Smart Pill Test

Has anyone had the smart pill test. I have gastroparesis and I think my intestines are worse than my stomach. Is there anything they can find out from the smart pill test that would help me under stand why nothing wants to move on its own. My doctor says your motility is slow we don't need to know anything else, I feel like more info would be better.

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I had the SmartPill test done almost 1 year ago. If you are considering taking this test please check first to see if your insurance company will pay for it or if the test is still considered investigational. I found it worthwhile because it pinpointed the location of my motility disorder which turned out to be my colon. This was the only motility test offered at the hospital I go to aside from the GES. My GES was normal so it wasn't clear which part of my intestinal tract had abnormal motility. It cost around $2600 including the test and the MD fee. I would recommend you check out the SmartPill website for more information. Lindsay Clark is the Marketing and Customer Service Manager. She responded very quickly to the questions I asked and was very helpful.

The test is rather simple. Prior to the test you stop taking certain meds like Prilosec and other meds that are specified in the test instructions. The day of the test you eat an approved meal (the SmartBar or scrambled eggs, toast & jam) prior to swallowing the pill which is about the size of a large vitamin pill. You keep diaries of your stool characteristics and output, when you eat, gi symptoms, and other things. You wear a recording device during the test which lasts 5 days. You record when you expel the pill, but I couldn't tell when I did. You can't have an MRI while the SmartPill is inside your body. You return the recording device to the GI clinic 5 days later. It took about 2 months before I got my report. If you take the test, I hope you get your report sooner than I did!

After all this has been said, I had problems with my test, because I ate the SmartBar and developed severe diarrhea because of fructose intolerance. I was mistakenly informed that the SmartBar was the only approved meal for the test. This is not true according to Ms. Clark whom I communicated with after my test. Check out the contents of the SmartBar to make sure it is safe for you to eat prior to the test. I should have done this, but my GI doc was vague about what I would eat for the test and I assumed I would be given safe food. This was not the case. I was told that the results of my test were still valid even though I was very ill during the entire test. My case was unusual because of the fructose intolerance.

I hope what I have written is of some help to you. Please feel free to ask me more specific questions if any come to mind.
LG

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I'm at the end of my rope with my motility issues and I have been practically begging my docs to do the smart pill for me, they have concerns that my motility is so bad that it may get stuck and they would have to retrieve it surgically. Do you think this is a strong possibility? I had a complete gastrectomy in July due to Gastroparesis (caused by my vagus nerve being damaged/cut after gastric bypass surgery in 2007). I know there is still something wrong with my small intestine because I have a J-tube and it technically works (not clogged), but I couldn't tolerate any type of tube feeding (horrible pain, vomiting, and diarrhea) and I tried to use the tube for medications and even though the clamp was on, after I put the meds in and did the flushing, they would ooze their way back down the tube (even after several flushes). Any thoughts that might help me? I vomit everyday, even if there's nothing in my stomach (I'm on TPN through a Hickman catheter). I am also still experiencing stenosis (scarring in esophagus & at the new connection they made that causes food to become stuck, most times won't go down or come up, and I have been dilated 3 weeks in a row through endoscopy). I welcome all advice, even just someone out there like me to relate to. Thanks & I wish you all wellness :)

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Dear jbird1972: One thought I had was for you to contact the SmartPill Company and discuss your case with them. Lindsay Clark acts as a liason with the doctors who work for the company. She was very helpful to me.

Another thought I had was how would doing the SmartPill test change your current treatment plan? I am really sorry that you've had such a rough time. When you were attempting tube feeding were you taking any pro-motility medications at the time?

