Gavin had an upper gi with a small bowel follow through yesterday and it showed a delay in emptying from his stomach and from his small bowel. How accurate is this given that it is barrium, not food and an upper GI, not an emptying scan? The ped said that it gives a general idea that there is a delay, it just doesn't quantify how significant that delay is. Would you all agree?

No structural abnormalities were seen (yeah) and the xray pictures revealed that his stomach contractions are weaker than normal. It took a little over 3 hours for the barrium to exit his stomach and small bowel. I guess normal is 60-90 minutes.

I take the no structural abnormalities were seen answer as a grain of salt because upper gis are so unreliable, but he doesn't have any other symptoms that make me think he would have something else going on. For example, Chelsea's large hiatal hernia did not show up on her first one, but she had lots of symptoms that something wasn't right--so when they scoped her 6 hours later, they found severe esophagitis, a large hiatal hernia, and she was still refluxing the barrium 6 hours later!

What is the difference (if any) of a delay from the small bowel? Does it mean anything specific??? I get the picture that food moves through slowly from the stomach all the way down (I assume the large intestine is slow too because he has trouble with constipation) and because of the back up, sometimes food goes up (hence the reflux). Can a delay from the stomach down point to any other problems?

The radiologist bugged me because he told me that once the barrium got to the small bowel it emptied fine after being so sluggish in the stomach. Then toward the end he started to back track on what he was saying when I mentioned an emptying scan saying that he is biased toward those because of the excessive radiation. Then the report he gave to our ped said that he had a slight delay in emptying in the stomach and a moderate delay from the bowel--the opposite of what he relayed to me. I would think 3 hours--twice the amount of normal time would be considered more than a slight delay-- suppose his definition of the delay doesn't matter though, just that he does indeed have one.

We see the GI on the first, so I am curious what his take will be. I live in California--anyone know of a doc here that uses domperidone in infants? He may not need meds, just checking incase he does. I suppose he does, his intake isn't normal yet. He is looking okay though, skinny but not sickly. He does have these huge purple bags under the eyes....due to the allergic reaction to milk based formula maybe? They look dreadful!

Let me know what you all think of this. I know he has delayed emptying but as far as where to go from here????????????????

Hello, yes, that test is pretty accurate for determing emptying problems, atleast making it obviously there, I think so because that is how we first found out there was emptying problems in our son, Then we went for an emptying scan test to see how slow it was, and they use the same type of drink for it so it should be a pretty good indicator. There are meds and foods you can avoid for emptying. We ended up having surgery because the meds didnt help. Our son ended up having his pyloral sphynctor muscle scraped off his liver! :shock: That was causing the problem, he empties perfectly wonderful now!

I have to agree with Erin about this study being a good indicator for delayed gastric emptying. It will diagnosis the problem but will not show how much or how slow it takes the stomach and intestines to empty.

My son has a severe delay in his stomach and in his small intestine but his large intestine is fine. He has bouts of constipation but that is due to the small bowel being so slow. My son has been on meds for years and has required surgery to help with his delays.

I was wondering if your gi doc is going to schedule a gastric emptying study in the near future. This test will give you further info on how delayed things are. I do wish you luck and hope that you get the answers that are needed.


Melanie

Hi-
I live in LA. I take Sarah to UCLA. She has DGE. We have found erthtromycin helpful but not helpful enough. I am going to talk to our GI next week to see if there is any other med we can try. reglan did nothing for us. If he gives domperidone I will let you know. Is this a good drug for DGE? They are recommending surgery for Sarah but I am not ready for that yet. I think if you have MSPI than that can delay the stomach emptying if you haven't taken it out of the diet. Let us know how your visit goes.
karie

Thanks for the tip on the MSPI, I am weaning him off of the milk based formula to Nutramigen right now, so maybe when he is on it completely--it will improve. I can hope at least. I thought if anyone in CA could get it, it would be someone at UCLA. Yes, please let me know--we are in Orange County, not that far--I actually grew up in LA, and my whole family still lives there. Domperidone is supposed to be good--like reglan without the side effects because it does not cross the blood brain barrier.

Eli had his surgery at UCLA :-D

Yes, domperidone is wonderful. I think that Melanie has mentioned using it too. Perhaps she knows of a good way to get it in the States?

I am hoping someone at UCLA will have it...if anyone in cal has it, I would think it will be them. I wonder if in the states though it is available on clinical trial since it is not approved. I am not sure how I would feel about that excpet that it appears both the UK and Canada use it safely?