[Dysphagia] alternatives to Reglan

[sem at new-vis.com (Suzanne Morris)]

Heidi,

Many things influence motility and especially the rate of gastric  
emptying during typical meals so motility issues can also be  
approached from a wide variety of perspectives, not just that of  
pharmaceutical medications such as Reglan.  Let me approach your  
question out of my personal experience with children.  I don't know  
whether your question about alternative/complementary approaches  
related to a child or adult client, but I think that these ideas are  
applicable with both pediatric and adult clients.

One of the most important tools we have in speeding up gastric  
emptying involves our ability to reduce stress in our personal lives  
and in the lives of our children or adult clients. Mealtimes are  
often very stressful when there are feeding and swallowing issues.  
When we experience stress, the pituitary releases CRF (corticotropin  
releasing factor) and other hormones produced along the hypothalamus- 
pituitary-adrenal axis.   The function of these body chemicals is to  
prepare the body for fight or flight in conditions of acute stress.   
The body, in this context, needs to shift the blood flow from the  
viscera to the extremities so that the person can deal with the  
dangerous situation.   One of the major functions of CRF is to stop  
or delay gastric emptying.  The whole digestive system slows down.  A  
number of research papers have speculated that this may be one of the  
factors that increases reflux and cyclic vomiting.

  Strategies that reduce stress become tools that can improve the  
quality of everyone's life, don't have side effects and don't involve  
insurance payments or major out-of-pocket expenses!    We want to  
think about the environment in which we prepare and offer meals.   
Think first about relatively simple changes a family might make in  
the mealtime environment.  How could they create a calmer place for  
the meal?  Does the person who is offering food feel stressed when  
going into the meal (especially if a child or adult often vomits the  
food because of slow motility and reflux)?  What could the feeder do  
to deal with their own stress for these short periods during the  
day?  Is the person being fed physically and emotionally comfortable  
or are there a lot of battles around the meal?    Feeling helpless  
and having no control can also be stressful, so giving choices, and  
honoring communication when the person says "no" or "no more" etc.  
can also help in so many ways.

  I find the use of music before and during the meal to be a real  
lifesaver for many children, adults and parents.  Music that is calm  
and organizing and focusing for everyone can make a huge difference.   
One of the most effective types of music is based on an auditory- 
guidance system called "Hemi-Sync".   There are several articles on  
my website that can introduce you to both the theory and ways of  
using it at mealtimes and other quiet times during the day.   See:   
"Opening the Door with Metamusic at << http://www.new-vis.com/fym/ 
papers/p-lrn11.htm >>  and  "Users Guide:  Hemi-Sync Recordings for  
Learning and Stress Reduction" at << http://www.new-vis.com/fym/ 
papers/p-lrn1.htm >>.

Suzanne


__________________________________
Suzanne Evans Morris, Ph.D.
Speech-Language Pathologist
New Visions
1124 Roberts Mountain Rd.
Faber, VA 22938
(434) 361-2285 ext. 5
www.new-vis.com


On Dec 27, 2005, at 3:51 PM, Heidi Sloan wrote:

> Hi -
> Is anybody familiar with any alternatives to Reglan to
> aid with motility?  The family that I am working with
> is open to any homeopathic/alternative treatments as
> well.
>
> Thank you,
>
> Heidi Sloan, MA, CCC-SLP