I had the SmartPill test because there wasn't any other testing available where I get my health care. I was and am capable of swallowing solid food without it getting stuck in my esophagus despite abnormal esophageal motility so I was able to swallow the SmartPill. I do not have narrowing of my esophagus like you. Are there other options for small and large intestine motility testing where you get your care? I am hoping other people can give you more practical advice than I can and have much more experience and knowledge than I do. Take care. You will be in my thoughts.
LG

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LG,
Thank you for your response, and I will contact the company (thanks for the contact name). I'll try to answer your questions, I'm currently being treated at the Cleveland Clinic (450 miles from my home, but well worth the trip). During the tube feedings I was not on any motility inducing meds (I've tried them all in the past w/no success, they actually had to give me Bentyl and Imodium after j-tube feedings started to try and stem the painful spasms and the flow of diarrhea, helped diarrhea but not the pain/spasms. The TPN doctors were convinced that my small intestine has absorption issues.
I'm hoping that a test that pinpoints which part of my small intestine is not working would allow my docs to be able to work around it or remove it from the equation because I can't stay on TPN forever (technically I could, but the risk of infection and the emotional meltdown that comes with it is too much).
Thank you again, and I will look into the company
Thanks,
Jules

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Jules,
What a rough road you've traveled. I had difficulties with my j tube feedings, too, but nothing compared to yours. Even though the SmartPill results pointed to my colon as the culprit, my GI doc also feels that my small bowel may be involved to some extent.

I hope Ms. Clark and the SmartPill staff can give you and your doctors some guidance. Maybe their doctors can communicate directly with your doctors. Their CTO, Jack Semler, was the one who contacted my doctor. The SmartPill website has a place for you to submit questions. Sometimes Ms. Clark answered me right away and other times there were delays because she was waiting to hear from the doctors.

Thank you for taking the time to give such a good explanation of your gi issues. I send you my love and best wishes that you can pinpoint the problem area in your small intestine and get off the TPN as soon as possible.
Eileen

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Thank you Eileen, and I hope & pray for your health as well :)

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lizardgirl: I'm confused. I thought what I was scheduled for soon was a "SmartPill" drop - to check my small intestines. But I'm only supposed to wear it for an entire day, not five days. It's called an endoscopy pill drop - something like that? It's a device that is a pill I swallow it takes lots of pictures along the way. They were going to give me Erythromicin - a small amount - which is an antibiotic that supposedly helps the stomach contract food along - but I was under the impression I not only was to eat prior to the test but they want my bowels cleared out - so I'm supposed to drink some of that stuff that clears food out like with a colonoscopy.

Is your test different than this perhaps? If so, I'll go online and check to see what mine is about versus this one. Either way it's supposed to help us determine what might be going on with some of my symptoms. Which are all over the place since I had my gall bladder removed; even before that I was sick. I can also eat solid food but I also have some type of constant phlem and mucus that stays stuck in my throat; I'm thinking this is an esophagus problem that's developed since the surgery. I keep coughing this up all the time and it keeps food and other items - even pills - from going down easily - I have to drink fluids to keep them flowing down. But they do go down eventually. SO concerned about a narrowing of my esophagus now because of this awful feeling of something stuck all the time. If I have the beginnings of GP I'm still having BMs just not as large as before and I have nausea frequently or a sick full feeling in my stomach - with just digestive issues that are constantly in turmoil. My gb was removed in July of this year...and I haven't been well since. Nor was I well before! For three months prior I was very ill; nauseous and couldn't eat much, my stomach just wouldn't let me - with pains and cramps, but not vomiting. I've lost 30 pounds in four months -

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Dear thisdogdonthunt: Sounds like we're talking about 2 different tests. While SmartPill traverses the gi tract it measures pH and pressure from the peristaltic contractions over time. All this info is transmitted to a recording device you wear the entire test which supposedly takes 5 days. The SmartPill doesn't send any images to the recording device.

It sends like you've been having a wretched time and I'm so sorry. Check out the SmartPill website to get the best information on the test from the experts. I hope your test goes OK and gives you and the docs the information you need. You are one strong person to be surviving all that's been happening to you. Good luck and best wishes from someone who can empathize with your symptoms.
Much love from Eileen and I'll be thinking of you in the coming days.

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Sounds like you might be doing a camera pill maybe? I know these are bigger, and take actual pictures of your insides along the way

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thisdogdonthunt: I had my esophagus dilated in August during an endocopy. This has helped my swallowing pain and reflux pain tremendously along with an increased dose of omeprazole. Along with everything else I have severe reflux and was having pain every time I swallowed solid food or drink from having a very inflammed esophagus. I haven't had the feeling of something being stuck in my esophagus. That sounds awful and scary.

