Gastroparesis?

This condition is most commonly found in people with both types of Diabetes.

Other causes are:

• Postviral syndromes
• Anorexia nervosa
• Surgery on the stomach or vagus nerve
• Medications, particularly anticholinergics and narcotics (drugs that slow contractions in the intestine)
• Gastroesophageal reflux disease (rarely)
• Smooth muscle disorders such as amyloidosis and scleroderma
• Nervous system diseases, including abdominal migraine and Parkinson's disease
• Metabolic disorders, including hypothyroidism
• Connective tissue disorders like Ehlers-Danlos Syndrome
• Idiopathic, the cause of the gastroparesis cannot be determined

The diagnosis of gastroparesis is confirmed through one or more of the following diagnosic tests:

1.A GET, or gastric emptying test, is commonly used to diagnose gastroparesis. Using a method called scintigraphy a gamma emmiting radioisotope is integrated into a selected food item, often scrambled eggs. Multi-centre clinical trials have established international standards for this test. The meal is eaten and images, utilizing a gamma camera, are taken of the stomach over a period from 2-4 hours.

2. Barium x-ray . May be perfored to look for any structral abnormalities within the stomach and upper gastrointestinal tract. After fasting for 12 hours, you will drink a thick liquid called barium, which coats the inside of the stomach, making it show up on the x ray. Normally, the stomach will be empty of all food after 12 hours of fasting. If the x ray shows food in the stomach, gastroparesis is likely. If the x ray shows an empty stomach but the doctor still suspects that you have delayed emptying, you may need to repeat the test another day. On any one day, a person with gastroparesis may digest a meal normally, giving a falsely normal test result. If you have diabetes, your doctor may have special instructions about fasting.

3. Antral duodenal manometry (also know as motility testing) is a means by which the pressure from peristaltic action inside the digestive tract can be measured. A thin tube is passed down the throat. While manometry is commonly performed on the esophagus, very few centers provide this test on the stomach and small bowel. When this test is performed on the stomach, it helps to reveal the pumping power and capabilities of the lower part of the stomach, or antrum. In gastroparesis, the function of the antrum is frequently found to be weak and inadequate. As well, during studies on the stomach, manometric measures performed on the pylorus may be helpful in demonstrating pyloro-spasm - another common problem found with delayed gastric emptying.

4. Blood tests. The doctor may also order laboratory tests to check blood counts and to measure chemical and electrolyte levels. To rule out causes of gastroparesis other than diabetes, the doctor may do an upper endoscopy or an ultrasound.

5. Upper endoscopy. After giving you a sedative, the doctor passes a long, thin tube called an endoscope through the mouth and gently guides it down the esophagus into the stomach. Through the endoscope, the doctor can look at the lining of the stomach to check for any abnormalities.

6. Ultrasound. To rule out gallbladder disease or pancreatitis as a source of the problem, you may have an ultrasound test, which uses harmless sound waves to outline and define the shape of the gallbladder and pancreas.

In me, I have double jeopardy - I take Topamax (for migraines, but this medication is used to treat for Parkinson's Disease) and I am a Type II Diabetic and have Gastroparesis. The medication either causes Gastroparesis or exacerbates it. Also, you might have your primary care physican prescribe you something for the Gastroesophageal Reflux like Protonix twice a day. I have had most of those tests that I mentioned done to determine the scope of the problem.

I would STRONGLY suguest that you get a qualified gastroenterologist who is a physician who specializies in stomach and bowel issues like these to take you to this next step in your diagnosis and impending treatment. They will work with your primary care doctor in your care.

If you are over 50, you should have him or her do the testing and while you are at it, do a baseline colonoscopy.

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