Gastric Emptying Test

Hello,

I just had my gastric emptying test yesterday. I was given oatmeal with the stuff they put in it to be able to take the pictures of my stomach. I have been really sick since. I have had diarreah and sick to my stomach all day. I usually am constipated, that's why I'm wondering if this stuff they put in the oatmeal could have actually made me feel worse than I already am. Has anyone else had this experience after having their GES test done? The tech that did my test seems to think I passed and I don't have GP---although I sure do feel like I have it. Has anyone passed this test and found out later they did have GP after all? What can I take for the constant upper stomach fullness and nausea even if it's not GP???? Thanks for any info because I'm miserable!!!

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:(

Misery is not a viable way to live. It's awful, isn't it, to try and think past it. But you will get past it. Just have to find the diet and meds (if any) regime that work for you. What have you been eating? Have you identified the 'safe' for you foods?

I'm surprised they gave you oatmeal! That's a shocker. Talk about giving sand to a thirsty person. Oats are loaded with fiber. I had a single scrambled egg as did many on the forum. Oatmeal just makes no sense. If you do have GP and have been avoiding whole grains and fiber (which is one of the key elements to our diet) then the oatmeal may have made you sick today. Possible your body is reacting to the dye. It does have a, well radioactive isn't the correct word, but it is I believe some type of isotope. Supposedly a friendly type. How do you feel tonight?

And yes, there are people on the forum who have had negative GES tests and actually did have GP. Some people can have good days when the gut moves. Are you taking any kind of motility medication like Reglan or Domperidone? Or any kind of stimulant or anti-depressant? The stomach can be made to kick into gear chemically. Oh, and when the tech said you passed, did s/he clarify what that meant? Passing this test could mean you failed to digest. Did they give you any numbers? The percentage of food you had left after an hour? Or two? My test was only sixty minutes (at the end of which I'd degested zero egg) but others here have had three and even four hour scans.

Oh and welcome! Nice to have you here.

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Thanks for answering Marianne. I am not taking any motility drugs as the GI doc wanted to see if that was my problem before he prescribeed me anything. I'm not on anti depressant yet, but will start on one in a couple weeks. Do they slow motility down? The tech said my stomach emptied 50% in 90 minutes. I had a 4 hour test, so don't know how much emptied at the 4th hour. But the tech said I probably passed. If I did, then that means the doc probably won't help me even though I have alot of GP symptoms. I eat nothing but soft foods, like soups, applesauce, sherbet, mellon, puddings, mashed potatoes and bananas, but my stomach still feels like there is a brick on it most of the time, and that causes shortness of breath too. I also have nausea, burping, gas, bloated (look like I'm 5 months along), and am very fatigued.

I also was tested for acid reflux and that too was negative. So I don't know what meds can help me if all these tests keep coming back negative.
I do have a small hiatal hernia, so wonder if that could cause all these problems? Don't see how a small one could do all this. I'm really depressed about all this and I cannot function. My poor husband has to do everything now.

So far tonight, I don't have diaherrah now, but still have all the other symptoms I mentioned. Hope it was the stuff they put in the oatmeal that caused me to be even more sick today. It's bad enough as it is---can't take it if it gets much worse.

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Yep yep. Yanno that old saying "If it walks like a duck and talks like a duck, it's a duck"? Well I'm saying welcome, from one duck to another. You certainly sound like someone with dysmotility. And I don't think half food gone at 90 minutes sounds all that zippy, but I forget what the rate is. It's around here somewhere on someone's post . . . lessee if google has it. Oh, funny, one of the results boomeranged back here to a post from 2008! LOL

So the standard GES is four hours, and they look for 10% or more of the food remaining. That could be why the tech said it looked like you 'passed', which I guess means you digested or looked to digest enough of the food to NOT get the GP diagnosis. My GES was only one hour, at the end of which I had passed no food, was given a dose of Reglan, and then whoosh the food began to move. My results were positive for GP. Maybe that particular healthcare system only uses one hour tests. Money-saving perhaps. In any case, my digestion was sufficiently slow to get the diagnosis, intially, of Gastrointestinal Motility Disorder, a vague term that told me nothing. The GI doc (the first of three I tried) laid out the options of what might help, all of which I said no to (or, in case of Reglan, "Oh hell no!") so he told me the best method of eating.

