Gastric Emptying Test vs. Upper GI

By joelee
Posted July 21, 2008 at 11:35 am · 5 replies
In Open discussion

Have been trying to get a diagnosis regarding my bizarre symptoms (lightheadedness, mental fatigue, overheatedness, numbness) when food enters my stomach. My gastroenterologist indicated that a stomach emptying test would be done; but today when I went to the hospital, they did only an upper GI. His prescription said "UGI to assess stomach emptying." The radiologist said there no obvious indication as to why these symptoms are occuring. I am frustrated because the nuclear gastric emptying test was not done and feel short-changed. It feels like my stomach fills during the day and that the symptoms become more intense with each meal. And there is sometimes a delay after eating before symptoms appear. I feel better when the gaps are longer between meals. On an empty stomach, I am feeling like some emptying takes pIace. If a basic upper GI is sufficient, why does the other test exist? Is an upper GI usually done first? Wouldn't the other test show what happens over time as opposed to within a few minutes? These symptoms are driving me crazy and I feel my doctor is not taking me seriously. Would appreciate any feedback.

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By Kate1
Posted July 22, 2008 at 8:18 am

Hi, there. That's strange that you went in expecting the gastric emptying test and they did an Upper GI instead... I think that Upper GI's are often done before a GES, so maybe your doctor is planning on doing that one next? I just think that he should have been more clear about the plan.

Anyway, I think that they can tell a little bit about gastric empting by how the barium moves through your stomach during the Upper GI, but it's not as conclusive as the GES. I could be wrong, but this is my understanding. If your doctor doesn't schedule a GES next, I would definitely request it. What GI diagnoses do you already have?

I'm sorry the test was not what you had expected. It's hard having so many tests done, and it's too bad if you have to go back again for another one. I hope that they at least figure out a way to help you after you are done with all of this. Good luck.

Kate

By joelee
Posted July 22, 2008 at 12:49 pm

My situation is very complicated. I have a longterm neurolomuscular disorder and was later diagnosed as having Berrett's Esophagus due to major acid reflux. This combination eventually caused difficulty in swallowing fluids and led to a peg-tube . The problems I mentioned began a few days after the tube was put in a month ago and have grown more intense as the weeks pass. But eating normally does not seem to improve the situation and creates the problems the tube corrected. My doctors seem baffled, but not exactly determined to help. I can literally feel sensations in my head most of the day, which get worse with each meal. This is also affecting my sleep. So I feel overwhelmed. I am hoping to hear from the gastroenterologist regarding the upper GI and will then request the "nuclear" test; but I suspect I am seen as a nut case and that my request will be denied. I trust this doctor as a surgeon; but his level of responsiveness is minimal. My next appointment is in September, which seems eons from now. The only way I learned of the emptying test was through an online question to a doctor who was willing to respond. I am searching for help wherever I can get it.

By chewy1
Posted July 22, 2008 at 4:32 pm

joelee,
I would suggest finding a new doctor if he doesn't see a need to do the gastric emptying scan now that the UGI has been completed.
Hopefully, he is just going through steps working up to the Gastric Emptying. I know that when I first began having trouble about 8 years ago that I was put through all kinds of tests including the UGI before they finally did the Gastric Emptying. I was told that because of the "craziness" of insurance requirements that they had to rule out problems with the 'easier" tests first. Of course, in the long run they ended up spending more by requiring the doctor to order the other tests first.
I think having to wait until September to see the doctor again is not good. I know that some doctors are hard to get into without a long wait..my neurologist was one of those...but, when you are experiencing new problems and don't know the reason for it, waiting just seems wrong!
It is hard to start over with a new doctor but sometimes you have to do it. If you think that the doctor is not taking you seriously, then it's time to try someone else.
I know that there are so wonderful, compassionate and over-all great doctors out there. Sometimes it takes seeing several before you find the right one. I wish everyone could have a Primary Care doctor like mine. He is the best. When he can't find the answer he starts looking for someone who can...My GI doctors that I have seen around home haven't been that good...they were some of the ones who pretty much threw up their arms and said good luck, we can't help you. However, the GI doctor that I was sent to see at Mayo Clinic restored my faith in GI doctors too because he is another compassionate doctor.
Anyway, my suggestion is ask why you haven't had the Gastric Emptying and if the doctor decides he isn't go to still order it...find someone who will!
Good luck and keep us posted.
Judy

By joelee
Posted July 26, 2008 at 3:56 pm

Judy,

Sorry it took a few days for me to get back to you. My plan is to call on Monday and find out if the tests proved anything and to ask about the gastric emptying test. I am also going to mention my unexplained weight loss to see if that generates any response. I am consuming 2000 calories a day, more than enough to keep me at the post-operation weight, but have lost 7 pounds.

My thinking on diagnosis has changed after doing more research. I am suspecting late Dumping Syndrome, since my symptoms compare very closely to those in the documents I've read on this disorder and since this is typically triggered by stomach surgery. Such symptoms often go away; but for me have gotten worse over time. Despite my doctor's scoffing at my mental symptoms, they are specifically noted on the lists I found on several web sites. This only irritates me more. I need someone willing to listen.

My doctor is primarily a surgeon and is only available afternoons, which limits his availability. A PA and RPN cover the mornings. If I do not get satisfaction when I call, I am going to contact another practice, which includes several gastroenterologists and see if they are willing to help.

By chewy1
Posted July 26, 2008 at 4:50 pm

joelee,
I'm happy to hear that you are going to call Monday to see if you can get some answers. I'm surprised that you weren't called or sent a letter with the results of the UGI by now. My doctors have always contacted me within a week of any test.
You definitely need to get some answers. I don't know how your weight is normally but as many people on this site can tell you that in the case of motility problems that it can drop rapidly and to a dangerous level.
Even on a gastric emptying scan you may get different results at different times. I have had several with a variety of results from only a slight delay to severe delay and the last test actually showed that I was dumping too fast! I was told the resulting symptoms would all be the same for delayed or rapid.
I think most people who are dealing with gastroparesis and other motility problems are also taking something for depression and anxiety. I was told that it was very important to deal with those issues too because they can just make things worse. I know that at times I have tried to wean myself off of my medicine and it didn't take me long to realize that I HAD to take it.
Good luck with talking to the doctor on Monday. Lets us know if you have any success.
Judy

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