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Advice needed for new diagnosis: acute gastritis, hiatal hernia and slow stomach

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Posted 1/8/2012 2:59 PM (GMT 0)
 

 A few years ago I was diagnosed with a slow stomach, after a few months of treatment the symptoms cleared up until about 6 months ago.  Now I have a constant fullness after meals, frequent burping, acid-reflux, nausea, and abdominal pain (cramps) after a meal. The worse was Thanksgiving and Christmas eve when I had to go to bed with a house full of company with stomach pain. In August, I went to my primary physician and he advised me to take a PPI.  Tried that and things have gotten worse and not better. 

I went to my GI and this week he preformed a EGD and the results are an ulcer and a hiatal hernia.  He has doubled the PPI to 30mg a day. Yesterday, I had a gastric emptying scan and though I haven't gotten the results of the scan the technican said and I could see on the monitor that the breakfest was mostly still in my stomach.  f

So I'm trying to find a diet but it seems what might be okay for the slow stomach might not be good for the acute gastritis (ulcer).  Also, should I take the PPI in the morning, at night or take one in the am and one in the pm. 

What I have found I can eat; low-fat organic plain yougart with a bit of honey in the moring, a simple spring mix salad for lunch and soups, stews with chicken for dinner and some pastas.  I have found that I can't eat beef unless it's ground and bread is hard on my system. 

I've lost a bit of weight but now it seems I'm starting to drop the weight a bit more rapidly.  I did need to drop some pounds but not any more.  18 months ago I was at around 165 now I'm at 133.  Two weeks ago I was at 136.  I've dropped a few sizes from a 12-14 to a 4-6.  I'm 55 years old and 5'7". 

Any advice on food and suggestions would be appreciated.  The GI wants to see me again in 6 weeks and recommended the PPI and 6 small meals a day that are low in fiber and fat.  Should I get another opinion?  I live in South New Jersey and near Philly if anyone has a recommendation ;-)

-Robin

Posted 1/9/2012 8:47 PM (GMT 0)
Hi there

I think I would ask to be referred to a dietician type person - low fibre and fat may help prevent food lingering, but I think the protein content is also relevant and it might be good to get some professional advice there.

You can ask a pharmacist or the person who wrote the prescription regarding the timing of the ppi - but I think the usual way is one in the morning (preferrably some time before breakfast if you can manage it) and one a couple of hours before bed (to give it chance to act before you lie down). However, some of the medics (from what I read) say the timing doesn't make a lot of difference - however, a lot of people on the user end find the timing does affect them. Sometimes it's a question of trial and error. If they haven't given you clear instructions on when to take it, then give them a ring. It should also be on the packet or the pharmacist's label as to whether it's a divided dose (morning and night) or not. We can't really advise each other on dosing here, although we can compare notes on what we find works best, which at the end of the day can be an individual thing. I would definitely get back in touch with them as they should not have left you in any doubt about what you take and when ....... (IMO).....

MMM
Posted 1/9/2012 8:59 PM (GMT 0)
Hi Robin --

Since you seem to be losing weight at an extreme rate, I would focus on smaller meals, nutrition and calories, while keeping your reflux and stomach-emptying in mind. IMO, I think salads occupy a lot of "room" in your stomach, but don't offer a lot of nutrition or calories (at least, the lettuce part!)...plus, some dressings could be a little difficult to digest. Soups can be nutritious depending upon the ingredients. Can you handle bananas? A banana or two a day would go far in helping to maintain your weight. Also, canned pears and peaches are higher in sugar so have more calories, and are easier to digest because they're softened as a result of the syrup. Applesauce, too.

Are you sleeping on an incline? That will help some with your reflux symptoms at night.

-Bruce
Posted 1/10/2012 5:40 PM (GMT 0)
Hi,   Thanks for the advice; I am finding that I'm learning what foods I can tolerate.  Foods that focus on the slow stomach seem to be the best for me now.  I did have a banana for breakfast today and had no issues! Thanks for the tip. Trying   to eat 6 small meals is hard for two reasons, the time management of working and not being hungry.   So far I can do 4 and yesterday I did 5…if you include ¼ c of applesauce a meal ;-)     I’m off to a conference for a few days but I packed a cooler with yogurt and some Gatorade.   I’ll call my GI when I get back on Thursday to see the results of the timed test and biopsy and to get more specific eating instructions.   I have found that if I take 1 PPI before my first meal and before dinner that seems to provide the best relief throughout the day.   I’m trying to eat earlier at night but I don’t get home until 6-7 which is an issue but I’m trying to do some batch cooking on the weekends so all I have to do is plate it up.   I like the idea of a dietician and I’ll follow-up with my GI and insurance to see if it’s an option.     In a moment of frustration, I told my family that I wasn’t cooking them food that I can’t eat they’re looking forward to me going away so they can eat steaks ;-)   Thanks again and take care,   Robin
Posted 1/10/2012 5:59 PM (GMT 0)
Hey Robin,

How were you diagnosed with "slow stomach"? What was the treatment for it?

Thanks,
Ashley
Posted 1/11/2012 5:20 PM (GMT 0)
Ashley:

I was diagnosed with Gasteopareis (slow stomach) by a Nuculear stomach emptying test. It took two hours. I had to bring a sandwich that they then added the contrast to, after which I ate it and they tracked it's progress thru my stomach. I was told that normal movement thru the stomach is 60 -90 minutes and mine was taking over four hours. I was told afterward that I should have been assigned a nutritionist, but I found a great diet when I Googled the condition thru the University of Virginia website. Good luck!
Posted 1/11/2012 5:59 PM (GMT 0)
Thanks so much for answering! I've been wondering about that. Did you notice anything that made you think that? My main concern is that I burp after eating I sometimes taste food that I ate like 4-6 hours before... it's very strange. Did that ever happen to you?
Posted 1/11/2012 8:22 PM (GMT 0)
Ashley:

My stomach was so bloated that my pants were too tight and very uncomfortable. I was hospitalized with acute pain in my chest and I thought it was a heart attack. After numerous tests for my heart they determined that wasn't the problem. Next came a endoscopy, regurgitation test where they only found a hiatal hernia. When I met with my Gasteo specialist he decided to order the nuclear stomach emptying test. What a surprises when I got the results! I wondered why no one had ever ordered that test before!

I know what you mean about tasting food from 2 - 4 hrs ago. Ick! But the diet recommendation from the U of V website helped immensely. I found I was eating all the wrong things - way too much fiber which kept foods even
longer in my stomach.

The diet also helped me prepare for life after fundoplication (once I get thru this liquids only phase).

Hope this helps!

Nyteller
Posted 1/13/2012 1:05 AM (GMT 0)
 

I had a 4 hour, gastric emptying study done on Saturday.  The radiologist served up some eggs and toast and the eggs had a contrast die.  Every hour they would take images to determine how much the stomach was emptying.  After 4 hours a normal stomach empties 90% of a meal.  I picked up my test results today and after 4 hrs. 79% of the meal remained. 

I had a few good days but not today, I ate my banana for breafest at 8:00AM and I still feel full. I did eat a bowl of soup and a little chicken with beans but I just can't eat anymore. I think tomorrow I'm going to do a more liquid diet and I'm going to call my GI now that he has rec'd the results and see if there is anything he can do to help with some relief. 

I still think the slow stomach is the big issue and not the ulcer or hernia...but who knows.  I need to come up with some questions to ask the doc!

-Robin

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