FAQ: Are Flare-Ups Random?
Katy recently posted this question on my Facebook page:
“Why do random GP flares occur even when you are a following a strict diet and taking your medication (Domperidone in my case)? Is it really just that random?”
Great question! Based on my experience and my work with other clients with gastroparesis, flare-ups aren't usually as random as they seem. While you may be adhering to a strict GP-friendly diet and taking your medication regularly, there are many other factors that affect how you feel day-to-day. Your menstrual cycle, stress (of all kinds), travel, other illnesses (even run-of-the-mill colds), changes in activity level (either more or less than usual), lack of sleep (even one night of poor sleep impacts digestion), poor nutrition (certain vitamins and minerals are essential for proper digestion), new medication or supplements, and overextending yourself can all exacerbate GP symptoms.
When I find myself in a flare-up, talking through what's been going on in all aspects of my comprehensive management plan often helps me identify the cause(s). Many times, it's related to increased stressed and/or paying less attention to self-care. Sometimes it's very subtle changes in the diet that I didn't even realize I was making (a food journal can sometimes come in handy here).
Of course, sometimes, even after you've considered all of these things, you may not be able to identify the exact cause of a flare-up. While there like is a cause, our guts are very complex and digestion is regulated by many things that we can't keep track of on our own -- neurotransmitters, bacteria, hormones. The best thing you can do in this case is to maintain all aspects of your comprehensive management plan, really prioritize self-care (a biggie when it comes to finding consistency in GP management), and not get too worked up. I know that's easier said than done, but I can assure you that you will feel better faster if you avoid the "flare-up freak out."
I used to spiral downward during flare-ups and have a terrible time getting back on-track because I'd become absolutely frantic -- incessantly search the internet (again...) for answers, make a bunch of changes, switch to consuming nothing but Boost (which made things worse in hindsight). Eventually I figured out that sticking with my nutrient-rich dietary staples, focusing on self-care, and getting more sleep, mild activity, and nutrition worked much better.
Bottom line: most of the time, flare-ups probably aren't random but there are many, many possible causes to consider. Based on the work I've done with both individuals and groups, however, the stronger all parts of your comprehensive management are, the more consistent your symptom management will be over time.
For more information about building your own comprehensive management plan, check out Living (Well!) with Gastroparesis.