Gastroparesis w/ multiple other symptoms related?

[Kathy__0__0]

  I am a 28yo female who, until 20 months ago, was in good health.  I am in the Army, and am fairly physically fit.  20 months ago I began experiencing hip pain when I ran or marched for any distance greater than 4 miles with a ruck sack.  I had x-rays taken and did a bone scan which only showed stress changes in the femoral necks.  It's been 20 months, and the symptoms have worsened.  I now experience sciatica when doing anything other than lying down.  The pain is not debilitating, but exercise is difficult.  Also, 4 months ago I began experiencing post prandial fullness and constant nausea w/o vomiting.  I did a nuclear gastric emptying study and was diagnosed with gastroparesis.  I have lost  21 lbs, and am unable to eat army rations.  Drs did ANA blood test that was negative.  What could be causing these things?  My career is on the line.  Please help me if you can.
_____________
Dear Kathy,
Many patients with gastroparesis do not have an indentifiable cause for the problem and are classified as idiopathic.  However, before considering you to have idiopathic gastroparesis, several treatable conditions must be considered.  First, thyroid disease must be excluded by a TSH and thyroid hormone studies.  Diabetes mellitus is another frequent cause of gastroparesis that must be eliminated.  Electrolyte abnormalities ( calcium, magnesium, potassium) must be eliminated.  Drugs with anticholinergic side effects e.g. antidepressants, antipsychotics must be stopped.
Your symptoms of sacrolieitis and oral ulcers raises the possibility that you may have a structural cause of delayed gastric emptying e.g. inflammation of the gastrointestinal tract or peritoneum can cause delayed gastric emptying.  In your case, I would want to exclude Crohn's disease as a cause of your symptoms.  You will require a study of small intestine (preferrably a dedicated small intestine series) and colon (barium enema).  IF not yet performed, an upper endoscopy is also needed.
If you are found to have idiopathic gastroparesis, your symptoms can be treated by using a prokinetic agent e.g. Propulsid
This information is presented for educational purposes only.  Always consult your personal physician for specific medical questions. If you want, we would be happy to see you at the Division of Gastroenterology at Henry Ford Health Syste.  You can arrange an appoinment with Dr. Fogel, one of our experts in the diagnosis and trerament of gastrointestinal illness, by calling our Physician Referral Line at [phone].  Her would review your records and arrange for any tests needed to complete your evaluation.
HFHSM.D.rf
*keywords: gastroparesis, Crohn's disease
0.3