Fast forward a year to this past March when one of his colleagues saw me, since he was the available one. He said oh I had IBS. Well sure my bowel's irritable. It's moody as hell. Too much poop, too little poop, too runny or acidic or non-nutritive or stoppered. But he decided all my symptoms (including the episodes) had just been IBS and due to constipation, which I did have pretty badly. He prescribed Miralax 17g twice a day. After a few weeks of crapping out slimy little cheeto-shaped stool, I cut myself back to once a day. Got a bit better. I also switched to a different GI office. My new doc looked at the year-old GES and said yep, gastroparesis. He also cut me back to once every other day with the Miralax so when I went it would be more productive.

Honestly I suggest you just follow a routine compatible with someone who already has been diagnosed with dysmotility. You may not get the GP diagnosis, but maybe another one. Regardless, eating low fiber, limiting fats, and avoiding most fresh produce will still end up helping. Maintain hydration. If your doc is amenable, ask about bloodwork to see if you're vitamin deficient. So many of us are, probably because our guts don't absorb nutrition properly.

As to the meds, anti-depressants have been shown to affect nausea, and sometimes help folks with dysmotility. They at least help with the emotional turmoil. I was already on one when my episodes began so I can't tell if the Cymbalta makes a difference or not. I know it does help my attitude! And emotional health so affects physical health.

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Trust how you feel more than what the doctors says. This disease affect everyone differently. You already know you feel better on a soft diet. Oatmeal makes me feel really bad for days. And I used to love it! You can learn an awful lot here that will help you figure out how to feel the best you can. Again- Trust your instincts!

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Hey, I agree with Merianne why would they give you oatmeal. Usually it's the eggs and 1 piece of toast. Who know you could be alllergic to the oats. Try ginger tea or pepperment tea sometimes stops the neasua. goo luck hope you feel beter soon becky

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Oatmeal is a no-no on the GP diet! Can't believe they gave that to you.

And yes, the GES can vary from day to day. If your tummy decided to kick into action that day, you could get a "normal" result.

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Marianne-------I too am taking Miralax---been taking it off and on for over a year now. It does help me go poop most of the time when I'm severely constipated. But nothing seems to help my burping, bloating, brick in stomach feeling and shortness of breath, even though I eat only soft foods and the only thing I drink is water except for some cranberry juice that I mix my Miralax in. Never ate oatmeal until the GES on Friday. Heck, I never liked oatmeal anyway and never even ate it when I was healthy.

Do you have shortness of breath and the brick on the upper stomach feeling as some of your symptoms? That is a frightening symptom for me because I also have this heavy feeling in my chest and a choking feeling that goes along with it. The choking feeling doesn't happen all the time, but when it does, it frightens me. I have had angina and take a calcium channel blocker for that, but am confused as to which symptoms are angina and which are possible GP. That's why I'm asking you what all your GP symptoms are. Do you have other diseases other than GP like hypothyroidism? I have heard being hypo can cause GP as well as other auto immune diseases. I was told by one Endo doc that I have hashimotos, but a 2nd Endo doc I saw disagrees and thinks I have something else, because along with all my other symptoms I also have a high Hemotocrit and hemogloblin level. Been tested for everything and nothing shows up. My B12 was normal as was my iron levels. They are testing me for Vitamin A---haven't gotten the results back yet from that one. I'm so confused and have seen so many docs, yet no one can figure out what my problem is for sure. All I know is, my soft diet isn't helping my stomach symptoms much and of course I'm not on any stomach meds yet except for Zofran which helps the nausea a little. I also have red, burning and irritated eyes. Sounds to me like I may have an auto immune disease or maybe several, but my blood tests don't show anything. So you see how frustrated and miserable I am.

On the positive side, I looked at some of your posts and was cracking up at the one you wrote about your symptoms in tune with the 12 days of Christmas----that was so funny. I love your sense of humor. It does help to have something to laugh about doesn't it?

