Could this be gastroparesis?

I am having a gastric emptying study done on Tuesday but I'm anxious to hear what people think about my symptoms.

I can't tell if these are two separate but related problems, but I will describe them as clearly as I can.

Problem 1: Every time I eat, I get huge amounts of air/gas movement back up through my esophagus. It flat out does not matter what I eat, nor to some extent how much. Obviously, certain foods are worse than others, and larger meals are worse than small ones, but there is absolutely no such thing as a food that does not cause this problem for me. I don't exactly burp, at least not in the way most people do. I think it's the basically the same mechanism, but a different valve. Specifically, I really think it's my lower esophageal sphincter (LES). Even though I don't burp, the release of air pressure has the same relief, at least temporarily. But this valve action can happen 10-20 times a minute for upwards of 3 hours after a meal. I've got nausea occasionally for a long time, but lately it's been worse. Some mornings after breakfast, I get very nauseous and double over with stomach pain.

Problem 2: An unbelievable amount of bloating. This also happens with every single meal, though it's worse at night (maybe I eat more at dinner, maybe food isn't moving through my digestive tract the way it should and it's built up by the evening, I don't know). Regardless, the bloating is so intense I have nightmares of my stomach literally rupturing under the pressure. My stomach swells up so much I look pregnant; my belly button will start protruding, veins pop out, it's honestly terrifying. I've eaten nothing but soft foods today (pureed soups, very watered down oatmeal, Greek yogurt), and the bloating is still terrible and I'm more nauseated than usual too. Even drinking water, plain water, will make me bloat. I feel like it's been getting worse in the past few weeks. (This has been going on for at least 3 months, though it started long before that, just less regularly.)

No amount of Gas-Ex, Tums, Gaviscon, Pepto Bismol, or any other over the counter medication has been at all helpful.

My docs are stumped. I do have Crohn's, but it's not really active at the moment and it's very mild anyway. I had a barium CT scan that showed that my colon was completely distended, it was so full of...well, you all know, LOL. My doctor prescribed a cleanse of GoLytely, and taking daily laxatives since then has kept me a little more regular but the bloating is exactly the same. I have trouble sleeping because I wake up feeling my stomach is absolutely full and weighed down.

Does this sound like it could be some form of gastroparesis? I don't vomit (then again, I haven't vomited in 18 years), but there is a lot of backwards movement from my stomach, it's just mostly air and acid.

Sorry this is so long! I tried to be as concise as possible but I wanted to make sure I described the problem as well as I could. Thanks to anyone who actually read through this :)

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21 replies. Join the discussion

Just from my own symptoms and those I've read about others having, it does sound like that is what is going on.................. :( I get bloated and have had problems with reflux since I was dx. I have to eat small meals and some foods do make symptoms worse. A lot of us have trouble with constipation too. I have not vomited either but it seems like it's different with everyone- which can make GP more frustrating! I also do better with purees and liquids.

It sounds like you came to the right place. The people here are VERY knowledgeable and helpful.

Hope you have a good belly night.

Sarah

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It's possible. Bloating and frequent burping are both symptoms of GP. I have the burping, nausea, VERY resistant reflux and abd pain but no vomiting. It is part of what made the diagnosis so difficult for me. I didn't have the vomiting or the weight loss that is so typical with most GP cases. I actually gained weight when it first started several years ago. Now I am thankful for that (although I was cursing it at the time) as I have lost over half that wieght in less than 6 months.

Diana

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It sounds as if you do belong here I am sorry to say! I used to get alot more of the bloating then I do now that I am pretty good about sticking to the liquid diet. When my stomach would bloat the pain was terrible and it felt like the stretching was causing the walls of my stomach to tear open. I have severe constipation that I am able to manage with a liquid diet, a capful of miralax (or 2-3 on bad days) , 2 dulcolax, and 3 flax seed oils capsules. I don't know if this would work for you but it does for me. I find that as time goes on I am les inclined to cheat both because the pain is so intense that I do not feel the pleasure of the food is worth the pain and also because it has now been so long since I have had many foods that I don't really remember the tastes of them anymore.

