GERD / Gastroparesis?

[pinewood]

I have been having some digestive concerns recently .... mainly a constant feeling of nausea, some abdominal/chest pains, minor reflux and unintentional weight loss. I was referred to a gastroenterologist and have had blood tests, a colonoscopy, stool tests etc ... everything has been normal.

He thinks it is IBS and/or GERD/acid reflux and has prescribed me a PPI (Omeprazole) to try. I'm very hesitant to start taking this, particularly since I don't have heart burn or classic acid reflux symptoms and I have read about some nasty side effects and people ending up being stuck on them for life.

From researching online I mentioned the possibility of gastroparesis to him, particularly since I have diabetes. He said he thinks it's very unlikely given I have only had diabetes 9 months and my control has been very tight. But my BG levels have been a bit crazy lately and the constant nausea seems to be a classic sign of gastroparesis (even though I haven't vomited), so I'm curious if anyone else has this and could share what their symptoms were or any experiences?

 

[Indy51]

There are quite a lot of threads about this topic on the forum. A recent long one can be found here:

http://www.diabetes.co.uk/forum/threads/gastroparesis.81337/

 

[ButtterflyLady]

Gastroparesis is very common in diabetes, esp. T1. Your symptoms do sound a lot like it. There are tests that can be done for it, and diabetes specialist Dr Richard Bernstein has written about the different testing options. I think there is a link to this in the above thread.

I have been taking omeprazole for nearly 20 years with no obvious problems. My GERD is so severe that I can't contemplate not taking it. It seems to help me with both GERD and the often related condition, dyspepsia. For nausea I take ondansetron, which I find very effective.

 

[pinewood]

Thanks. I'm worried to take the Omeprazole I've been prescribed for the suspected GERD/reflux because I've read it can delay gastric emptying and therefore make any gastroparesis much worse. I think I'll ask my gastroenterologist for a stomach emptying test so that I can find out if it is gastroparesis or not. Do you get bad heatburn from your GERD? I don't understand how I could have GERD without acid/burn sensations...

 

[ButtterflyLady]

Thanks. I'm worried to take the Omeprazole I've been prescribed for the suspected GERD/reflux because I've read it can delay gastric emptying and therefore make any gastroparesis much worse. I think I'll ask my gastroenterologist for a stomach emptying test so that I can find out if it is gastroparesis or not. Do you get bad heatburn from your GERD? I don't understand how I could have GERD without acid/burn sensations...

There is a condition called silent reflux; I don't know much about it but it could explain having GERD without those sensations. Sometimes GERD is just felt as pain/pressure in the sternum/centre of the chest. For me, I get pain, pressure, and burning, along with sometimes being aware of food refluxing the whole way back up

 

[donnellysdogs]

Did your consultant give you a shapes test? You swallow 60 different shapes in capsules over 3 days and go for xrays to see how soon they are expelled from body. They look at xray and within 5 days they should be gone.

My gastro chappie thought I had IBS and admitted if it wasn't for my diabetes that is what my diagnosis would have been. However, as he knew I was diabetic he did the shapes test and found out Inhad slow colonic transit as I still had 57 shapes still in various parts of my stomach, colon, bowel etc after 5 days.

I paid privately to see my comsultant and was going to pay privately for all the procedures like endoscopy etc but my consultant put me thru the NHS system. I am so glad that I saw him privately as it was not rushed and he really listened and although I am discharged from his care, we still stay in touch. This is because I manage my slow colonic by natural methods and he is interested in how I do this etc..

Normally I wouldn't necessarily pay privately. Today I went NHS for breast care and had the best possible care ever.

If you have had a shapes test done then it may be as consultant says. However, I would fully recommend from my experience only to see uf you could have a shapes test done.

 

[ButtterflyLady]

Did your consultant give you a shapes test? You swallow 60 different shapes in capsules over 3 days and go for xrays to see how soon they are expelled from body. They look at xray and within 5 days they should be gone.

My gastro chappie thought I had IBS and admitted if it wasn't for my diabetes that is what my diagnosis would have been. However, as he knew I was diabetic he did the shapes test and found out Inhad slow colonic transit as I still had 57 shapes still in various parts of my stomach, colon, bowel etc after 5 days.

I paid privately to see my comsultant and was going to pay privately for all the procedures like endoscopy etc but my consultant put me thru the NHS system. I am so glad that I saw him privately as it was not rushed and he really listened and although I am discharged from his care, we still stay in touch. This is because I manage my slow colonic by natural methods and he is interested in how I do this etc..

Normally I wouldn't necessarily pay privately. Today I went NHS for breast care and had the best possible care ever.

If you have had a shapes test done then it may be as consultant says. However, I would fully recommend from my experience only to see uf you could have a shapes test done.

I agree with this. I had a similar test which diagnosed slow colonic transit. It was nice to have objective evidence that there is a real physical problem, and it's not just me saying I feel a certain way. Knowing what the problem is, is half the battle sometimes.

 

[donnellysdogs]

Please ask for a shapes test to rule out slow colonic and gastrparesis..

 

[Sucre Bleu]

I had a gastroscopy/colonoscopy ages ago when I was initially diagnosed with gastroparesis. Maybe 4 years later I was consolidating all my different clinics I attended to be at one hospital.

