Stomach problems - extremely frustrated

[Knellie]

Hi guys-  

    So earlier I had a post about heartburn and indigestion after every meal. I went to my doctor to get this checked out. I was put on Omeprazole for two weeks, and he said that because of my age I shouldn't have symptoms anymore. I tried it, and while the burning sensation went away while I was on the pill, it made me really nauseous after every meal instead. When I got off the pill, not only did the burning sensation come back, but it was accompanied by the nausea. Occasionally I would get so nauseous after one meal, that I wouldn't eat for 24 hours. I got an H. pylori test, which, of course, came back negative. My doctor then ordered a CMP, a CBC with differential, and a Lipase test along with and Ultrasound of my abdomen. I was hoping for some answers, but both of my tests came back perfect. My doctor is just telling be now to go back on the pill, but when I went back on it didn't even work for the burning sensation anymore.

      Has anyone experienced the same thing? I know that some dysautonomia patients have some form of gastropariesis, and not just the crazy throwing up all the time kind. I have heard that a lot of people have trouble digesting food, and get similar symptoms. If it is a kind of gastropariesis, does anybody know how to test for that/fix that?  All my doctors keep telling me that it is a good thing that they can't find anything wrong, but I don't think so because they can't help me. I am really frustrated because none of my doctors are being helpful. Any advice? Thank you guys so much for your answers!

[Guest KiminOrlando]

The next step is typically a colonoscopy and endoscopy. They typically do a biopsy to rule out stuff, then you go for nuclear testing for gastroparesis. Basically, you eat scrambled eggs with some kind of additive that glows under their equipment. They take images for about 3 or 4 hours to see how long it takes fir the eggs to leave your stomach. 

Edited October 8, 2020 by KiminOrlando
Spelling, hopefully right this time.

[Guest KiminOrlando]

I went to four or five gastroenterologist before finding one willing to do this. None of the others thought I needed this test.

[Pistol]

@Knellie - I think I answered your previous post, so I apologize if I repeat myself. I experienced severe heartburn and nausea when my illness first started, and EGD showed inflammation all throughout my GI tract from the excess acid. I was put on PPI, something called a GI cocktail ( Mylanta, Viscous Lidocaine - to numb the esophagus - and Phenobarbital - I believe to make less acid - ) and Zofran. This treatment did help to heal the existing inflammation and eventually I was able to just stay on the PPI. Despite the potential for side effects from long term use I have been on the PPI for over 10 years and have less heartburn and no further damage from the acid. 

Due to the visible damage to the lining in my stomach they did extensive GI testing - EGD, Barium Swallow test, Gastric Emptying study, HIDA scan ( to check function of gall bladder ) - and it was determined that I had both IBS-D ( IBS with diarrhea ) and fluctuating gastroparesis, meaning I could go back-and-forth between the stomach being too slow in emptying and too fast - causing dumping. Here are a few articles that talk about dysautonomia and GI symptoms: 

https://chronicallysalty.com/2019/03/27/dysautonomia-and-digestion-how-pots-can-affect-your-gi/#:~:text=You may be reading this wondering if your,and incontinence%2C among others. Dysautonomia in a Nutshell 

https://www.dysautonomiasupport.org/gastroparesis

https://n.neurology.org/content/84/14_Supplement/P1.280

This article explains that further studies may be needed in your case, you may want to show this to your doc: 

CONCLUSIONS: Subjective GI disturbance is common in patients with POTS, and these symptoms are not necessarily related to primary GI pathology. Symptoms are frequent and prolonged, likely decreasing quality of life. Given the importance of autonomic input to normal GI function, the same autonomic impairment that leads to postural tachycardia may also affect the enteric nervous system, leading to gastroparesis, abnormal gut motility, and esophageal reflux. Further studies correlating subjective symptoms with objective abnormalities of GI autonomics are needed.

[shoshan]

I have gastroparesis. It was diagnosed by Gastric Emptying Scintigraphy, or GES for short. It's done in the hospital in the Nuclear Medicine Department. They give you radiolabeled food to eat and then scan over the next few hours to track the food's progress through your digestive system. Since digestion is an autonomic process, in some patients the food takes longer to digest, which causes symptoms. Severity of the digestive delay doesn't necessarily correlate to symptom severity, so you should check it out even though you say symptoms aren't too crazy.

[p8d]

I had severe GERD like symptoms underwent all the tests GES (no), upper endoscopy (fine) but I had a gastroenterologist who was familiar with dysautonomia and diagnosed neuropathic pain. I was put on gabapentin and it worked. Mine was so bad I lost 25 pounds in a month and was hospitalized and put on TPN for 6 weeks. 

[cmep37]

@KnellieI do sympathise.  I've had tests to rule out stomach ulcers, cancer etc - an upper GI endoscope and a barium swallow.  The gastroscopy showed a lot of inflammation; not surprising when I vomit most lunchtimes although that is down to a problem with my vagus nerve being stimulated by my high heart rate rather than gastroparesis.  I've never been tested for gastroparesis but I tend to have symptoms (nausea and vomiting up undigested food) during a bad flare and my GP treats me as though I was formally diagnosed as the waiting list to see a gastro in my area is now 4+ years.  She prescribes domperidone for the duration of my flare (usually a fortnight) which really helps.