pain after eating

[dingy19]

My granddaughter returned from Africa, after a two week stay, over a month ago.  During the flight back to the U.S., she became sick.  She cannot eat without a lot of pain.  Doctors have performed all sorts of tests with negative results.  She is back in the hospital as I type and not much attention is given to this condition.  The weight loss and the pain is becoming a very large issue but there seems to be nothing the medical profession can do for this young, once vibrant girl who happens to be an RN.  Anyone have some suggestions?

[boron]

It sounds like gastroparesis, causaed by some event. Trigger was maybe that food poisoning.

I can't imagine how could some new disease cause gastroparesis all of the sudden. Hypothyroidism is one possible cause or predisposition.
Gallbladder - if only ultrasound was done, gb disease is not excluded. HIDA scan can be done. Gallbladder pain is on the right side under the ribs. Abdominal migrain is another possibility.

[dingy19]

Granddaughter is young, 23 yrs, RN
She had upper endoscopy with negative results.
She had lower GI series.  negative results.
Tested for all sorts of parasites.  negative.
Tested for pregnancy.  negative.
Tested for typhoid and other diesases---. negative.
Gallbladder tests have come back negative.
Many types of blood tests.  all negative - has been treating hypothyroid for past 3 years.
Her "illness" began on the flight back to the Unied States.  She ate ? and became sick and did have diarrhea for two days when she was home.  During visit in Africa, she ate beans and rice, main foods.  What else, I do not know.
Pain begins after eating, with pain in stomach area then back up in esoph, when
food starts backing up into the esoph...sometimes regurgitates.  Pain lasts for about two hours then subsides once she regurgitates or tries to get through light pain from fluids.
No further diarrhea but does have some with new med she is taking.  She does have some "bloat feeling" after eating solid food, of course.  light nourishment as liquids not as severe pain as with solid foods.  Test for diabetes will be next.  Of course, some meds produce same symptoms as diabetes, elevated sugar levels...catch 22.
Granddaughter is taking the new med but at lower dose.  High dose produces great anxiety. She found that lower dose does help food digest, less pain, and does not make her feel like climbing the walls.  She has followup appointment in one week plus more tests in the mill.  Low fat diet and "grazing" - no large meals at one time.  That is all I know at this time.  I cannot recall the name of the med she is taking to help digestion.
Thanks for your in-put.  Much appreciated.  

[boron]

For all known viruses, test exist. But usually, one test shows only one virus, and not all possible viruses.

How old is she?

She should get enough calories with food. There are some caloric vegetable and soy juices, which could be appropriate.

This could help in finding the cause:
How old is she?
Problems started abruptly or gradually?
Where exactly is the pain - in upper middle abdomen, below the right rib cage...? Pain is only after earting?
Any other symptoms beside the pain: bloating, diarrhea?

Beside gastroparesis (which means slow gastric emptying) the cause of pain may be gastric ulcer. This can be diagnosed only by upper endoscopy.

Here are some causes of gastroparesis:
Functional gastroparesis
Type 1 diabetes
Type 2 diabetes - though gastroparesis is less common than for Type 1 diabetes
Gallbladder disease
Pancreatitis
Postviral syndromes
Anorexia nervosa
Stomach damage
Stomach surgery
Vagus nerve surgery
Gastroesophageal reflux disease
Stomach cancer
Smooth muscle disorders
Amyloidosis
Scleroderma
Abdominal migraine
Parkinson's disease
Metabolic disorders
Hypothyroidism

Source:
http://www.wrongdiagnosis.com/g/gastroparesis/causes.htm

[dingy19]

Thank you, boron.
After uppper G.I. yesterday with icetobe (sp?) with food and following food under survey, determination is "gastroporesius" (sp?) - massive regurgitation- the stomach is not processing food normally, thus the pain before emptying into the duodenum and causing great pain because food is backed up into the esophogus and more pain results plus acid reflux.  The doctor said it is idiopathic which in my book means "don't know what's causing this." Virus that is not dedected by any tests?  Granddaughter has been put on low fat diet - no more milkshakes, fatty foods and has a medication to help process meals/food.  She started eating foods because she was very hungry and sick of light soups, "milkshakes," applesauce, ensure, etc. but that is when the pain was increased after solid food was ingested.  There is not any bright red or black stool.  Granddaughter visits same doctor next week for follow-up. The doctor believes she picked up a virus in Africa and sometimes, tests cannot detect certain viruses.  Many other exams and tests have been conducted out of hospital - all negative.  Since she was given an antibiotic at first and that did not solve the issue, the condition is possibly virus related.  Thank you for following this condition through with me.  It was scarey because I couldn't understand why she was released from the hospital on the first visit without total body exam and finding some results before releasing her.  She had lost 15 pounds (she was 130 pounds), became dehydrated and that seemed pretty serious to me.  We shall see if this last diagnosis is correct and meds will solve the condition and get her back to a "normal digestive system."

[boron]

If pain is shortly after eating, it may be
- gastritis or ulcer, dx is with upper endoscopy.
- gallbladder related, if the pain is like a cramp holfding her for some minutes or hours, pain occurs after a fatty meal
- aneurism of abdominal aorta, dx with ultrasound. Hert beat may be heard through abdominal wall with the stetoscope
- stenosis of pylorus - stomach exit. Dx: gastric emptying test or X-ray with barium swallow

Where exactly is the pain, can it be felt by pressuring on the spot? Diarrhea, blood in the stool or black stool? Pale stool?

[dingy19]

Graddaughter has had all the blood and stool tests.  Negative.  She has had scans, as well.  This morning, doctor is going to coat real food, have granddaughter eat, and follow the food until it begins to pain her.  This test was scheduled for August 12th but since she was admitted to hospital, again, for out of control pain, the doctor decided that he would go ahead with this procedure now instead of making her wait until scheduled date.  That's nice.  At last, something is being done to follow up on this case.  She has been admitted to the hospital two times and both times released before having any answers.  She does not have loss of appetitite but scared to eat because of the pain that follows.  Thus, loss of weight and dehydrtion.  We shall see what happens with the procedure that is to take place this morning.  Thank you for your in-put.

[boron]

When someone comes back from Africa, and get sick, the first thought is infection. Weight loss may be due to lost appetite, pain which prevents her to eat, or malabsorption, which may be due to intestinal infection. Stool tests for bacteria and parasiters, and blood tests for typical viral diseases from Africa should be done. Now I don't know what tests she already had.