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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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