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Thank you all for your responses, I'm glad to know that there are people who understand. It's such a strange experience, anytime I put anything in my stomach, even just water, I feel like it swells up like a balloon. I'm trying to make it through a soft foods breakfast right now, and I'm so full and nauseous after only a little bit...but the soft foods yesterday made the night less unpleasant, which was good! I might go back to eating "normally" for the next couple of days until my test, though, I don't want to mess with the results by self-treating.

I've read that this gastric emptying test isn't always accurate, that I could have a normal test but still have GP. Has anyone here had to have multiple tests before they were able to obtain a positive diagnosis? What can I expect during the test itself?

Nancy - the pain I experience doesn't sound quite as intense as yours, but the way you describe the bloating sounds very familiar! I didn't realize a stomach could even stretch the way mine does. I've been doing a capful of Miralax a day, but that's just barely doing the trick and I'm considering increasing it. Have you found anything that relieves the bloating at all, medication-wise?

Thanks again everyone :)

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You have to rely on your doc to put the pieces together: the scan results and your symptoms. There are people here who have had "normal" scan results, but going by thier symptoms, their docs are treating them for GP. And a bad part is that the scans can vary from day to day, be slow one day and normal the next.

My scan was about 90 (give or take). At the end of that, I only had 10% of the egg I ate empty. And that was with taking reglan that morning like my doc told me to. When they got the results back, he said it wasa like a light switched on. It all made sense. The persistant, nagging reflux that became resistant to meds, the pain, nausea, early fullness. Even the esophageal ulcers and chronic gastritis/esophagitis made sense. If the food and acid just sit there, it's going to cause a lot of problems.

It's a pain in the butt to get the diagnosis because it can be so tricky, but at least in the end you will have a name for what is causing you pain. Then comes the fun part of trying to deal with the symptoms.

Diana

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I understand your burping too. Unlike the rest, my stomach doesn't swell and I actually have a moving digestive system. Of course mine is a mild case and I have dyspepsia. Good luck with the test.

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Alyssa,
I hear what you are saying about the water. Believe it or not...it is one of the "foods" that make me vomit. Plain water...who would have thought? Your symptoms sound a lot like what I was experiencing when I was first diagnosed. I have since gotten worse....vomiting and not able to tolerate much of any food. I eat saltines, baby food and sometimes some cream of wheat. That's about it. I can not tolerate any dairy, meat, veggies or fruit (baby food fruit is ok). Although strange enough, coffee is fine with me as long as I just drink 1 or 2 small cups. I have heard a lot of people say coffee doesn't agree with them.

I hope you get some answers and feel better soon!
Lisa

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Thank you for your responses! I will post here again tomorrow to say how the study went and if I have any results to report.

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There are a lot of symptoms mentioned that are consistent with GP. But there can be a lot of other things that share symptoms. Don't know if you got the results back yet or not, but I hope you're lucky and this is something (like LES problem) that can be relieved relatively easily by surgery or stretching the valves. Unfortunately with GP it's usually nothing to do with valves or something that can be fixed easily (as you can probably tell by reading all of these blogs/journals)

Best wishes that it is something for which relief will find you soon and not GP.

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Yup. It sounds like GP to me. Especially the bloating, and more bloating in the evenings. That's what I had that made my doc check for GP. If you can't eat dinner, don't even try. Or, just have liquids for dinner, like a banana smoothie (a small one!). Try a more liquid diet, and eat / drink small amounts at a time. Your stomach will have an easier time emptying with the liquids / small amounts.

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I don't have the official results back, but what the guy doing the scan saw he said looked normal. (He showed it to me, it honestly looked normal to me too.) Which is great, except I have no idea what the heck is going on. GP started to make a lot of sense, but if it's not GP, I don't even know where else to look. Also, what is the likelihood of normal test results but still having the condition? How else can I know if it's GP or not?

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Sounds like it sorry to say, I have Celiac disease and Gastroparesis and not only have an intolerance to Gluten but am actually allergic to it. For me it was easier to know what foods had Gluten in it because my neck swells up plus the usual symptoms like bloating, gas etc. All I'm suggesting is if you don't know if you have an intolerance to gluten please try to remove all gluten from your diet for one weeks and you should feel a difference. I know I do and I can eat some foods without to much trouble as long as I don't come in contact with Gluten. I also take a drug called Motillium 10 mg 3 times a day which helps the stomach to process.
Gook luck to you!!!

