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From Melvindale, Michigan, USA:

I'm curious about gastroparesis. I've had Roux-en-y surgery so I know my actual stomach is displaced, to say the least. Since December, I've had an almost constant pain, sometimes burning, right under my lower right rib. No one can find anything "wrong" aside from the pain and the fact that a lot of the time after I eat, I throw up. There's no nausea, just a feeling of needing to throw up after eating. I've had multiple tests including an MRCP (magnetic resonance cholangiopancreatography), colonoscopy, endoscopy, "swallow test", CAT scans, and ultrasounds, not to mention multiple laboratory tests on different dates. Everything always come back "normal," save for the one time I'd thrown up so often my potassium was a bit low. I've had type 1 for well over twenty years with no complications, but I'm wondering if this could maybe gastroparesis and if it could be, what test would prove it? Do you have any idea what this might be?


It is not going to be possible for me to give you a diagnosis using this format. It is problematic, to say the least, when your symptoms continue with no answer as to their cause. It sounds like the doctors are looking. Clearly, the symptoms sound like they could be mechanical. However, making a decision as to where the problem lies requires a lot more information. Gastroparesis from diabetic autonomic neuropathy is a very difficult problem to treat. I am not sure why you had the surgery. However, it sounds like the anatomy has been changed dramatically. The combination of surgery and gastroparesis may make it very difficult for your stomach to empty normally. You can have pooling of food/fluid in the stomach so that there is no room for new food and resulting diarrhea. There are medications that increase the propulsive motion of the gut. However, these can often fail over time. The doctors will have to determine if there is obstruction to the outflow of solid and liquid at the sites of the anastomoses where the gut is sutured together. They will also have to determine if the stomach is able to drain adequately. These problems are not always easy to fix. Make sure you work closely with your doctors to insure you get the best follow-up and treatment options.


Original posting 14 May 2007
Posted to Aches and Pains and Complications


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