My Digestive Study (Gastric Emptying Study)

Yes, I am skipping my Part 2 of My GP Story.  Hopefully tomorrow I will get more time.

Tonight it is about the Digest Study I had done.  That is what my GI Dr called it.  Come to find out it is really a Gastric Emptying Study (GES).  It seems that across the country this test can be different for us all.  Ranging from 2 hours to 4 hours and we all can have different ‘food’ to consume first.

During my test I was given a full egg salad sandwich (other option was oatmeal) and a glass of water.  I was asked it I could consume the full sandwich or if I needed 1/2 of one.  The 1/2 sandwich would still contain the same amount of egg.  I said I would get the full one down.  The liquid was also required.  It took me about 20 minutes and pray it would stay.  At that time I didn’t know what was wrong with me, but typically would eat anything, but only in a small amount.  It stayed down, for the record.  But I felt as if I was gong to gag at any moment.

The ‘food’ you are given contains a radio active material.  So they have to document how much you ate and do what ever it is with the numbers they have.  I ate all but a little crust.

ImageThen, I got to lay down for 2 sold hours on a table with a machine over the top of me.  I could not move in any direction and even if I tried to lift my head I would hit the machine.  I could look up or to the right.  Luckily, to the right was the monitor.

Every minute there would be a new picture of my stomach and the food in it.  It looked more like an ultra sound picture than anything!  But beside counting the tiles on the ceiling, there was nothing else to look at.

Each 30 minutes I was asked if I needed to quit or just walk around.  I was not a quitter and going to do this!  I gave no sounds or indications I wanted to be done.   She kept telling me that most people she has had only last 30 – 45 minutes and that is okay.  They can work with those numbers.   In my mind I didn’t see how ‘accurate’ that would be.  I stuck it out the full 2 hours.  My butt was numb and parts of my legs.

After the 2 hours, I got to sit up slowly and then do it all over again.  Well sort of.  I was taken to another room with the same machine.  She wanted me closer to her office so that she could monitor me better.  I had to walk there (speeding digestion with gravity alone) and then laid back down.  This time I was given an injection of Reglen, very slowly.  As soon as the second drip happened, I was itchy, hot, claustrophobic and was in fear of everything, especially my fast heart rate.  Then the third drip hit and I was in so much abdominal pain it was crazy!  I had about 15 minutes left of that 30 min test and I was ready to run to the bathroom.  I made myself do it and she documented what was happening to me.  Since I was at a hospital for this, I knew it would be okay.  I made it the 30 minutes (still think she let me go early) and headed off to the bathroom for the next 30 minutes.  After all that I just headed home and went to bed!

About 2 weeks later I got my test results.  Mine had the number that they estimate I would have an empty stomach after that ‘meal’ and what the regular populations time would be for the same thing.  It took me 4 times longer.  The test of mine told me that I am at 250 minutes and a ‘normal’ person is 60 minutes.   There is a lot of controversy over what ‘normal’ is.  But that is what it showed on my test results.   Then there was the section where I was given the small does of Reglan and my processing time was speed up to 30 minutes!

Therefore, I was diagnosed with Idiopathic Gastroparesis.

Now you know a little about the Gastric Emptying Scan in general and how mine was done.  Below are some links for more information on the test.

Here are my concerns with the test/study:

  • The Gastric Emptying Study is suppose to be a 4 hour test.   How can the logorythems for anything other than that be accurate?  Especially if the place I went to is okay with just a 30 mintue test??
  • The ‘food’ types are different.  For an accurate study, wouldn’t we all need to eat the same food?   I understand that some of us can’t even tolerate solid food anyway.  But for those of us that can, it should be the same food.  For me, if I took the oatmeal, I know for a fact that my stomach would have problems with that (over the egg) and my results would have been even slower.  My stomach (GP) does not like oatmeal!
  • Gravity!  My place allowed me to get up and walk around, if needed.   I didn’t.  But, this would speed up digestion, even if it is a little bit, it still messes up the results.  Then the image is not in the exact location it was before when you go to line up the pictures.
  • Repeat tests — Some will take the ‘test’ and then have it done in a year or two to see where they are at.  I don’t agree with this practice.  Just save your money!  Any day or even time of day for us GPer’s our stomach processing time will be different.  How do you know that when you first did it, it wasn’t a ‘good day’ (you were quicker) and then the retest may be on a ‘bad day’ (your slower)?  How would you look at the results then?  Even eating something different will change the study… for just you.  Or the amount you were able to consume.