I did not really take a shine to the gastroenterologist I have been seeing, however he did have some good ideas, my chronic diarrhea with all the symptoms of autonomic neuropathy, he thought might be also bacterial overgrowth, a month long course of antibiotics worked a treat. My GERD symptoms were out of control, high doses of Nexium help those now. I also had a gastroscopy, no surprises with a gastroparesis diagnosis, this time I remembered to ask how they knew that and he said...considering you need to modify your diet and fast prior to the procedure, did I do that? Yes. Well my stomach was still full of food, hence demonstrating delayed emptying- gastroparesis.

During my last hospitalization, the Diabetes Professor told me of all the complications I have, gastroparesis is basically the only one that improves with tighter control.

I have never heard of a shapes test. Fascinating and makes perfect sense.

 

[ButtterflyLady]

I also take a high dose (40mg) of omeprazole. In addition, I sometimes take 300mg of ranitidine, and 10mg x 3-4 per day of domperidone. And if needed, 8mg of ondansetron. Plus a laxative.

Just thought I'd let you know what else can help with GERD and related stomach symptoms, in case it helps you @Sucre Bleu

 

[Sucre Bleu]

I also take a high dose (40mg) of omeprazole. In addition, I sometimes take 300mg of ranitidine, and 10mg x 3-4 per day of domperidone. And if needed, 8mg of ondansetron. Plus a laxative.

Just thought I'd let you know what else can help with GERD and related stomach symptoms, in case it helps you @Sucre Bleu

Thanks @CatLadyNZ I appreciate it, I take Nexium 40mg twice a day, a Tazac in the evening, and the domperidone the same as you. (I hate them tho)
In the lymphoma forum I go to, one of the guys said his oncologist put him on Nexium strictly for a month. I have been on it for at least 4 years, which made me a little nervous, have you ever heard that?
I did some reading, and possibly his Dr was being overcautious (I hope)

 

[ButtterflyLady]

Thanks @CatLadyNZ I appreciate it, I take Nexium 40mg twice a day, a Tazac in the evening, and the domperidone the same as you. (I hate them tho)
In the lymphoma forum I go to, one of the guys said his oncologist put him on Nexium strictly for a month. I have been on it for at least 4 years, which made me a little nervous, have you ever heard that?
I did some reading, and possibly his Dr was being overcautious (I hope)

I think people should use PPIs like Nexium and Omeprazole (and any drug) at the lowest effective dose for the minimum effective time. If that's a month, then that's great.

Long term use of PPIs can impair the absorption of vitamin B12 and folate, so blood testing and supplementation may be needed. There are also other possible side effects but I'm not concerned about them, because I need this medication, to avoid severe pain. I've been on it for 16 years and counting. If it harms me, I'll take it as a trade off for all the symptom relief it's given me.

It can also be used for 2 weeks and this can provide relief for up to 3 months. I think this only applies to mild cases though. When I started I took it for a month and then stopped to see if I still needed it, and I did. Some time later I needed to have 40mg instead of 20mg. Later when I tried to go back to 20mg I couldn't. It took about 6 weeks for the symptoms to settle after I returned to 40mg.

 

[eddie1968]

I've had bouts of gastroparesis over the years and sends my BGs crazy. I usually get a "sulphurous" taste and do vomit. I am on Lanzoprazole 30mg and take Metoclopramide 10mg for vomiting and to correct delayed digestion. Get well !

 

[pinewood]

I've had bouts of gastroparesis over the years and sends my BGs crazy. I usually get a "sulphurous" taste and do vomit. I am on Lanzoprazole 30mg and take Metoclopramide 10mg for vomiting and to correct delayed digestion. Get well !

Thanks Eddie. In what ways does it send your BG crazy? Do you just find that the rise occurs much later after eating?

 

[Indy51]

You can do your own DIY colonic transit time test using sesame seeds (I would use white not black though):
http://www.peak-health-now.com/bowel_transit_time.html

 

[tim2000s]

You can do your own DIY colonic transit time test using sesame seeds (I would use white not black though):
http://www.peak-health-now.com/bowel_transit_time.html

I use sweetcorn

 

[donnellysdogs]

I use sweetcorn

Like that but would give me a total blockage..

 

[ButtterflyLady]

I think observing foods that come out undigested can help with noticing SCT but the x-ray tests are better because the target objects can come out over a long period eg 7-10 days. I was x-rayed at 5 and 7 days after ingesting the radio-opaque markers and at 5 days they were all still in the colon and at 7 days some were still in the colon, all the way around to the start of it. So heaven knows how long the last one took to come out, lol. It's disturbing how slowly the colon can move in some people

 

[Indy51]

Oh, I agree that the professional test is the best one, but maybe having done the DIY version first at least is something specific that can be relayed to the doctor when requesting further investigation?

 

[ButtterflyLady]

Oh, I agree that the professional test is the best one, but maybe having done the DIY version first at least is something specific that can be relayed to the doctor when requesting further investigation?

Yeah, I'm sure it would help. In my case I didn't realise there was anything wrong with my bowels until I saw a gastroenterologist for reflux and he said constipation can be a big factor in causing or worsening reflux. There's a myth that if you are having a bowel motion every day you can't have constipation. I learned that it's not that simple.