I'm supposed to start cymbalta in a couple weeks. Sure hope it helps as I'am depressed. Did you have any side effects in taking it? Thanks for any info and advice you can give me. Terri

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WHEN I HAD MY LAST GES TEST ABOUT SIX MONTHS AGO I WAS GIVEN OATMEAL AND IT WAS FOR FOUR HOURS. I ASKED WHY I DIDN'T GET THE EGG AND TOAST AND WHY IT WAS FOUR HOURS WHEN MY FIRST ONE WAS ABOUT TWO HOURS. I WAS TOLD THAT NOW THIS TEST IS BEING CONTROLED BY A STANDARDIZE METHOD OF OATMEAL DONE FOR FOUR HOURS SO THAT ALL RESULTS WILL BE BASED ON THE SAME THINGS.

I HOPE THIS HELPS YOU.

SANDY

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the symptoms you're worried about either sounds like GERD or your body is over stressed ... your body, not you ... that happenes when you're body is in pain. ask your dr for cortisol test since they said negative for reflux. and as many here have said, your test results could vary ... I passed one and failed one miserably ... so, i'm a living proof that those tests are not perfect by any means. and why in the world did they give you oatmeal???

I hope they're not talking you into taking antidepressants. if you need them, they're great. if they make you take it bc they're convinced all of this is in your head since tests are coming back negative, I suggest you get a second opinion. also from a personal experience.
have you tried otc reflux meds? try getting your cortisol level checked ... with these functional illnesses, you really have to demand attention. good luck!

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Agree with Chocolatte, your body sounds stressed. Stress can up production of stomach acid which can be hell on the esophagus! I'm thinking perhaps you've burned the base of it. Maybe even a hernia there on the hiatus? I have one. I try to not ever lie down after eating, nor eat while lying down. Food sometimes feels actually STUCK in my esophagus. My meds certainly can! Sometimes I find that straitening my posture, and dropping my chin down will help me feel as if I've successfully swallowed. Reflux is horrid. The burning, the sensation of choking, the sensation of a rock at the base of the esophagus. Yah, try an OTC med for reflux.

Agree, too, about the anti-depressants. If they're being prescribed to treat clinical depression, woot. If low dose for GP symptoms, that happens too. But if you're being told your symptoms are anything but physical, find another opinion. As for the Cymbalta, I did at first have nausea. (Oddly enough.) But it didn't FEEL like nausea. I just lost my appetite. My doc is the one who said that was the first stage of nausea, which is a common side-effect of the drug. Hm. In any case, that didn't last but the first week or so. The dry mouth, now that I still get, even after all these years. Remember, though, I'm on a dose to treat clinical depression, and a fairly aggressive type. I'm on the highest dose prescribed--120 mg a day. I began at 60, then was upped to 90 during the winter blues, then eventually--two winters later? three?--was upped to current dose.

Cheers to feeling happier! (Or, at least, feeling capable of being happy again.)

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Okay....lots of stuff here!
Oatmeal makes me sick. Gluten-intolerant, and have problems with eggs sometimes. So- I wonder about that meal if I ever have to have the GES (which my doctor doesn't want to order because I'm doing so well with the domperidone, which would be the treatment anyway). Surely it must be relatively common for people with celiac's and egg allergy to have GES- so what do they do for them?

ON THE ANTIDEPRESSANT: I take desipramine, a tricyclic, at a very low dose (25 mg) for nausea control. It was the first thing that helped me. There are a few tricyclics that are prescribed for nausea. They are prescribed at a "subclinical" dose- that is, lower than would be effective for depression. They are also prescribed for pain control and sleep disorder.

I know that cymbalta is prescribed for pain control; don't know if it is specific to nausea or not.

So don't freak out if you have been prescribed an antidepressant if you have a chronic condition because they can be very helpful in treating them. It does not mean that the doctor thinks you have an emotional problem or that you have depression and that is what is causing your illness.

The amount I take is too low to treat depression, but I still feel a little anti-depressant "bump" from it. But I don't know if it is because it is working as an anti-depressant, or if I feel better mentally because I am feeling better physically.

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Okay, just googled it and nausea is the first side effect of cymbalta. Is your GI doc the one who is prescribing it?

