This is Dr. David
has he been tested for H Pylori bacteria in the stomach?
yes. Came back negatve. Also I took him to a nutritionist who tested for food sensitivities and found wheat gluten dairy yeast corn intolerant. I know the science behind Igg test is doubtful but anyway I have kept him off these things and followed the normal advice about citrus tomato etc with no effect either way
he should get a barium study and a stomach emptying study to make sure food is moving out of his stomach.
he could be having gastroparesis or lack of motility of his esohpagus and stomach.
He had lower and upper endoscopies done where they pumped air in. Would this have shown gastroparesis?
endoscopy just looks inside of the stomach and esophagus.
it does not look for function and motility.
and does not check for gastroparesis.
Biopsies were taken.
Also GI specialist works at prestigious hospital and has 30 years experience. I am not asking you to comment on his practice but would motility be something that might have been an obvious thing to check?
Would gastroparesis be something that coexists with oesophagitis?
yes, it can
it is rare in children, but I think it is rare to have reflux at his age.
so rare things needs to be checked.
we tend to see gastroparesis in older patients who have nerve damage to their stomach
like diabetic patients who have nerve damage
and the nerves which tell the stomach and esphagus to move don't work.
but it would be going on in him as well.
let me know if you have other questions.
talk to his GI doctor about motility testing
and testing for gastroparesis
which can cause nausea.
How is gastroparesis treated? Would that be the reason why amitriptyline helped> Though not sure why it stopped being effective
the nerves might not be working correctly to move the stomach contents.
there are pro motility medications like reglan which could help
or other nerve medications like neurontin (gabapentin) which could help.
What could cause gastroparesis in an otherwise healthy non diabetic child? Why do medications stop working? ie the amitriptyline.
amitriptyline is an old tricyclic antidepressant which is sometimes used for neuropathic pain or nerve related conditions.
but it is really an old antidepression medication
it is inexpensive, so some doctors try it to see if it helps nerve related issues or nerve pain.
I don't know why he would have gastroparesis.
but he should be tested for it to be sure.
it could be from his constipation possibly
or why he also has constipation as well
or could be from his mild aspergers possibly.
What is the test for gastroparesis? Would a doctor try a pro motility med like reglan without clear diagnosis?
I don't know what his doctors will do.
it is a stomach gastric emptying study which uses fluoroscopy
which uses xrays and radiation.
so his doctors may not want to do it.
they could just try the reglan and see if it helps.
I have been back to consultant regarding intractable nausea . He has basically said that there is nothing else medically that they can do. He has suggested raniditine again - although that did not work in the past and continuation of amitriptyline. He thinks my son's problems are psychosomatic in origin. I do not. Should I get a second opinion?