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Slow Stomach Emptying


marnian
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My gastroenterologist got back to me about all my recent tummy tests. The basic conclusion was that there's no obstruction etc, but inflamation and delayed emptying. I'm on protonix for the inflamation, zofran for the nausea, and trying zelnorm at a low dose to see if it helps move the whole system along. But here's the problem:

My doc said I should start eating more and more solid foods. I've been on a mostly liquid diet for 6 weeks after I began to rapidly lose weight with these tummy problems. I'm able to keep down Ensure-like things and it's really helped me feel better and slow down the weight loss. But this doc said to stop drinking those things and do the best I can with solid foods (although avoiding fat and fiber). That I should deal with the pain/nausea/vomiting it causes for awhile. He said that I would turn a moderate problem into a severe problem by continuing to "give into it". But that I might be able to reverse it through the right diet. Have you ever heard of this? What do I do?!?

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Hi Marnian,

I am sorry you are having such a rough time. "Don't give in to it" -- that is easy advice from someone who has never had a difficult-to-diagnose-or-treat problem! You have no choice but to feel what you feel.

What tests did you have? Forgive me if you have posted this already. There are lots of good products and dietary recommendations made for specific dysfunctions, but we need to know a little more.

Best wishes.

OLL

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I had an EGD that showed inflammation and food left in my stomach (even though the most recent thing I had drank/eaten was 2 saltines with gatorade over 12 hours before). I had a gastric emptying study that showed "slow gastric emptying" but I wasn't given any specific details other than that it was abnormal. I have POTS and increased intracranial pressure (probably unrelated) so I've had a million other tests to get to those diagnoses. The current theory is that I got sick with "something" that triggered a bunch of symtoms (this all started with a cold in June that led to hospitalization in July so I'm still actively going to doctors now).

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Marnian,

The only thing I can think of is that he may want you to try solid foods again so you don't lose the digestion abilities of your stomach completely. Easy for him to say when your vomiting---nausea ect. He could have put things a different way though-----he didn't sound very sensitive.

When I had trouble in the beginning of my POTS I had a terrible time----eating a saltine cracker sent my stomach into painful knots. I lost 25 pounds in 5 weeks.......... :unsure: However, during this time I forced myself to eat tiny amounts of food-----cereal helped me---cheerios. Cereal is fortified with vitamins, and it forced my stomach to work. It took a considerable amount of time, and my guts aren't perfect, and still get very constipated, but my stomach motility is OK. I also didn't have the vomiting problems---so it made things easier.

I'm fortunate as I don't think I had true gastropareses--(spelling?)----possibly temporary at the time. My concern sometimes is that some folks with this are over medicated. The pump inhibitors concern me the most as they are shutting down the stomach's natural acids which aid the digestion process--(motility). But it's a catch 22-----as the acid builds up in the tummy from the slow digestion, and it backs up into the esophagus causing damage.

Pump inhibitors were prescribed for me---protonix---and prevacid. I took prevacid, but it made me feel worse. I never took the protonix. Depending how bad the gastric reflux---it may be possible to take over the counter antacids only when needed. The pump inhibitors may be great for people who don't have slow gastric motility, but have chronic acid reflux. I'm guessing the gastric reflux for people with slow motility is secondary. It's a tough call, as you can't walk around in misery. They also found inflammation in my esophagus in 2001 with an endoscopy. I assume it was temporary because my motility is fine per the gastric emptying test I had a year and a half ago.

Your Doc may have a point, but he sounds like he's being a jerk about it. Maybe you could try tiny amounts of food---like starting with a tablespoon at a time, and work your way up. Try easily digestable foods----canned fruits in light syrup, apple sause, canned vegetables, soups---then introduce more low fat foods as you go. It's important to get some protein-----low fat though---maybe white meat chicken ect.

They told me I had acid reflux, but my gut feeling was that I was sick with something else--(not yet diagnosed with POTS), so I figured it was secondary to whatever was going on with my body. Also, Ensure actually made me feel sick----I didn't digest it well at the time.

