GASTROENTEROLOGY / DIGESTIVE DISORDERS EXPERT FORUM
Rumination/Delayed Stomach Emptying

Rumination/Delayed Stomach Emptying

I posted a couple weeks ago. Today I had an endoscopy and there was nothing irregular except that I had salad in my stomach which should not have been there. They are going to test me for Delayed stomach emptying. I was wondering how this is treated and what it means? Also, they said I had rumination. It means that I regugetate my food. Has anyone ever heard of this or known anyone who has it? It is not common in adults.
My symptoms are:
eating after meals and throwing a little bit up at a time,
most notable with tomato sauces, caffenine, green vegetables.
There is no pain.
The doctor says it is common in those who have an eating disorder, but I never have.
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I know a lot about this, because I have it myself. The test for this is a gastric emptying test. You eat a small meal with a tasteless isotope. Then you lay on a table, and they take x rays of your stomach as your food digests. My test lasted 90 minutes. At the end of the test, your stomach should have emptied by 50%.
Anything less is considered abnormal. Foods that are hard to digest are anything high in fat or fiber. These are more difficult for the stomach to digest. The fat slows down the stomach, and fibers (fruits, vegetables, including salad, whole grains, anything with a skin or seed, such as popcorn, beans, etc.) are mechanically difficult to break down, thus they stay in the stomach. The name for this is also called gastroparesis. About 30-40% of all people have idiopathic gastroparesis (gp for short), which means of unknown origin. The others with gp have it as a secondary disorder from things such as diabetes, autoimmune disorders, multiple sclerosis, etc. Your doctor should do testing to rule out other possible causes. Although many doctors will recommend a drug called Reglan, it is difficult to tolerate by many people (including myself) and has some potentially serious side effects. A better choice is a drug called domperidone, or Motilium is the brand name. It is not sold in the US, so must be ordered from out of the country. Your insurance will not cover it, but it is not costly. This is the medication that I take. I went from eating hardly anything when I got very sick, to being much better through the use of domperidone. It is the drug of choice by the top stomach motility doctors in the country. I have seen specialists at U of M Hospital and the Cleveland Clinic, so I have heard it from the experts. This is a very safe drug, and is completely legal to buy, it is just not available in the US because of the complex and costly FDA  process. It has been on the market for about 40 years, and in many countries is sold over the counter.
I would suggest several things. First of all, modify your diet, and eliminate those foods with high fat and fiber. I know it doesn't sound healthy, but that is what we have to do to prevent being sick from the foods we eat. Naturally, this will include more carbs, such as white rice, pasta, breads and potatoes, etc, and lean meats such as chicken and turkey, lean pork and fish. Red meat should be avoided as well. Next, have the gastric emptying test, it is easy and painless. I would find a motility specialist if that is the diagnosis. In addition, search the internet for more info, use keywords such as gastroparesis, stomach motility disorder, and delayed stomach emptying. It is not unsual for the motility problem to affect other parts of the digestive tract, often resulting in constipation. I joined and online support group through Yahoo, they have been a lifesaver, and remain my chief source of information. Some of the information can be frightening, as people with severe forms of this disease end up requiring feeding tubes, IV feedings and implantation of a gastric stimulator. Keep in mind that is not the majority.
I know I have given you a lot of information and may be confusing. Let me know if you have any questions. First things first, get the test, but in the meantime, change your diet and see if that helps. Many end up with some type of proton pump inhibitor as the stomach tends to retain acids, etc as well.
Hope this helps.
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