Gastroparesis years after RNY

I had RNY about 11 years ago and lost 160 pounds with no complications. After a couple of years, I went through 5 pregnancies. Two full-term and three missed miscarriages that resulted in D&C's. Eventually, even with watching my diet and portions, I gained pretty much all of my weight back, mostly due to depression and an alcohol addiction that lasted a couple of years.

For the last two years, I've had chronic nausea and vomiting almost every time I eat, no matter how much or what it is. After losing 50 pounds in 3-4 months, I finally told my doctor shortly after recovering from pneumonia. I was given an abdominal CT scan that showed some liver damage and portal hypertension. I was also referred to a gastroenterologist.

The gastroenterologist tried many tests including a colonoscopy and endoscopy, and a gallbladder function test. A cardiologist even suspected pulmonary hypertension and I had an echocardiogram and nuclear stress test (both were normal). As a last resort, the GI doctor did a gastric emptying test but he was sure that wouldn't be the problem since I'd had gastric bypass. I got my results today, and low and behold it was abnormal and showed a significant delay. So, I don't see the doctor again for a couple of weeks but I know the diagnosis is gastroparesis.

Has anyone ever developed this after RNY and how was yours treated? I'm already on an acid reducer and phenergan three times a day but neither helps at all and so far, they wouldn't give me anything stronger. I know one treatment is a gastric pacemaker but I'm not sure how well that works after RNY. I've also read that Raglan can sometimes help but I tend to not respond well to many medications.

Just curious as to what types of treatment other RNY patients have had and whether it resolved the symptoms or not.

That is pretty much were I am at too as far as what GI has done with suspected gastroparesis. The phenergan does help me a little bit and small, frequent meals during flares...although to be frank, during a flare I tend to just not eat rather than risk that reflux and heavy nausea that I can't escape from. A lot of foods suggested during flares aren't RNY or bypass plan foods, which doesn't help with maintaining a healthy weight. I have seen such mixed reviews on gastric pacemakers and I refused to try Reglan but some people say it has helped them.

I only wish I had flares, but mine has literally been every day for the last couple of years. It started out as just after eating, but now it's sometimes even a few hours after a meal. I sometimes even wake up from strong bouts of nausea. I had lost 50 pounds in about 4 months awhile back because I had no appetite and was only eating about once a day. But right now I also have chronic insomnia so I tend to eat several times during the day and night even though I get sick. I think I finally decided to start back eating since I was getting sick whether I ate or not. Hopefully you'll find something that works for you as well. I have my GI appointment on the 12th and will try to update then.

Hi, I know that your post was a couple of months ago, but I'm 3 1/2 years post bypass and was just diagnosed with gastroparesis. I've been on been on Pepcid and Prilosec twice a day plus 3 doses of Carafate a day since August with NO relief. Finally I couldn't keep anything down and was hospitalized. Many consults, tests and diagnoses later it was determined that I have gastroparesis.

It was probably caused/triggered by 3 abdominal surgeries (bypass, total hysterectomy, plastics) and meds, particularly heavy doses of opioids, narcotics, etc. for c-spine OA. My body just kinda broke.

In the hospital, I got 4 doses of Reglan, which really helped, but it has horrible side effects so more than 6 doses is highly discouraged. My doc says that there is a Canadian med that's better but hard to get.

I'm currently on a pureed diet, several small meals throughout the day and sometimes get horrible bloating, gas and pain. Once it all clears out, I generally feel better.

I'm still very weak and walking with a walker but hoping for progress. I have NO advice but just wanted to share my experience and see how you're doing.

Much love and cheering for your improved health.

Janet

Thank you for sharing your story! My GP is pretty much still the same as it had been. I'm still only on Phenergan and Prilosec, but that doesn't help. I try to eat a small soft meal a few times a day. I have had a few random good days lately, so maybe it's starting to ease up a bit. At least I hope so!

