gastroparesis, swallowing diff., change in bowel habits
I have had upper left abdominal pain and nausea for several years. After multiple scopes and GI films without abnormalities, I was assumed to have GERD and placed on Prevacid, which I still take twice daily without any relief from the pain or nausea but the doctor insists I need to continue it. I finally had a gastric emptying study that showed I have gastroparesis. That was about 3 years ago. I was told to eat low fiber diet and I did not need to return to the gastroenterologist for any follow up. I have also had chronic constipation problems for several years and have been taking generic Myrolax with relief. Recently, my symptoms have changed. Suddenly, I am having problems with diarrhea, alternating with mild constipation, also a feeling of pressure but cannot pass anything, and excessive foul smelling gas. At the same time, I have started having increased abd. pain and nausea, as well as much increased problems with early satiety and feeling very full in my stomach. I discussed this with my PCP and he suggested taking an antacid, which only seems to make the symptoms worse. I have decreased my Myrolax to 1/2 the dose with some relief from diarrhea/constipation. I have also been having increased trouble swallowing. Swallowing studies have shown decreased motility in the esophagus and slow closing of the epiglottis. Could this be causing the GI symptom changes? I do have a movement disorder, which has not been diagnosed but is believed to be neuromuscular in nature. Could it be the cause of the my apparent GI system dysfunction? Lastly, I have Sjogren syndrome with very dry throat and a very enlarged thyroid with nodules (mild hypothyroidism) - to be removed in a couple of weeks in an attempt to relieve some of my swallowing difficulties. I need to know how to proceed. Should I have my thyroid removed or is my swallowing problem most likely due to decreased motility and/or dry throat? Should I have more studies done due to change in bowel habits and increased bloating, abd. pain and nausea? I do now have trouble eating frequent small meals because my movement disorder worsens if I get hungry and I think the food empties so slowly that I don't get the nutrients into my bloodstream fast enough, even though I eat small frequent meals. I am not diabetic but I am obese and not losing weight from the gastroparesis, probably because I need to eat more frequently than 5-6 small meals. How can I manage this? Sorry this is so long and may be confusing. I am really confused by all this and cannot seem to get answers from my doctors. Thanks for your help.
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