A man who vomited more than 60 times a day and lived in extreme pain told the story of how he asked for help to pay for treatment after the battery of the treatment device that was the only way to relieve his symptoms died and he was in critical condition.
Matthew Pascoe (33), who lives in Colchester, Essex, England, initially thought it was a ‘simple viral infection’ when he began having difficulty eating and vomiting in 2018. However, his condition rapidly deteriorated to the point where he lost about 44kg of weight in 6 months and vomited an average of 50-90 times a day. Although he visited several hospitals, he could not receive a clear diagnosis, and eventually, after collapsing at home, it was only through treatment by a private specialist that he was able to confirm that he had a rare gastrointestinal motility disease called ‘gastroparesis.’
Gastroparesis is a disease in which the motor function of the stomach is paralyzed, preventing food from going down to the small intestine. This makes it difficult not only to eat food but also to maintain daily life properly. There are many days when I cannot get out of bed because my stomach is virtually paralyzed.
The only treatment that stabilized his condition was the insertion of a ‘gastric nerve stimulator’. This is a technology that helps gastric motility through electrical stimulation. However, as he was not included in the UK’s National Health Service (NHS) general benefit list, he had to raise £20,000 (about 34.5 million won) to have the device inserted in 2019. Afterwards, the quality of life improved significantly, with pain decreasing and food intake becoming possible to some extent.
Recently, the situation worsened again when the battery of the gastric neurostimulator device expired earlier than expected. The above neurostimulator battery usually lasts 10 to 15 years, but his device was overworked and died in 7 years. The cost of battery replacement alone amounts to 15,000 pounds (about 26 million won). However, this time, the NHS did not approve the cost support, so we ended up barely raising the cost of replacing the battery through the online fundraising platform GoFundMe. He also pointed out the lack of awareness of gastroparesis and institutional blind spots.
A disease that causes the stomach to stop working, gastroparesis, chronic vomiting, and nutritional deficiencies
Gastroparesis, which Matthew suffers from, is a disease in which the speed at which food moves from the stomach to the small intestine abnormally slows down or almost stops. The stomach literally lost its function and became paralyzed. The key lies in delaying gastric emptying. A normal stomach uses muscle contractions to break down food and move it into the intestines. However, in gastroparesis, this movement is greatly reduced, causing food to remain in the stomach for a long time. This causes chronic vomiting, abdominal distension, early satiety, indigestion, weight loss, and nutritional deficiencies.
The most common cause is decreased vagus nerve function. Diabetic neuropathy is known to be the most common form, and when long-term high blood sugar levels damage the vagus nerve, the stomach’s ability to contract is reduced. Idiopathic gastroparesis that occurs after viral infection, nerve damage after gastric surgery, and drug effects such as opiate painkillers and anticholinergics are also reported to be important causes.
The standard diagnosis according to the American Gastroenterological Association (AGA)’s recommended criteria is a ‘gastric emptying scan’, and if more than 10% of food remains in the stomach even after 4 hours after eating, it is defined as delayed gastric emptying.
In Korea, there are still no national statistics available to confirm the exact incidence or prevalence of gastroparesis. This is because there is a lack of epidemiological surveys targeting the Asian population, and gastroparesis is considered a relatively unfamiliar disease in domestic medical settings, so patients often have to go to various departments and diagnosis is delayed, making it difficult to calculate statistics.
Referring to overseas studies, in the United States, the prevalence rate is reported to be approximately 9.6 for men and 37.8 for women per 100,000 people in the general population, and it appears more commonly in women. In particular, gastroparesis is one of the representative complications of diabetes, and there are reports that delayed gastric emptying is observed in 15 to 40% of diabetic patients. Considering the high prevalence of diabetes in adults in Korea, experts estimate that there are quite a few patients with potential gastroparesis.
The basic treatment for gastroparesis is diet control such as low-fat, low-fiber, small-sized meals and drugs that promote gastric motility (methoclopramide, erythromycin, etc.). However, the drug’s effectiveness is limited and there are long-term side effects, so ‘gastric nerve stimulator’ is chosen for seriously ill patients. As in Matthew’s case, the effect of improving symptoms in patients with incurable diseases has been reported by reducing the frequency of vomiting and gastric stagnation by inducing gastric contraction with electrical stimulation.
Because it is a chronic disease that is difficult to cure, some patients require gavage or intravenous nutrition. Experts assess that gastroparesis is not a simple digestive disorder but a serious gastrointestinal motility disease that threatens nutritional status and overall health, and emphasize that early diagnosis and continuous management are key.
