Gastroparesis Mystery

Can I get a diagnosis please?

The first almost two years after my first flare-up, I had multiple colonoscopies and endoscopes, all of which came back negative.  They did see gastritis and diagnosed me with GERD.  The GI I was seeing at the time could not, or should I say would not, help with the chronic constipation except suggesting Senna laxatives.  He was convinced that I was bulimic and I needed to see a psychologist right away based only on the fact that they could not explain the vomiting.  To be fair, the vomiting was happening only when I ate fatty or greasy foods, so my diet was workable and not life threatening.  I weighed around 205 lbs and had not lost any weight because of vomiting.  The GI also suggested I go on a diet and that along with counseling should stop any issues.

In my heart, I knew I was not making myself vomit and there had to be some underlying issues.  In my head, I started to second guess myself.  I decided to start Jenny Craig.  After a couple weeks, I was feeling better but I could not tolerate some of the meals.  I chalked that up to GERD because most of the meals contain tomatoes.   After just over a year being on Jenny Craig I got down to 155 lbs.  I had seen a counselor during that time for six months and was attempting to get my stress under control by doing yoga and just trying to relax (the GI had put me on Celexa during my first year of flare-ups).  We came to the conclusion that I was not bulimic but getting my stress under control could only help the situation.  I maintained my weight for 10 months and was able to eat plain foods (including turkey sandwiches) but I still ate some of the Jenny Craig meals.  I still vomited but not every day.  I thought I had found a manageable eating plan and was making progress.  Then in Jan 2010 I began experiencing horrible pain in my upper abdominal area.

I decided to get a second opinion from another GI because the pain was not manageable.  I had an ERCP done and ended up with pancreatitis.  The GI ordered a Gastric Emptying Study and when the test came back with slow motility, he decided he could no longer see me.  Since that hospitalization, my symptoms have slowly progressed.

My PCP put me on a pain management schedule the summer of 2010 because the pain would not go away with over the counter medications.  The probiotics I was put on after the pancreatitis were not helping and my insurance did not cover them so I decided to stop taking them.  At this point my diet was consisting of crackers and dry cereal.  After a couple months on Demerol, I was able to start eating more of a variety but nothing very nutritious.  I slowly began gaining weight and hit 174 lbs at my highest.  The pain meds helped with pain but my vomiting stayed consistent.

I had to find another GI in the summer of 2011.  He ordered a colonoscopy, which came back negative.  The letter he wrote to my PCP stated that my slow motility was the result of the pain meds, not taking into account I started the pain meds after having symptoms for 4 years.  My PCP decided to no longer continue prescribing them and I was told to take over the counter pain meds again.  The GI was convinced I did not have Gastroparesis and everything was a result of the pain meds and poor diet.  He had me stop taking Celexa because the anti-stress med would also cause digestive issues.  He put me on Miralax twice a day and ordered me to get my diet under control and the vomiting should stop soon after.

I stuck with that plan for six months before I made an appointment with yet another GI at the University of Arizona Medical Center, who I am still seeing today.  My new GI looked at my tests and came to the conclusion that I did indeed have Gastroparesis but he wanted to order more tests to see if we could figure out what was causing the GP since I do not have any other issues that would cause it.  A month later I ended up in the ER.  I was there for a week with not one test performed.  I saw intern daily and none of them could figure out why I was in so much pain and what was causing the vomiting.  I decided to discharge myself.  A couple weeks later, I had an Esophageal Manometry study, a pH study and a Sitz Marker test.

As of right now, the GERD is not bad enough to cause the vomiting.  My esophagus is not contracting 90% of my swallows.  I do indeed have chronic constipation.  My motility is slow.  My weight is now at 140 lbs.  I still do not have a reason as to why any of this is occurring.  I’ve seen many specialists and all have told me I just need to manage it and I’ll probably never know why any of this occurred in the first place.  I cannot get the pain under control and since pain meds hurt the digestive system, I do not know if I’ll ever get help for the pain.  The vomiting happens at least once a day and my diet changes daily.