Q: My mother-in-law suffers from a problem of gradual and continuous loss of appetite since last 24 years. It started with cutting down to two meals a day (no breakfast), then one meal a day (two chapattis at dinner only), and sustaining on several cups of tea and a few biscuits throughout the day. Currently, she does not even feel like having her dinner at all. She is ever worried that consuming any food would simply make her throw up. Meanwhile her weight loss continued consistently from a healthy 58-59 kg to 44 kg as of now. She has lost 2 kg in the last 6 months. Associated with this there have been complaints of acute stomach pain and severe constipation for past 8-10 years. Off late, she manages to pass her bowel only after 15-20 days. We have consulted several medical practitioners in the past when multiple abdominal scans and endoscopies were done, without any conspicuous findings. Her current consultant has diagnosed the problem as gastroparesis. Today she was advised the barium meal x-ray of her stomach and duodenum for further diagnosis. Could you please suggest a way ahead to put an end to her ailments?

A:Gastroparesis, also called delayed gastric emptying, is a disorder in which the stomach takes too long to empty its contents. Your mother may not feel like eating 3-4 regular meals because her stomach is not empty to feel hungry. The feeling of being full gives her a feeling to throw up if she force feeds. It is suggested to take small meals may be 6-7 times a day. You have mentioned that she takes tea and biscuits several times a day. I would suggest replacing tea and biscuits with healthier food options. Drinking too much tea (caffeine) will further lower her appetite. Clear soups, strained fruit juices and buttermilk kind of drinks will be a better option than tea. Biscuits can be replaced with other smaller snack size food items of choice. It is not unusual for a patient to face difficulties to make these dietary modifications so don't try to make too many changes at one time. It may be a good idea to replace one teatime with another food at a time. Your doctor may also recommend avoiding high-fat and high-fibre foods. Fat naturally slows digestion and fibre is difficult to digest.