I doubt I had "true" acid reflux, as I would not tolerate all the v-8 juice, orange juice, and tomato sauces I eat today. I only notice acid backing up my esophgus when I am very back up from not being able to go to the bathroom for more then 4 days. then I either take something, slow down my solid food intake, or both until the problem clears. There is a lot of people that have ANS neuropathy, and it affects the motility---and it really stinks-----because they are always in a catch 22 position. After all---they need to live as comfortable as possible, and that usually requires the aid of drug therapy.

I hope you find something that works well for you............. :)

Maxine :0)

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Marnian..I too was diagonsed with gastroparesis..you really need to watch what meds you take..remember the PPI's are ridding you of natural acid that some of your body does need. You really do need to keep trying to eat..nibble on small amounts crackers,gatorade, pretzels,etc. I at first lost about 38 lbs.(not sure if it was meds or what) but eventually I trained my belly to hold down foods again..

Umm..also I was put on Reglan but had to discontinue due to side effects..One thing a doc suggested to me to help coat my esophagus in a safe way and help me to GO was aloe vera juice. It is quite safe and will help coat your digestive system.

Good luck with this...

Bee :unsure:

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"Don't give in to it" -- that is easy advice from someone who has never had a difficult-to-diagnose-or-treat problem! You have no choice but to feel what you feel.

that is such a true statement. i am having a hard time right now with my stomach. it is cramping continuosly. i am nou nauseous but i am having the other problems. i haven't been to the doctor yet... which is very dbof me cause it has been like this for mnths. i guess i am just too embarrassed. i don't really have much advice for you but when i was trying my "POTS diet" a lot of my stomach issues went away but that is when i started losing too much weight. you said that you are losing weight as well so that wouldn't be a good idea for you either. i am going to try a new diet again and see if it will help me before i pay yet another visit to another new doctor.

basically i just wanted to let you know that i am thinking about you and i do realize that what you are going through is difficult and i wish there was something that i could say or suggest to make it all better for you. if i can get a "new" diet to work for me i am going to post it for all to see. hang in there and do what you think is right.

anything a doctor tells you should just be taken as advice... atleast that is the way i look at it. different doctors tell me to do different things for the same problem all the time. i just take the advice that better works for my style and what i know i would actually be capable of doing.

dionna :unsure:

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there's a fine line between pushing just enough & pushing too much and that line is different for everyone. and it may change for a given person over time or even within a given week or day. pushing for me, for example, means a tortilla chip or two and two popsicles or so throughout the day; obviously that wouldn't be considered pushing it for many but my stomach is all but entirely non-functional and even then i still get sick (vomit) on a regular basis.

your doctor is right that not pushing at all can make things worse, but like i said there's a fine line to walk and pushing won't necessarily solve the problem. at some point it can make things worse, i.e. if you push to the point where everything comes back up.

i'm glad that you've found some relief by doing ensures & the like. obviously i'm not your doctor, but it seems that a more gradual approach might be wiser that all of a sudden changing everything you're doing....like adding things in every day to try to expand what you can tolerate a bit more while still drinking the ensures/liquids to keep yourself healthy. have you seen any of the gastroparesis diets that are available? they all suggest this and have very detailed suggestions. i know they've been posted on the forum before but let me know if you don't have them & i'll hunt down the links....

hope this helps,

:huh: melissa

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That's lousy advice, if you ask me. Sorry you're dealing with this and him! I have the opposite problem as you, so my own experience wouldn't help, but if you can keep ensures down, can you keep on them and try to eat a few solid foods, like those low in fat and fiber, in addition? I wasn't under the impression that gastroparesis or delayed- emptying necessarily coincided with inflammation, so have they looked into what the inflammation is about? I have chronic inflammation of the stomach- no idea why or what, but I don't have IBD, and was put on meds to actually slow down my emptying (like i said- opposite!!), and I just hope that there's not more going on with you than dysaut. related problems.

Anyway, sorry I'm not much help. Good luck, and maybe it'd be worth finding a new GI doc?

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