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Okay, why in the world did they give you oatmeal for your GES test?!?!?!? That would make any of us sick!! I have had GES tests numerous times and at numerous medical institutions and have always been served the lovely egg with radioactive pellets in them and a piece of cold mushy toast - sounds very appetizing doesn't it? Any my tests have always been the 4 hour GES tests. Just because you might have "passed" the GES test you just had doesn't mean that you do not have GP. I also have been told by my current GI doctor, who is one of the best GP doctors in the country, that they look at the amount still in your stomach at one hour, two hours and 4 hours and have certain levels for each of those time frames. So, if your GI doctor says you do not have GP or a motility related issue, then you might want to consider finding a GI doctor who specializes in motility issues and get another opinion. I bet if you took a poll of all of us GP or motility patients, we would all say we have changed doctors along the way to find a GI doctor who has a specialty in motility issues. I too have taken Cymbalta for some of the emotional issues you deal with going through all of this. I took it for about 4 months last year until I decided I didn't need it anymore but am now starting to take it again. One of the good things about the Cymbalta is that it helps with other issues as well like joint pain. If they are having you take the Cymbalta for emotional issues/depression, then okay but if they are having you take it because they are saying this is all in your head, then RUN not walk, out of the doctors office and find a new doctor!!!!!

Welcome to this site! You will find it very beneficial and helpful because there are so many here that have usually been through whatever it is you are going through and will give you very good advice and will help you be an advocate for your health care. They are some really nice and compassionate people here. I pray that you are able to get some relief and that you are lead to the right health care provider who will help you and walk with you through this lovely GP world!

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Hi,

I had oatmeal for my test (2.5 hours only) and felt pretty bad for a few days. Could be the isotope, could be the oatmeal, could be the stress. I don't usually lie down for a few hours after eating either, and definitely felt awful the rest of the day (I only got down about 1/3 of what they gave me and almost none of it passed through and I was still burping it up well into the night).

Hang in there--drink fluids to stay hydrated. I know you're probably frustrated, but trying out a GP diet even without a "proper" diagnosis can't hurt. And if it makes you feel better, then that's even better!

Feel better!!!

A.

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Usually the preference for the GES test is egg, but they always have instant oatmeal as an alternative. I haven't been able to tolerate eggs for years so asked for the oatmeal and was tested with it instead. It used to be only used if people couldn't tolerate egg but guess that may have changed at some testing locations. At mine, egg is still the first choice.

Hope you feel better soon!

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Oatmeal. I am so sorry. How miserable.

Ok, well, here is my story: I did the 4-hour with egg and toast (thankfully...I was only sick for a day from the egg and toast, not the 3 or 4 the oatmeal would have caused). At 1 hour I was 19%, at 2 hours I was 39%, and at 4 hours I was 89%. I was LITERALLY as "borderline" as one can be. But, as I told my doctor (and I know he believed me) this was the best day I had had for about 2 months. Go figure, right?

So anyway, because I went about 3 months with no solid food and had a borderline test he told me I have GP. I have every symptom and what do you do when someone can't eat? Send them home telling them that their test is "borderline" and come back when things get worse? Doesn't get much worse than zero food.

He also explained that these tests are only so good and just help the GI to see what is going on. It's not exact because you are dealing with the human body and fluctuations. So it's a snapshot in time. He also said he would like to try to do it again one of these days and time it with the week before menstruation. I am SO BAD that week, which he said is typical for women. He thinks this would show me at my worse, which is really what they want to see because it lets them assess how bad it gets (whereas mine showed the best I can be).

Anyway, take the test for what it shows and go with it. Were you having a good day? If not and the test in negative don't just dig your heels in and insist that it's GP--tell the doctor you need to find out what this IS. I agree with choco130 that maybe it's GERD or something else. I don't have GERD (in fact, my GI can't believe how well my sphincter seems to work--at least I have some functioning GI body parts!!), but I know others here do and they might be good to ask about comparing the GP symptoms to the GERD symptoms. They overlap quite a bit...

Feel better. Are you on liquids now? Doing that for a week or two after a flare up helps me immensely.