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Thank you! I actually did try being gluten-free for 3 months...for me, it made no difference. However, my dad tried being gluten-free and in only a few days, his symptoms improved dramatically. So he maintains the gluten-free diet, but I no longer do. Do you think it's worth another shot? It's been a year since I tried it, going gluten-free for a week wouldn't be very difficult and something may have changed since then.

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A GES is generally a pretty definitive diagnosis of gastroparesis. That's only if it's done correctly, meaning it has to be a 4 hour test, especially if after 90 minutes or 2 hours it's normal...researchers have found that MANY cases of GP are missed by a 90 min-2 hour test.

I've had 3 GET that I remember, the first one was 10 years ago roughly and I think it was 2 hours and I ate oatmeal for the test and although I don't know the exact results, I was told it was abnormal. More recently I had a 4 hour GET in 2007 which showed I had 76% remaining at 2 hours (normal <60%) and 55% remaining at 4 hours (normal <10%) showing severe gastroparesis. However I had one 6 months ago (90 minutes) but I only ate 2/3 of the sandwich before vomiting and was told NOT to drink any water...and surprise, surprise, it came out normal. That is one way where you can get false normal results...you're supposed to start out with a specific amount of isotope and I had maybe 1/3 of what I was supposed to have to start out with. Not to mention it was a much smaller volume than I was supposed to have which means it emptied more and also harder to measure how much emptied. Unfortunately the doctors that ordered the test didn't want to listen to anything I had to say, so after that test, they stopped all my treatments (including nausea and pain management) and decided it was psychological or something, they never actually told me (or my parents) what they thought was going on and what to do about it. Oh well. Such can be the way with doctors...some people get a correct diagnosis and proper treatment very quickly after onset of symptoms, and others (like me) have to wait many, many years for proper diagnosis and treatment. It's been 20 years since I first started having symptoms of GP and CIPO...wasn't until 2008 that I was finally diagnosed with CIPO (Chronic intestinal pseudo-obstruction).

Sarah K

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My test wasn't even 90 minutes...they had me eat half a sandwich and then took a second picture after only an hour. I also drank a glass of water with it. It sounds like I should be asking my doctor for the 4-hour test because even if this one is normal, it was small amount of food washed down with a glass of water (which, btw, made me really nauseous!).

The problem is soooooo much worse at night, too. The mornings aren't usually so bad, but that's the only time they do the test.

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Your symptoms are sooooo identical to mine! I have had 3 90 minute emptying studies that were normal (except one was very slightly slow but not enough to diagnose as GP and then a 4 hour study which was also normal). All of these were done in the morning which is when I can usually eat the most. Lunch time I start feeling full and supper usually is a half a glass of fat free milk or soy milk with a bite or two of something soft. A full meal would sit there for hours and wake me up in the middle of the night and want to vomit. My GI doctor said that you can have normal studies and have GP because the motility of the stomach varies day to day and morning to night. I've read other people on this forum have the same response from their doctors too when their results were normal. Frustrating having an invisible disease!
Liz

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Alyessa621,
It may take longer for the gluten to leave your body because of the GP so you may have to try for longer.

The test I took only took 90 minutes also, what it tells them is how much your stomach emptied in that amount of time. The Dr told me it should be at least 70% in 1 hour and mine was 17%.

I also started taking liquid vitamins, CQ10, Aloe Vera and fish oil (needed to absorb the CQ10).

I think the reason your stomach is worse at night is because anything you ate for the majority of the day is still there waiting to be digested. I try to eat most of my food early in the day and very very little in the eve.

May God Bless You!
Faye

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Hi there.

I had symptoms similar to yours. I had the weird thing where it felt like I needed to burp but I never actually burped -- it was more like air. And I felt pressure high in my chest. And I got full from eating barely anything and my stomach distended like I was three months pregnant. I had reflux as well, and it did not respond to medication.