I saw the esophagus expert today for follow-up and he said I may need future dilations when symptoms return. I was living in la-la land thinking I was fixed for good. That was pretty stupid of me.

How is your weight doing now? Have you seen a dietician to get some nutritional advice? Good luck with the camera pill testing.
Eileen

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Thanks Lizardgirl: I'm still losing weight and it's really frightening me. I'm not at a 'danger' zone yet, thank God I was already overweight when this Hell started or I would be. I've lost 30 pounds in 4 months. I was around 177 in May, I got on the scale today and it registered 146. I was 149 at the clinic on Sunday. Sunday! And it's just now Tuesday night. It seems sometimes that I'm losing a pound in a day...I've seen a nutritionist/dietitian and she's tried to help me. But the problem is the amount of food and the types she wants me to eat my digestive system simply won't tolerate - at least not yet and not now. I tried to guess at the number of calories I'm consuming per day and I doubt it's 1,000. Maybe a little higher on a 'decent' day. Frankly I'm running scared; not sure what to put down my mouth at any given moment, afraid of the consequences when I do. It just changes every day and sometimes by the hour.

I don't experience severe pain when I swallow it just feels like something is stuck. I do, however, have esophagus spasms, burping and sometimes food feels like it's taking a long time to get down. I have to swallow water or other liquids to make sure it goes down. I'm sure I have reflux, acid and possibly even bile - I hate the thought of the bile frankly, because there just isn't much that can be done for this. I just want so badly to have a management plan - food wise - and work arounds for my digestive system so I can function better than I am now.

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Thisdogdonthunt: I hope they can fix you, I just had a food stuck issue today, and I'm sure I scared the heck out of our 11 year old son. I was standing over the sink and started gagging and dry heaving, my body trying to get the food out of my esophagus because it was not going down :( It is awful & scary!

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jbird1972: what was it that you had eaten? Did you end up drinking a lot of water or other liquids to finally get it down? I've not had that bad of a food sticking issue but I always drink something with nearly every bite I take of anything...Did it finally just go down? When was your last GI visit? Sounds like you definitely need to make an appointment to see a GI doctor and have more tests run on your esophagus, my dear. This is going too far...I'm worried about you!

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jbird1972: How are you doing now after that food got stuck in your esophagus? You're very brave. I would have been scared out of my wits. How is the vomiting issue doing? Are you having problems with nausea, too? I have been taking Anzamet for nausea and vomiting issues I have because of small intestinal bacterial overgrowth syndrome as well as motility problems.

thisdogdonthunt: I lost 40 lbs. over 6 months and ended up with a feeding tube because of motility problems. I'm worried about you because I know what it's like to not be able to get enough calories orally. I don't want you to end up feeling the way I did before I started tube feeding. I had never felt so weak and just plain awful in my life. I thought at the time that this is what it must feel like when you're dying. I could barely walk and was bedridden. The PA who was evaluating me wasn't keeping track of me while I was having testing done. I had my testing at a university hospital which is the only one in the state. Because of the huge patient volume it took over a month to get the testing done. In hindsight she should have recognized how serious my problem was and advocated for me to get the testing done in a timely manner. I had to call the PA and tell her how bad things had gotten. I wasn't even scheduled for a follow-up appointment for her to know how I was doing or monitor my weight. Inexcusably bad "health" care. I don't want anything like this to happen to you. Best wishes and you're in my thoughts.
LG

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ThisDog: I had eaten one cooked macaroni noodle (over cooked on purpose) with a little bit of sauce/ground beef, basically a micro bite that I chewed the heck out of, and it still got stuck. I can't drink and eat at the same time and definitely not when the stuck episodes happen. I have tried in the past to use water to flush down whatever is stuck with really bad outcomes, it actually makes the episode worse because the stricture is so tight that water can't even flow around it, so it just adds to the pile of stuckage. I wish I could drink at the same time and wash it all down :(
I have a blog I keep on ObesityHelp.com. I'll figure out how to post the link as a discussion on here, there might be something helpful in there for some of you guys. It is a long read though, good bathroom reading lol

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