GERD/HIATAL HERNIA/GASTROPARESIS

[mcbehr]

HI,
I am 42 yr old female, take diovan, lipitor, metformin and protonix since 10/2004.
On 9/27/05 an upper GI series was done and it showed Gerd .
Several months later a CT scan and ultrasounds were done showing hemangiomas on my liver.
On 4/14/06 a stomach emptying scan was done showing gastroparesis.
On 4/17/06 and EGD showed a haital hernia. I am currently waiting for results of stomach biopsies although the Dr. feels they will be fine.
All of these tests are being done to locate the cause of a pain I have had in my right side (at waist height)since fall 05,a pain that never really goes away and seems to get worse after eating,although it is worse in the morning with an empty stomach, also nausea at random times of the day , I test sugar at those times and it is usually normal .
After the test on 4/17/06 the Dr. told me that the pain in my right side would not be caused by the hiatal hernia or gastroparesis.
My ? is any ideas on the right side pain and since I already take protonix for Gerd I assume that would also be taken for hiatal hernia, what are the treatments if any for gastroparesis?

[Kevin Pho, MD]

You have had a pretty comprehensive evaluation.  

If the hemangiomas are large enough, this can lead to some abdominal discomfort.

You can also consider a HIDA scan with CCK stimulation to evaluate the gallbladder ejection fraction.  Gallbladders with a low ejection fraction can lead to some abdominal discomfort.  

Gastroparesis can be treated with pro-motility agents such as erythromycin or Reglan.  If there is evidence of diabetes, control should be optimized.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b

[kazma]

Hi,
After having hearthburn surgery I developed gastroparesis due to a damaged nerve during the surgery. I have had the sthomach emptying problem for 4 years since surgery. You can try to use Cytotec (misoprostol) 100 mcg. This medicine is used for labor inducing therefore it should not be taken during pregnancy. However, I have had better success taking another medication called Motillim. But it is not sold in the US, and you can get it from Canada. The chemical name for it is Domperidon, and made by Johnson and Johnson. It works well for me. These medications should be taken 1-1.5 hours before the meals on empty stomach, so that it can be absorbed to the blood stream just in time for the meal. I avoid red meat, since I find it hard to digest. Try eating plain yogurt, since it is easier to digest if you are lactose tolerant. I wish you good luck with your condition, since I can guess how you feel.

[boninclyde]

Would you please tell me about your upper GI procedure (meds? how it was done? where you awake? How long did it take you to wake and back to normal?). I go Monday for this procedure and I'm scared to death. I also have panic attacks so this condition does not help much.

[mcbehr]

Hi ,
In answer to your question about your upper GI .
Please don't worry yourself about it, it is absolutely painless, I assure you of that.
They will give you a drink in a dixie cup, it is a little thick but I it tasted fine, kind of like thick maalox with a better flavor, they ask you to drink it and then they basicaly take film of it while it goes into your body, then they have you lie on a table and they ask you to have some more and take some more film, it was so easy, really ...Don't listen to people that tell you otherwise.
And if in the future you have to have the EGD (where they put a scope in your throat down to your stomach, you will feel nothing at all , they knock you out and wake you when it's done ..
The best thing you can do is don't tell your friends what you are having done and it will spare you having to listen to the stupid stories they have.
good luck and please relax ...   : )

[boninclyde]

Thanks so much for the info. I have had the baruim swallow and it was no big deal. Maybe I wrote the wrong test down. I'm having the endoscopy on Monday. Anyway to get a step by step detail of what to expect? I'm allergic to almost every medication there is. And the putting me out part is the scariest. I get hives and worry about the throat swelling. They don't want to give me the epimephrine because I have heart problems so all info would help (Meds used, mgs, how long it takes to wear off, how I will feel during the procedure, etc?).I'm a big chicken and have had many bad experiences with doctors.

[mcbehr]

Hi,
I was put out for the endoscopy and I am not sure of the medicine used for that. It was explained to me as a drip that is very safe as you are put out but as soon as the procedure is done the drip is stopped and you wake up. I felt nothing at all during the procedure . I also know that this procedure used to be done while people were awake and I know 3 people that did it that way and also were fine . One friend who is someone that works giving tests such as the body emptying scan had one and was not put out and was fine , they sprayed his throat with a numbing spray and did the scope that way, he said it did not hurt at all . The only thing was a slight sore throat the next day , almost like the beginning of a cold , but in a few hours that was gone also. I wish I could tell you more but I think you will be fine. hope that helps, M  :)

[boninclyde]

Thank you so much for the info. Any info helps.

