06 September 2018

The teenager who vomits 30 times a day

19-year-old Caitlin White throws up nearly 30 times a day due to a rare form of gastroparesis.

Caitlin White vomits nearly 30 times a day as a result of a rare and severe form of gastroparesis.

The 19-year-old, from Perth, Australia has suffered from the gastrointestinal disorder since she was 14.

The constant vomiting is due to a delay in the emptying of her stomach. As a result, White is unable to keep down the food she consumes and has to rely on daily nutrient infusions, which she receives from the hospital.

When she was first diagnosed she weighed 69kg, now five years later she weighs 38kg.

Deadly disorder

White’s daily hospital visits can last up to 12 hours at a time. These nutrient infusions, although beneficial to her health, does put her at risk of life threatening infections. This year alone, she has suffered from septicaemia on six different occasions. 

White’s rare case caught the attention of Scotland’s chief medical officer Dr Catherine Calderwood, who referred her to gastroenterologist, Dr Ruth Mckie, in Glasgow. Dr Mckie suggested that a total parenteral nutrition (TPN) could be a possible option, but that it was a high-risk procedure.

Speaking to the BBC Scotland, White said, “It's a Catch 22: if they decide to give me feed (TPN) I'm at high risk of 're-feeding syndrome', infections and blood clots. But if they don't do it, I am also at risk of infection. I'm malnourished as it is, and there's (the risk of) organ failure as well."

White has been told by doctors that if a solution is not found, her disorder may kill her within the next six months. 

What is gastroparesis? 

Gastroparesis is a digestion disorder that commonly affects patients with Type 1 and 2 diabetes. Other causes of the disorder include hyperthyroidism, autoimmune conditions, cancer and eating disorders.

According to the National Organisation for Rare Disorders (NORD), the disorder is more prevalent in women, especially in idiopathic cases. The organisation believes that idiopathic gastroparesis may be linked to an enteric autoimmune disease.

When a patient has gastroparesis their stomach muscles are slowed or do not work at all and thus the stomach is emptied too slowly and inaccurately. As a result, the person is unable to absorb enough energy and nutrients and this then causes malnutrition and rapid weight loss.

Symptoms of the disorder include chronic nausea, vomiting undigested food, acid reflux, abdominal pain and feeling full after not eating much.

Treatment of gastroparesis usually involves a change in diet. Smaller meals are suggested to patients as well as eating foods that are well cooked and not too fibrous. In extreme cases, like that of Caitlin White, TPN can be a possible option for treatment. TPN involves pumping nutrients like glucose, amino acids, vitamins and minerals directly into the bloodstream.

Image credit: iStock