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Gastroenterology (Expert Forum)
Gastroparesis?
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Gastroparesis?
by Rach1111, Dec 12, 2003 12:00AM
I am a 21 year old English woman and for as long as I can remember I have experienced nausea, indigestion, burping and stomach ache almost every time I eat. It takes ages for me to get hungry and I become full very easily. I also get very tired and sleepy, irritable and a feeling of general malaise and being unwell after eating. I weigh 112Ibs and am 5ft 10in tall, so am quite skinny!
My symptoms always worsen as the day progresses. Breakfast is usually fine, lunch ok and dinner the worst time of all!! Now I rarely eat lunch and stick to just two small meals or snack.
I have cut out cows milk products and wheat as I was told I had intolerances to these. I was told I may have candida, but cutting out sugar didn't seem to help so I have given up. I do not eat meat as I have been vegetarian since birth. However, my symptoms still persist.
I have in the past been on domperidone, but this didnt really have much affect, and also have had numerous blood tests for things like coeliac disease. Every test comes back as negative. I am being referred to a dietitian but do not expect this to help as I have tried everything, from herbal remedies to exclusion diets. Doctors do not seem to know what to do.
My lower GI health is mainly fine. I do suffer with some constipation and small pellet like stools, but never diarrhoea and these problems do not bother me.
The main problem is the nausea. I feel full most of the time, and can only eat a small portion before being full up. If I eat too much this turns into indigestion and reflux which can go on all night and then the next day I will still not feel hungry and feel sick with no appetite. It can go on for days if I do not stick to a very strict regime and eat very little to 'cure' it for the time being. If I eat when I am not hungry, I feel nauseous and sick.
It takes ages for me to get hungry, and sometimes it is not what i call a 'true' hunger, but a sort of hunger mixed with nausea.
I wondered if I may have gastroparesis. However, although I often feel very nauseous and sick, I never actually vomit...though sometimes I feel this is just through pure willpower not to, as I also have developed a phobia to vomiting!
I am at my wits end....I cannot enjoy food anymore and feel ill constantly.
Any ideas what may be wrong? What do you recommend I do, or ask my doctor to do?
Many thanks.
My symptoms always worsen as the day progresses. Breakfast is usually fine, lunch ok and dinner the worst time of all!! Now I rarely eat lunch and stick to just two small meals or snack.
I have cut out cows milk products and wheat as I was told I had intolerances to these. I was told I may have candida, but cutting out sugar didn't seem to help so I have given up. I do not eat meat as I have been vegetarian since birth. However, my symptoms still persist.
I have in the past been on domperidone, but this didnt really have much affect, and also have had numerous blood tests for things like coeliac disease. Every test comes back as negative. I am being referred to a dietitian but do not expect this to help as I have tried everything, from herbal remedies to exclusion diets. Doctors do not seem to know what to do.
My lower GI health is mainly fine. I do suffer with some constipation and small pellet like stools, but never diarrhoea and these problems do not bother me.
The main problem is the nausea. I feel full most of the time, and can only eat a small portion before being full up. If I eat too much this turns into indigestion and reflux which can go on all night and then the next day I will still not feel hungry and feel sick with no appetite. It can go on for days if I do not stick to a very strict regime and eat very little to 'cure' it for the time being. If I eat when I am not hungry, I feel nauseous and sick.
It takes ages for me to get hungry, and sometimes it is not what i call a 'true' hunger, but a sort of hunger mixed with nausea.
I wondered if I may have gastroparesis. However, although I often feel very nauseous and sick, I never actually vomit...though sometimes I feel this is just through pure willpower not to, as I also have developed a phobia to vomiting!
I am at my wits end....I cannot enjoy food anymore and feel ill constantly.
Any ideas what may be wrong? What do you recommend I do, or ask my doctor to do?
Many thanks.
Doctor's Answer
by Kevin Pho, MD, Dec 13, 2003 12:00AM
, Dec 13, 2003 12:00AM
Certainly gastroparesis is a possibility. The best test to ask for would be a gastric emptying study. If there is evidence of this, there are various treatments, such as antibiotics (like erythromycin which as a prokinetic effect), Zelnorm which may help with gastroparesis, or investigational drugs like botulinum toxin injection.
If this test is negative, I would suggest an upper endoscopy to ensure no masses or anatomical abnormalities are causing your nausea.
If the GI route is not revealing, consideration may be made to a neurology referral. There are various nervous system disorders (multiple sclerosis, brain masses etc.) that can cause chronic nausea, unrelated to the GI tract.
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.
Thanks,
Kevin, M.D.
If this test is negative, I would suggest an upper endoscopy to ensure no masses or anatomical abnormalities are causing your nausea.
If the GI route is not revealing, consideration may be made to a neurology referral. There are various nervous system disorders (multiple sclerosis, brain masses etc.) that can cause chronic nausea, unrelated to the GI tract.
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.
Thanks,
Kevin, M.D.
my wife has the same thing as you, its irritable bowel syndrome,if you cant each without feeling sick or bloating ,try some of the nicer foodtype drinks, tyr complan, very cheap tastes lovely and gives you around 500 calories per glass which is the same as a small meal, but wont hurt or bloat you out,
i am in the uk as well,give complan a try,
happy christmas malcolm
Try a google search, use the words healthy awareness to access archives then one of your symptoms each one has been discussed at length
If you need more info post
look up my post on 12/4/03