Test for Gastroparesis
 

May I ask if Upper GI test using barium can also be used to diagnose slow emptying problem as an alternative for the gastric emptying study (using radioactive)?

My GI doctor does not think I have problems with gastroparesis because normally, patients would vomit after eating. Though, I dont vomit after eating but I feel bloated after eating. I eat frequent, small amounts of food, but even with this, I still feel so full. When I start feeling bloated, my breathing becomes more difficult. Its a cycle.

My abdomen cat scan was normal. NOrmally, she said she would have given me an endoscopy but since I just had a bronchoscopy, she gave me request for upper GI test intead. While searching on the net, I found this article about alternative tests for gastric emptying test and upper GI was one.

It is important that I should gain more weight. I am thin for my height and for patients with Mycobacterium Avium, it is really required to add more calories.

Thank you.

A spasm of the pylorus will also cause this type of symptom.

It can be tested for with the upper GI. (also it can be relieved with an antispasmotic drug like Levsin.) I often get this because my GI tract is twisted... a rare congenital thing I was born with.

Also an upper GI "may" show a hiatal hernia. Mine showed up dramatically and I even had to lie on my right side and drink MORE Barium! However, my doctor said only about 10% of hiatal hernias show up.

When the stomach and esophagus move up thru the hernia, there is a pressure and feeling of "doom". I have learned to live with it. One thing is to NOT bend over after eating and not eat large amounts of food at a time.

For bloating, you can take Gas-X (or any simethacone product) and it will help you to burp and reduce discomforts. Gas is one thing that will make GERD/heartburn much worse.

I use a Maalox product with both calcium and simethacone in it to help move things along better, sometimes. I avoid carbonated drinks, and gassy foods too. But you can do the simethacone alone if you want.

I'd get the upper GI... it will probably be useful. The upper GI can be ordered with a small intestine request. They will have you sit around after the upper GI and see how long the barium takes to move thru the upper intestine. For me it was 20 minutes instead of 3 hrs (normal)...because of the maltodextrin in the suspending agent for the barium. I am intolerant of that, so my barium moved thru in a BLAST! They barely had time to take the X-rays to show it even. If your stomach holds the barium too long, that will show up as well.

The gastric empty test is the gold standard to diagnose gastroparesis. It is a very easy test...just eat some scrambled eggs laced with contrast (you can't taste it), then lay down flat for 2-3 hours and watch TV, listen to music, or nap...just can't move. Images are taken over the 2-3 hours to track the food/contrast and determine the empty time.

Sorry for the short reply. I'll try to elaborate more later.

Thank you en bloc. Your short reply is okay and appreciated. I was hoping that I could maximize the results of the upper gi test. So I could avoid other diagnostic tests.

Does the diaphragm show on chest cat scan, even if its not the focus of the test? I am trying to rule out every possible cause. I asked the doctor about my diaphragm but he said that its normal because if its not it will be "elevated". But you know, when he said this he was already on his way out of the room (on to the next patient). I am not sure if that reply was "reliable" :-).

Thank you Mrs.D! It is really so frustrating. This bloating contributes to my discomforts. Me and my husband were on Nexium but recently his med was changed to Protonix because it seemed that he was no longer getting relief (he has been on Nexium for a long time). I know its wrong, but I have been trying his new medicine. So far, I dont see any improvement in my bloating.

In between I take Ranitidine.

I am not sure if I have gas. I used to hve so much gas (big time) when I did not know that I am lactose intolerant. But now that I have corrected that, I seldom hear my stomach grumbles.

I am trying to minimize my exposure to x-rays and radiation because I will need several cat scans to monitor the improvements of my lungs. Please pray for me that I complete the whole course of the antibiotics with minimal side effects. Needless to say, the antibiotics adding to my stomach problems.

I will try that Maalox with calcium and semithacone. Does calcium affect the absorption of all medicines/vitamins ?

Does anyone know if the barium that is used for the upper GI test is same as used in culturing the mycobacterium avium in the laboratories?
Or, does anybody can point me to the right field of expertise to ask this question. I just read this from one of those online discussions and I want to validate the veracity of this claim. I dont want to be drinking something that will encourage the growth of this bugs.:D

Will appreciate your feedback.

You don't have to take the Maalox with the calcium, it is just that I use it. Simethacone comes alone without anything and is
called Gas-X (and other names).

Bloating means GAS and gas will come from all the acid blockers.
These drugs impair breakdown of protein, which then is fermented nastily in the intestines by bacteria. The gas will move up when high in the tract and will move down if lower.
It is a consequence of acid blocking drugs and really leads to more heartburn as the gas bubbles up and splashes the esophagus.

Gas-X? We have plenty of that here at home, in boxes! My husband is using it. The feeling of pressure is right in the middle below the breasts. (sorry, I dont know what exact words to use to point the exact spot.) Its the spot which I feel pressing my lungs which in turn giving me more shortness of breath.

Thank you Mrs.D!

There are esophageal spasms that can occur there.

And the hiatal hernia will come up into the chest and cause pressure there or generally. I find lying on my left side reduces any pressure when it comes for me. (my stomach is twisted to the right).

If gas I have my hubby gently pounds my back...sometimes even just pressing on spots with his fingers while I am sitting up, will
move the gas around and enable my burping. This may be only true for me however, because my stomach is twisted 90 degrees towards my back to the right, and that is where the food is moved along to the intestine (for me only). People with normal positioning would feel otherwise I would think.

difference in exams
 

Upper GI: Drink barium and get evaluated under fluoroscopy. Fluoroscopy equals dynamic x-rays, thus involves radiation. Primarily used for anatomic evaluation, such has hernias, reflux, masses, ulcers, and abnormal rotation. If gastroparesis was severe, it could be detected. The main issue with gastroparesis assessment is that barium is a liquid. Most people with gastroparesis, will have normal emptying of liquids with delayed emptying of solids. If gastroparesis was severe, it could effect liquids and thus be seen on the upper GI. Gatroparesis would also be a subjective call made by the radiologist.

Gastric emptying study: Eat a radio-labelled meal, which usually includes eggs with a small amount of tracer. Our protocol involves getting imaged at 0, 30, 60, 120, 180, and 240 minutes. Imaging takes about 5 minutes at each time slot. You do not have to be still for the entire portion of the exam. The benefit of this exam is that it assesses solid emptying. There are also standard criteria to determine if it is delayed or not, so this gets an objective result.