Gastric Dumping without Surgery

I am a 28 year old Male.  I have lost around 90 Pounds in the last 3 years. I have been constantly sick with nasuea and diahrrea since I was a kid. I have had an EGD, Colonscopy, and Endoscopy done. Colonscopy showed Possible Celiac and Red stomach. Blood Work supports Diagnosis of Celiac. However, changing Diet did not help.  Gastric Emptying Scan was latest test and showed 23 Minutes where normal range is 50-90.  I was given Librax to help take away constant feeling of frequent bowel movement, which caused severe nausea and more diarrhea.  However, I still have problems with upset stomachs a lot.  The Librax just stops the feeling after an initial upset stomach of having to go multiple times which intensified nausea  .  Librax dosage = 2x a day. Also on Pronotix. Tried Bentyl made me horribly ill. Any suggestions?

[patient915]

Welcome to the gastroenterology community!  I don't know what you mean by colonoscopy showing possible celiac because celiac disease shows on an endoscopy not a colonoscopy.  There is a rare type of celiac disease where the patient doesn't respond to diet changes.  Did you try a 100% gluten free diet (0 cheating) for at least 2 months?

[Jc2k10]

Well they did a biopsy of my stomach and some indicators came back as showing Celiac but the results were inconclusive.  I don't have the paperwork on hand but the results essentually stated that patient shows possible signs of celiac.  I had bloodwork done and some IGA's were elevated, too.  My primary doctor believes I have Celiac, though I saw someone else who wasn't so sure.

I have followed a Celiac regiment for several months now.  I have maybe cheated a couple times since October but I've been pretty strict to adhering overall  Quite honestly, the diet change really hasn't made a world of difference.

The only thing where I have been any bit better is walking at night and taking the Librax 2x a day but that isn't a cure all strategy.  I still have quite a few bad days, like today.   Pretty much if I have to defecate more than once a day, I feel very ill and always have major cramping, bloating, pain, and naseua in my stomach.

The only difference I have seen from the Celiac Diet is a less rotten feeling in my stomach but the general  problems persist.

Diagnosis thus far:

1) Grade 2 internal Hemmorhoids

2) Erythema (redness) and congension in the anterior bulb and posterior bulb

3) Small Hiatal Hernia

4) Bravo (had a bravo study scan) was found to be distal in the esophagus

5) Congestion, erythema, and nodularity in the antrum and stomach body compatible with gastritis

6)  Erythema in the lower third of the esophagus

7)  Congestion and erythema in the distal bulb compatible with duodenitis

8) Early Satiety (From gastric dumping study) - Normal range is 50-90 minutes I am told.  Mine was 23 minutes!  While I have lost close to 90+ pounds between walking and being so sick, I have not had surgery.  Oddly enough Gastric Dumping is usually brought on by surgery, too.

9)  Diahrrea (more often than not though I get frequent bowel movements that start solid then turns softer and softer as the frequency increases during the day).  If I go once a day, I am generally "OK".  More than 1x and I cannot hold, I feel terrible a few days and cycle continues again/

10) Celiac though the ohter doctor (did not have biopsy) wasn't sure based upon bloodwork alone. Still, I am adhere to the diet.

Hope the information helps.
2)Erythema and congesion in the antrum

[patient915]

Celiac disease is a problem in the small intestine which is looked at during an endoscopy, so I'm not sure how your stomach biopsy shows possible celiac.  I would recommend seeing a gastroenterologist that specializes in celiac disease.  This is a quote from the wikipedia page on celiac disease that you might want to think about:

"A tiny minority of patients suffer from refractory disease, which means they do not improve on a gluten-free diet. This may be because the disease has been present for so long that the intestines are no longer able to heal on diet alone, or because the patient is not adhering to the diet, or because the patient is consuming foods that are inadvertently contaminated with gluten. If alternative causes have been eliminated, steroids or immunosuppressants (such as azathioprine) may be considered in this scenario."

[CalGal]

You may also want to consider trying a trial of taking dairy out of your diet as well as having removed all wheat/rye/barley and oats to adhere to the gluten-free side of things. Many with celiac can cross-react to casein - the major protein in dairy.

[Jc2k10]

I don't do dairy a whole lot as too much reacts poorly to my stomach.  I do dairy on a very limited basis, so that is a non issue.  Also, I have removed all wheat / rye / barley / oats and am adhering to a gluten free diet, minus a few times i've purposefully overlooked it.  One or two occasions shouldn't be a huge factor.  I've been following the diet since October with probably a 99.5% adherence.

[CalGal]

Jc2k 10, even if you only do a little dairy - almost miniscule - it could still be an issue. It's not a matter of reacting to the lactose portion of the dairy - the sugar. It's a matter of producing specific antibodies to the casein portion of the dairy - just as you would produce antibodies to the gliadin moiety of the gluten. IF the problem is diary, even a speck of dairy would cause the autoimmune reponse and could be mediating a continuation of the problem.

I'm not saying casein is definitely a problem for you, it's only an idea to check out.