I was originally diagnosed with Gastroparesis. But then I went to the Mayo Clinic, and their more thorough testing (48 hour gastric emptying study) revealed I didn't have Gastroparesis. I was diagnosed with something called Intestinal Pseudoobstruction. In short, the small intestine acts like it has an obstruction, but it doesn't.

That was 6 months ago and I could barely eat or drink anything at all. Now, I am on the mend. I did a lot of research into diet, nutrition and alternative therapies. I found that diet made the biggest difference of anything I did.

Sugar and bad carbohydrates turned out to be the cause of my bloating. I also figured out I have a sensitivity to dairy.

I follow a diet called the Specific Carbohydrate Diet and you can learn about it at breakingtheviciouscycle.org. The is diet has been successful with many digestive issues.

The premise is that certain foods promote the growth of bad bacteria while other foods promote good digestive health. Allowed foods are: meat, fish, fruit, vegetables, nuts and some dairy (I don't have any dairy). Disallowed foods are: sugar, starch, flour, bad carbohydrates, anything artificial.

I had to puree everything at first, but now I'm back on solid foods.

Also, eating only warm or room temperature foods makes a big difference. Cold food and drinks constrict the digestive tract while warm ones make it relax. Try it. You'll be surprised.

Another thing -- I found relief by eating incredibly slowly. I eat six times a day for an hour each time. I take two bites every five minutes. It's painstaking, but I can get food down.

I am now eating a variety of food including fish, ground beef, squash, zucchini, eggs, avocadoes, banana smoothies, and more. My stomach no longer distends and the reflux has subsided. I'm presently trying to wean off my heartburn meds.

In short, there is much medicine for digestive disorders. In my experience, Diet, Yoga and Acuupuncture have made the biggest difference of anything I tried. That and losing sugar. Sugar is toxic.

One more thing -- digestive enzymes helped me. Acid Ease is one, but now my doctor prescribes one called Pancrease and it works great. I take them with each meal.

Take care, and good luck.
- A friend.

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BetterEveryDay - I've been reading up on intestinal pseudoobstruction and it fits my symptoms a little better than GP does, I think. I feel like my stomach empties, it's just miserable in the process. Intestinal pseudo-blockage seems to fit my symptoms a little bit better.

My stomach bloats almost immediately upon eating. Is that what happened to you too? I often stay bloated for 2-3 hours or more after; I'll feel sick and nauseated for a couple of hours and then suddenly I'll be hungry, even to the point of realizing I'm hypoglycemic. I'll go from feeling like, "Oh please don't give me any food, I'm so nauseous and icky-feeling" to "I'm absolutely STARVED and my hands and knees are shaking and I need to eat NOW". It's so strange!

The Mayo Clinic does some amazing things. I would love to go to them for some testing. I'll talk to my doctor about it.

Meanwhile, I've ordered the book, "Breaking the Vicious Cycle". It will be here Friday. It seems like something worth trying, most definitely. Thank you!

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Alyssa,

One of the theories that we've been working with right now is that my primary issue is pseudo obstruction, at least that's where my motility is worse and that my stomach empties slower in response to my intestines not emptying fast enough...it's quite a plausible theory. Just keep in mind that EVERYONE is different, what works for some people has the opposite effect on others. Sugar is the most easily digestible of all foods, but on the other hand, bacteria LOVE it, so it can cause bacterial overgrowth or make it worse...it's tough to balance. It's seemed to me that people with pseudo obstruction have a more difficult time with figuring out what foods work than gastroparesis. I could be wrong though. I would encourage you to talk to your doctor about probiotics, they definitely help prevent bacterial overgrowth at least which can help ease the bloat. There's also Boost Breeze to consider which is clear liquid nutrition...it's like Ensure or Boost but there's no fat in it and it's clear so more easily digested. The protein is supposed to be easier to digest too. I strongly urge you to talk to your doctor before changing anything with diet and ESPECIALLY with herbal remedies...especially if you're taking any medications because they can potentially interact dangerously without you knowing about it. I saw a western medicine practitioner and he gave me some herbs to try and they had the opposite effect on me, I was vomiting violently a few hours after taking them. Worse than it's ever been. If you choose to explore alternative medicine, PLEASE, PLEASE make sure all your physicians are communicating with each other, including the alternative medicine practioner.

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