Catherine

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Thank you all for your posts. I'm being prescribed cymbalta for the joint pains mostly, and I'll admit I have been depressed for a while now because no one can seem to find what is wrong. I have been to umpteen doctors and all my tests come back negative or borderline, so I'm very frustrated to say the least!! I have also been tested for Gerd and acid reflux, and that too was negative. I have been on most of the PPI's and none have worked. The only one I haven't tried is the new one called Dexilant----my insurance won't pay for it.

The next thing I will try is a meal replacement drink such as boost or carnation breakfast to see if those will soothe my stomach some. Just hope something works soon because It is so terrible to be nauseated and feel like a brick is in my stomach all the time.

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Hi..I too passed a gastric emptying test this year after the worst six month bout of GERD and Gastroparesis I ever had. So they did not believe that i had it again. Even though i had taken reglan for two years after i had a positive test in 2008 and a bezoar in 2005. I went off the reglan summer of 2010 because of neurological side effects and i was feeling better, but 4 months later...i was sick again.
After an endoscopy, they found a small hiatal hernia and
severe scarring but the docs also said that should not
cause the severe GERD I was getting (Maybe it was
caused by the undiagnosed gastroparesis getting out of
hand?) PH monitoring while on nexium was also normal.
I also never heard of using oatmeal for the test...usually
radioactive eggs and toast. I was finally taken seriously
after an admit thru the emergency room...I think they admitted me because at that point I was suicidal from enduring pain and nausea for six months and losing 25 lbs and no sleep.
They put me on a liquid diet for four days and morphine,
on fifth day a soft dinner and an endoscopy the next day
It revealed little- no digestion of the food and undigested
barium from one week before from another test. It was a
long painful road to re-diagnosis and life of domperidone,
nexium and Cymbalta.
And now weaning off methadone(pain drug of choice by hospital- weird,huh?) BUT I am doing better every day. So my suggestion is to
find a doctor who realizes that these tests can sometimes be negative and let them monitor you through a
particularly difficult and painful period. It sucks to know
something is wrong and to be made to feel as if you are
nuts. Or if things get so unbearable, the very real threat of suicide might get an er doc's attention..just make sure they put you in for the pain and vomiting and not the psych.floor!

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I got really sick during all three of my gastric emptying studies. Two were done with eggs and one with the oatmeal. The one with the oatmeal was the only one i was actually able to finish. I think your stomach functioning will vary from day to day so please dont give up on finding whats wrong if the drs say this test is normal! GI problems are miserable and i wouldnt wish them on anyone. Good luck and I hope you get some answers soon.

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The oatmeal and egg diets have both been used historically to test for gastroparesis. The reasonis that you can take a liquid substance (raw egg--or egg beaters, oatmeal in water), add the contrast material, heat in the microwave and the contrast material is cooked into a semisolid substance that does not leach into liquid--giving more accurate results of solid emptying times. Some institutions, prior to standardization of the tests used to do things such as squirt the contrast into beef stew, on a fried egg, and other methods where the contrast was not incorporated into the protein mass, but was on top of it. The techs would tell the patients to chew slowly to mix the contrast into the stew or egg (or etc.) while at the same time rushing the patient, to hurry up because the meal had to be eaten in 10 minutes. This gave mixed, unreliable results.

The guiding nuclear medicine society worked for years to get the various institutions where these tests were performed to standardize the meals and methods for this testing, so that a test performed in Michigan is comparable to a test performed in Utah (also that tests are comparable within the same institution).

The final determination is that the first choice for a test meal is Egg Beaters, toast with stawberry jam and water. If there are contraindications the next choice is the oatmeal meal with toast and Jam (I believe it has toast and jam--been a while since I read the recommendations). At the U of U where I go they still use the stew meal. I had it done once and my "stew" consisted of gravy and a couple of bites of potato, meaning it wasn't a solid meal, it was a liquid meal! I told my Doc. this and went and had it done correctly at an IHC facility (out of network). The results from the 2 facilities were wildly different, from mildly impaired to severly impaired! I asked the head of radiology at the U why they weren't following the guidelines of their own association. He had no reply.

The most important thing is that each subsequent test you have done should be done using the same method and meal. Doing it with oatmeal one time and egg the next is not going to give comparable results. This is the recommendation of the Society for Nuclear Medicine, and American Neurogastroenterology and Motility Society . If a Dr. tells you differently, recommend they read the guidelines.

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