[Aub]

It looks like Kildiz had had problem with repairing a hiatal or diaphramic hernia.  The doctor I am thinking of going with has done about 100 sugeries.  He never had any complications like cutting a nerve (he says).   I believe the surgery is vastly improved and not sure that the people on this board have had more problems than normal.  I had the manometry test that was excellent.   This is a good sign the surgery will work.  I had the barium swallow yesterday and will talk to the surgeon next week.

Aubrey Sonsini

[celine149]

Usually the doctors use Versed and demerol to do the EGDs and colonoscopies.It is called conscience sedation. They say you aren't really asleep and you can respond to commands but you have no memory whatsoever of the procedure. I have never had any pains with my EGDs. I also had an unsedated EGD..I wouldn't recommend it, but that is just my opinion.

[mcbehr]

Yes , I have had weight gain , 14 pounds since November, and I am at the gym at 5am 5 days a week working out , so that is pretty frustrating...The Dr. said this could be due to the diabetes and glucose being out of whack due to the gastroparesis, they are working on it. Right now they have advised no carbs except those from vegetables or fruit, I will try that and see how it works. good luck , :)

[md1johnson]

I also GERD/Gastroparesis/H.Hernia. Had gall bladder removed several years ago. I also have liver problems and pulmonary hypertension. My question is has anyone had weight gain with these stomach problems. Constipation is also a very big problem in which I take lactulose helps some. But this weight gain has me really depressed I tell the Dr's I really don't over eat because of the Gastroparesis if I do it makes me very uncomfortable. If anyone has had the weight problem I would love to know what I could do to loose some weight.Forgot to mention I do have some edema due to the pulmonary hypertension. Thanks

[md1johnson]

I also GERD/Gastroparesis/H.Hernia. Had gall bladder removed several years ago. I also have liver problems and pulmonary hypertension. My question is has anyone had weight gain with these stomach problems. Constipation is also a very big problem in which I take lactulose helps some. But this weight gain has me really depressed I tell the Dr's I really don't over eat because of the Gastroparesis if I do it makes me very uncomfortable. If anyone has had the weight problem I would love to know what I could do to loose some weight.Forgot to mention I do have some edema due to the pulmonary hypertension. Thanks

[md1johnson]

I also GERD/Gastroparesis/H.Hernia. Had gall bladder removed several years ago. I also have liver problems and pulmonary hypertension. My question is has anyone had weight gain with these stomach problems. Constipation is also a very big problem in which I take lactulose helps some. But this weight gain has me really depressed I tell the Dr's I really don't over eat because of the Gastroparesis if I do it makes me very uncomfortable. If anyone has had the weight problem I would love to know what I could do to loose some weight.Forgot to mention I do have some edema due to the pulmonary hypertension. Thanks

[Duchess47]

Have you had your thyroid checked?  Gatroparesis can be caused from being hypothyroid which can alslo cause weight gain among other problems.

[nogood]

I have had very strong BURNING, BORING sensations mid-ribs for a very long time.  Nothing else (i.e no reflux). The pain goes right through to the back.  It is so bad that I rub my back against the door frame to try and relieve it - there being no one to massage me.    It usually is felt in the night and on waking.  Some small gall stones have been diagnosed.  I take 15mg Lansoprozole before breakfast and this seems to have helped.  However it seems to have got worse (still no other symptoms )  and lasts longer so I have upped the dose to 2 x 15mg.   I also have HYPO glycaemia so have to keep the blood sugar up therefore try to eat something late at night i.e. a shortcake biscuit with milk or a fruit cookie-  anything with sugar in it. Likewise, on getting up in the morning - quite an effort with low blood sugar (which I monitor - sometimes down to 3 early morning - ) I drink a fruit 'smoothie' .    I start the Lanzoprozole before (usually late) breakfast.  My diet is quite bland and certainly not with strong seasonings - strongly dairy , wholegrain bread,lots of cups of milky tea  and carbs.  with daily banana , probiotic, and smoothie.  I also eat very little (all my life)  do not touch alcohol as have never been able to take it even 2 choc. liquers go to my head!)  

I am female, underweight (so I am told) at 50KG and middle aged.

The problem is in balancing the sugar levels (i.e eating as late as possible at night to prevent the HYPO's ) and preventing pain from what may be the gallstones or undiagnosed ulcer - can anybody help with this ?    The pain is intense and added to other pain at night mainly from a major spine operation years ago which left damaged nerves in the left leg , I have interrupted sleep but SO FAR have mostly resisted taking pain killers other than paracetamol.  I take no other drugs other than those mentioned as also, I seem to have bad reactions to everything else.  Something to do with being so thin and my metabolic rate- so I have been told (ref my note about choc. liquers!)

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