I was not diagnosed with Gastroparesis, but I deal with IBS-C. If i am not careful and monitor what and ho much I eat, I may end up with intestines full of food and feces. Over the years I developed a method to help my body deal with that.

I take 2-4 heaping capfuls of generic miralax first thing in the morning in my coffee. It's a lot but that helps to wash out any food residue, and keeps the liquids inside my guts. The following morning as a walk. getting my coffee and tea ready, feed the cats, and do small chores around the house, the movement and gravity allow me to get soft BM. How much miralax I take depends if my intestines got empty or if there are still stuff inside. I follow my coffee with black and green teas, warm, but not hot. I probably drink 100 oz of liquids before noon. Only after that I can start eating. I have to avoid foods with fiber. the more fiber its in foods, the slower the food transition. And pain. Too much pain. Most of the time I eat very easy to digest foods as my first meal.

During the day I probably drink another 60 oz of liquids, specially between meals. If the food gets "stuck" I drink more warm liquids. I often drink electrolytes drink, (Electro-mix packages by Alacer).

At evening, before bed I take 1200-1600mg of magnesium oxide. A lot. But that also helps bring water into my intestines. I often move around after eating to help bring the foo down. Gravity and gentle exercise. In worse case I gently massage my gut to move the food. If I need it, my partner can do much stronger, deeper massage. By now we know the drill.

Stress is really bad for my gut. Things just stop moving. Everything gets stationary. When that happens, I just drink liquids until things start moving again. I can hear gut noises when things work OK. No= no sloid foods.

I'm just getting around to reading your response and it makes alot of sense. I've been taking 2+ caps of Miralax per day for a couple of years, and it really helps to keep things regular. I was really worried that there would be too much fiber in it though, but now I'm not "regular." My GP wants me to take mineral oil, but ugh!! Then again there isn't much that goes in, so not much to come out!

My GP suggested walking after eating, but I've been too unstable to do much. I know that movement does really help.

Also I agree that warm liquids help to move things along, and my GP said that caffeine helps to increase the stomach's motility. Problem is that it can also irritate my stomach so I'm touch and go with that. I've also found since RNY that warm & iced fluids are more palatable to me than room temperature liquids, so I keep an insulated bottle of iced water/tea and a bottle of warm tea (often herbals with lemon & ginger) next to me all the time.

Thanks again for your input. If you have any other thoughts, experience or suggestions, feel free to message me with your contact info!

Janet

Couple of comments:

Miralax

is not fiber. Miralax is a chemical that increase liquid in the guts, small and large intestines. I do best what I take 2 ful capfuls of miralax with coffee first thing in the morning and follow with a lot of liquids. I start eating solids when I am awake for at least 4-6 hours, and I had at least one good BM. If not, I push liquids.

The best price for generic Miralax is in Costco or Sam's.

Coffee:

I have problem with GERD - stomach pouch irritation, and I still like my coffee. I make my own cold brewed coffee, using organic coffee and filtered water. I often make a bunch or a very strong, concentrated cold brewed coffee, a week or 2 worth. To prevent any possible pathogens in coffee, plus make is even less acidic, after I filter the coffee grounds, I put the strained coffee in SS pot and add 1 Tbs of calcium carbonate to bind any acids residue. I put the very hot coffee in jars, or bottles to keep them pathogens free. I open one bottle and use in 3-4 days.

Temperature of the drinks:

I like ice water but my system can cramp and everything stops, plus cold water can further prevents digestion. i drink very warm tea, and I have and use 2-4 thermoses to bring my premade tea to work, have in the car, IMO, Contigo or Thermos brands thermoses are best to keep drinks very warm. When I started using them, I burned my lips/mouth a couple of time when I forgot that they do keep the temperature very well, sometimes too well.

As for things very hot, I love a very hot drinks. but because of the RNY, i cant drink very hot on empty pouch. I burned my stoma and intestines right after the stoma. I don't recommend that. .

I am sorry to read about what you have been going through. Did you get your answers from the doctor? Hopefully you are feeling much better now.