If strong lower abdominal cramps (middle and right sided), strong emesis and nausea plus headache over months on a daily basis are said to be 'functional abdominal problem only, most likely post viral, will take 6-12 months, hang in there' in a 14yr old girl, after blood test CRP neg, Leukoc normal = appendix will not be touched, no laparoscopy, after ultrasound shows normal uterus and ovari (does not exclude endometriosis, appendix was not looked at, conveniently documented as 'not found'), after stool culture/parasite negative, after stool calprotectin negative = colonoscopy will not be performed (even 8% are false neg! in children), gastric emptying study for full fat milk 3 times slower (szinti) = diagnose of gastroparesis as a symptom, but finally an MRI enterography done shows 'moderate colonal faecal loading, everything else normal....' (unfortunately without mentioning the exact localisation in which segment...duh, it's a difference if it sits lodged in caecum or rectum from how well it can be reached) and I can see obviously an enteroptosis in the MRI pic (the transverse colon is hanging all the way beneath her belly button = sharp angles at liver and spleen curves = would explain constipation),
HOW would we LODGE the so called faecal loading safely?
I do fear, that she has old, very old, stone hard stool bits in her colon, that maybe cause all those symptoms due to trying to push it out, partially being in the way and toxicating her.
It is completely brushed off by docs.
She is on 1 Movicol per day and we changed from Ondansetrone to Domperidone, which doesn't help against the nausea as well at all, but she has managed to get 3 black hard 'stones' out in green liquid besides the normal Movicol sausage....she is not feeling any better.
I would try 2 Movicol on the weekend.
Another problem and contradiction:
FIBER! The gastroparesis diet asks to have hardly fibre in the diet, could we safely introduce soluble psyllium fibre with lots of water for the constipation or dislodge old stool-trial?
What do you think please?
How do we tackle a 'moderate colonic faecal loading' and massive abdominal cramps/nausea/emesis being left alone now since nothing obvious in routine tests showed up and clearing the colon would not harm, I guess.
Citrus is also forbidden in gastroparesis diet, THE so called colon cleanser. ;-)
What next or what to try or where to go?