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1 9th May 23:49
peter
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Posts: 1
Default Update and Gastroparesis Questions (psychosomatic nexium nortriptyline stomach prilosec)


Howard,

I am still suffering like a dog and I am not having a good time with the new
gastro who found the ulcers and retained food when he scoped me, and
therefore couldn't do my bravo placement. On my three week revisit things
didn't go to good and he got pissy with me. I am having a gastric emptying
test tomorrow because he is concerned about possible gastroparesis. I took
reglan for 3 weeks after the EGD and it did nothing at all to help my
burning, and he agreed to me stopping it since I was already getting slight
hand jitters. I also told him I wanted to drop from nexium 40 mg BID to
prilosec 20 mg BID since I thought the nexium was causing gas type pain
between my shoulder blades and in my chest, and making my throat sore (as I
have reported previously). The pain stopped between the shoulder blades but
I still burn like hell and I am screwed.

He also started alluding to the "psychosomatic corner" that Vanny just
mentioned in another post, and that got me upset. I told him my problems
are pathological and everything was okay until the PPI's stopped working.
Damn it I have been suffering since June. He told me I was hyper (no
kidding, I live in constant pain) and mentioned the old
amitriptyline/nortriptyline crap and said he would only prescribe 25 mg at
bedtime, which is far below the usual dose of three times daily (since he
was not my primary care doc). I knew that wouldn't do anything since I have
taken them before, and they constipate me immediately, but I will try
anything out of desperation, and agreed to the Rx.

The tricyclic anti-depressants (which are also have off label usage for
various pain syndromes) are notorious for side effects and have
anti-cholenergic type effects that constipate you and cause urine retention.
*But* yet he wanted me to get the gastric emptying scan since he suspects
gastroparesis could be causing part of the problem. I took one
nortriptyline first night and immediately got constipated (my bowels have
been fine). IMO he should not have prescribed it since it is
contraindicated for gastroparesis and could skew the test I am having
tomorrow. I haven't taken any more of the nortriptyline and may not take it
because he agreed to scope me at 8 weeks from the last EGD to check on the
ulcers, and if I take the nortriptyline it may cause food retention again.
I told him I thought the food retention he saw during the EGD may have been
caused by a valium I took the night before.

He also said he doesn't want to do the bravo now and I told him that is why
I went to him and I needed to verify acid reflux if I was to consider the
surgery. Now I am really depressed after going to Dr. Marohn at Johns
Hopkins, and now this. He said even if the Bravo did show acid reflux it
wouldn't matter and he doesn't think I should have the surgery. I don't
understand or agree with his logic. He is a young doctor (fellowship in
2003), but I believe he is hung up on the "old school" attitude you
mentioned in regard to "people who don't do good on the pills don't do good
with the surgery".

Howard, this is so depressing and I can't get anyone to help me. Let me ask
you a couple of questions.

If my gastric emptying scan shows delayed emptying, which is gastroparesis
(basically treated with reglan), and if the reglan doesn't help (which it
didn't, and your not suppose to take it long term anyway even if it did
help), then couldn't a lap nissen still stop the burning above the LES. How
would gastroparesis cause heartburn or other types of burning in the
esophagus, chest, throat, tongue, nose, face (which I have). I know it's
coming from my stomach either acidic or basic or both. It is really messing
up my lungs and my mucous and coughing are increasing.

You told me once before you didn't know the vehicle for abnormal esophageal
motility (which I also have) causing burning pain. Could you try to explain
how gastroparesis can cause burning types of pain.

Thanks Howard...Pete
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2 9th May 23:49
howard mccollister
External User
 
Posts: 1
Default Update and Gastroparesis Questions (dyspepsia)


Internal organs have a limited number of responses available to injury.
Additionally, the pain of functional dyspepsia is subject to interpretation.
Dull aching in one person, burning pain in the next.

A gastric emptying test to look for functional dyspepsia is a reasonable
next step.

HMc
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