that many AD drugs give sexual disfunctions. And I was not an exception. So I decided to taper with some discipline, lead a healthier lifestyle where possible, and thankfully I was blessed with a beautiful and healthy daughter last April.

 

After finishing my taper (which was slow - not the slowest, but slow - from April 2022 to August 2023) until a couple of weeks ago I was also feeling completely fine. Tired, from work and parenting, sure, but not more than usual I would say.

 

Then, at a certain point, it's like my digestive system "stopped working". II even thought it could be my liver, rather than the stomach (which I cannot exclude, but I am not able to determine - hence my GP check today). All I know is that after reinstatement, things got slightly better. Far from being ok, but manageable. Which leads me to think it's AD withdrawal. 

 

Again, it can be that some alternative non-AD medications + diet and lifestyle adjustment might help.

[Riccardo]

I do not feel quick satiety after a small amount of food. My appetite is more or less the same as before. 

The problem is the slow digestion, from stomach to bowels, with acid reflux, bloating, constipation, some abdomen and even back pain.

 

I believe we have slightly different symptoms, but overall similar, in terms of digestive system. Happy to share with you my GP opinion's later once done.

[Prozack]

@modelarz71 I will repeat, how to calm you down a bit. I have all above mentioned symptoms, but I don't have any intestinal villi damage. I have the pictures of it, they are totally healthy.

 

@Riccardo How low after tapering you get gastrointestinal issues? I also remember that at the very beginning it wasn't that bad. It started in the next years after WD.

[modelarz71]

5 hours ago, Prozack said:

@modelarz71Powtórzę, jak Cię trochę uspokoić. Mam wszystkie wyżej wymienione objawy, ale nie mam żadnych uszkodzeń kosmków jelitowych. Mam jego zdjęcia, są całkowicie zdrowe.

 

@RiccardoJak nisko po stopniowym zmniejszaniu dawki występują problemy żołądkowo-jelitowe? Pamiętam też, że na początku nie było tak źle. Zaczęło się w kolejnych latach po WD.

I am glad that your villi are ok. 
This is important because they write that it is difficult to grow them from scratch.
I tried the digestive enzyme betaine and pepsin and it hurts a little less.
 

[Estman]

On 11/11/2023 at 11:05 PM, Altostrata said:

 

Paroxetine is the only SSRI that is substantially anticholinergic. Types of antidepressants other than SSRIs, such as TCAs, may be anticholinergic.

Yes, TCAs are strong anticholinergic drugs.
Unfortunately, I have a lot of gastroparesis
Even if my reduction is only 3% at a time
Unfortunately, there are also frequent headaches
Sometimes it is so strong that I have taken half a tablet of Sumatriptan or Levomepromazine
Headaches are usually accompanied by high blood pressure
When I take these medications, gastroparesis starts about a day later
The headache is usually not, but the digestion seems to stop
It lasts for several days and is very painful
I can't even sleep because of the nausea
I want to vomit, but I can't
I've tried some anti-nausea medications but they haven't helped
Tried Metoclopramide , Buscopane and some antihistamines
The first one increases anxiety and makes sleep especially bad.
Buscopane makes your heart beat faster and gives you a headache.
Both are anticholinergic drugs and could alleviate the cholinergic rebound, but no
Has anyone been helped by Antiemetics- Kytril - granisetron
or Tofran -  ondansetron?

Is Cholinergic rebound nausea caused by too Hhgh or too low Acetylcholine?

[Jake1590]

Hey everyone,

 

I CTd Escitalopram (Lexapro) and reinstated to the original 10mg dose 11 weeks ago. Went through the whole WD Hell for a good 2 months.

 

Now things are more tolerable but for the past 2 weeks I’ve been having really bad bloating, which I wasn’t getting before (lower belly is literally inflated like a balloon). Has anyone experienced this “delayed-onset” GI issue after reinstatement? Did it resolve at some point?