Low Bp When Taking Motility Meds... Normally My Bp Is High

[janiedelite]

I have small bowel dysmotility and have been trying to reduce my nausea and abdominal pain with the help of a gastroenterologist. I've done the dietary modifications (low fat/fiber, small meals). I'm not having problems losing weight, but I have to put off eating any real food until evening when I don't have to be functional. Eating more than soup, crackers or yogurt during the day leaves me in pain, nauseated, and SO tired.

I tried domperidone 10mg 3 to 4 times a day a couple weeks ago and LOVED the reduction in nausea. But I was more and more fatigued on this med. On the fourth day, I checked my upright BP and it was 80/50. Normally my BP goes up on standing. Since I started carvedilol, it's 120-140/70-90 upright. I took my BP a few more times with same result and called the GI doc who took me off domperidone. Sure enough, the excess fatigue went away and BP came back to normal.

So a few days ago she started me on erythromycin base tablets 250mg 3 to 4 times a day. After the first day, I started cutting the pills in half because it was causing more nausea and pain than I had before taking the pills. Also, I was feeling sluggish again. On 125mg, I actually finally have a bit of an appetite but my BP is down to 90/60 standing and I'm fatigued AGAIN!

Two meds that act on the body in totally different ways are causing this rare side effect. I'm wondering if it's not the meds themselves, but the increased motility that's dropping my BP for some reason. I've read all the posts on erythromycin and domperidone and I seem to be the only one with this side effect.

Any thoughts?

[juliegee]

Sorry you are dealing with this too, Janie I am trying to think outside the box for you....Hmmmmmmm .

With dysautonomia patients, motility problems are almost always caused by misbehaving nerves (as opposed to muscles.) So, your small bowel doesn't empty effectively because your nerves aren't working smoothly together. It's almost as though your small bowel were blocked at times. This leaves you feeling pain, nausea, etc. Pain is notorious for raising BP. What if your chronically untreated small bowel dysmotility raised your BP just enough to mask many of your dysautonomia symptoms? Kind of like florinef. When you treat your small bowel dysmotility, you eat more (which can lower BP as blood rushes to your GI tract to do unfamiliar work & leaves less for vital organs) and you relieve pain (which can also lower BP.) Just a theory....

In the long run, treating the small bowel dysmotility would be the healthiest thing for you. Properly fueling and nourishing your body throughout the day would be ideal. I would try tiny doses of liquid "E"- as little as it takes to do the job- and small meals thoughout the day. If the low BP persists, treat it with increased liquids, salt, and maybe a tiny dose (1/4 0.1mg florinef.) The "E" and florinef together did wonders for me.

Weird....but aren't we all?

Hugs-

Julie

[futurehope]

I had the same reaction to erythromycin that you did. It made me feel very sick. Let me know what you decide.

[juliegee]

I had the same reaction to erythromycin that you did. It made me feel very sick. Let me know what you decide.

Hey Futurehope-

Out of curiosity, what dosage of erythromycin were you taking? Was it liquid or solid form?

Through lots of trial and error, we have learned that only liquid works, Ery-Ped 200, and tiny doses, like a 1/2 tsp 15 mins before meals. Too many GI's (and even motility specialists!) prescribe too high of a dose which definitely exacerbates symptoms.

Julie

[janiedelite]

Thanks, Mack's Mom! I am actually enjoying being on the 125mg "E" dose. I'm cutting out my afternoon dose of carvedilol to see if I can stay on the "E" with a manageable blood pressure. I'd like to stay on it, if my body will let me.

This is so wierd for me as I'm used to dealing with hyperadrenergic symptoms (chest pain, migraines, stuff associated with high BP). How I feel on these motility meds is completely different: drunk, spaced out, cold, clammy at times. It gives me an idea of how you folks the Orthostatic Hypotension feel regularly.

[futurehope]

Mack's Mom,

After being diagnosed with SIBO, and being given a course of antibiotics to take for it, I questioned whether I should be taking something daily as a preventative? I do not consider my gastro doc an expert in gut dysmotility by any means.

I can't remember anymore what form or dose of the E that I took? I'd have to call the pharmacy and ask. Whatever it was, it was a very small amount.

[Broken_Shell]

How I feel on these motility meds is completely different: drunk, spaced out, cold, clammy at times. It gives me an idea of how you folks the Orthostatic Hypotension feel regularly.

this is how i feel when my gi system is reved up and moving too fast like it is right now. i dont have a good explanation other than guessing that it has to do with blood shunting and different neurotransmitters and hormones related with gi motility. it must just be that the stimulation and increased motility of the gi tract causes reductions in bp and these symptoms regardless of what is causing the speed up. i hope you can find a good combo that helps you and your body function best.

curious, how was your sb dysmotility diagnosed?

[janiedelite]

this is how i feel when my gi system is reved up and moving too fast like it is right now. i dont have a good explanation other than guessing that it has to do with blood shunting and different neurotransmitters and hormones related with gi motility. it must just be that the stimulation and increased motility of the gi tract causes reductions in bp and these symptoms regardless of what is causing the speed up. i hope you can find a good combo that helps you and your body function best.

curious, how was your sb dysmotility diagnosed?

This is a great explanation!

Anyway, my sb dysmotility was diagnosed at Mayo with their motility studies. They had me eat a radioactive egg and followed it through my GI tract, timing where it was at intervals. My stomach actually moved through very fast, sb extremely slow and colon borderline slow.