Knowing the amount of a delay you have will give you the diagnosis of gastroparesis, but does it really help knowing how slow we are?   It does to a certain extent that you know after you ‘eat’ a real meal, when it will be out of your system.  And if the processing time is extremely long, you may want to alter your diet to more soft and liquid meals.  This way your stomach has a fighting chance to process the meal and not leave you with bad symptoms.  Okay, worse symptoms.  As we all know, it is hard to get rid of them!

Thanks for reading my rant!  If you didn’t guess… it’s my option that this only test that we have to diagnose gastroparesis is a joke!  We need something better and more accurate.  Yes, it is a good jumping off point.

 

========UPDATED 7-2013==============

I was sent to do a 4 hr GES.   Here is more info on the difference between the two that I experienced.  Click HERE.

 

 

LINKS:

http://www.healthline.com/galecontent/gastric-emptying-scan

http://www.medicinenet.com/gastric_emptying_study/article.htm

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15 responses to this post.

  1. My Mayo doctor made it clear that anything less than a four hour test WITHOUT medications would skew the test and the results. =(

    *Emily*

    Reply

    • Thank you for your comment. My new GI Dr has said the same thing. She can not honestly tell me I have gastroparesis based on how the study was done (former GI Dr). I agree! I just wish places would hold true to the 4 hour test and do it consistently. Otherwise it is a waist of money! And if where I live it is okay to do only 30 minutes.. I can not imagine what the results would be! Others from around the US have said their test were 2 hours or less. Very few (unless Mayo Clinic or some universities) I have read do 4 hr tests. Which, as we know is the correct procedure.

      Reply

  2. Posted by In the Shadows on June 4, 2013 at 12:57 am

    I wasn’t aware that people were given this test in different ways.

    When I did it, I ate egg beaters and two pieces of white (nasty) toast. Then, I was scanned, and told to come back 2 hours later. I had to do this two more times for a total of three times. I was not allowed to eat or drink during the waiting period, so I became hungry and thirsty. By the time I was done, I couldn’t eat, as my stomach had cramped-up too much to eat anything!

    At that point, I was not diagnosed with anything besides GERD. I could eat, but not very often and even then, in very small amounts. However, I felt better physically then than I do now. I actually feel worse, even though I’m being treated medically for my GP.

    The test is a good starting point, but it’s not very detailed, and it seems to vary too much from person to person. Since not many GI doctors know how to treat GP in the first place (nor any other type of doctor), I’m not surprised that this is the only method that has been developed to determine the GP disorder.

    Reply

    • It is odd how the test is different in areas of the country. I read one where the person stood up for part of the test. I assume it depends on what they are wanting to know. But still, I think I paid about $1,500 out of my pocket after insurance, to later be told that the test is not accurate enough for my second GI Dr to take it seriously. Again, I am thankful that I had it done and know that my stomach is slow to empty, but still!

      I agree, they should have developed something different to diagnose gastroparesis. Yet, that is a lot to ask when they don’t know much about it in the first place (as you also said).

      So very sorry to hear that you feel worse now than before. Trying different drugs to help with my symptoms (nausea was my biggest issue besides pain), seemed to make me worse too. Now that I have stopped all of that and am just doing supplements, I feel better. But my GP is really not that bad compared to a lot of people.

      Thanks for your continued support. I hope today is a good day for you!

      Reply

  3. Mine was a 4 hour study too, but I’ve read some papers on the shorter studies. It seems like the consensus supports your conclusion, 2 hour or less studies make too many assumptions to be accurate. Mine was at a big teaching hospital in the northeast US where they take their protocols very seriously, so I guess I lucked out on that. Actually, it was a terrible day up here. As I was driving home from the test (feeling so bad), there was a bombing in my city. A strange and surreal week. I didn’t want to call about my test results because the hospital I’d had the test at was one that received a lot of the injured, including children. So I just sat around wondering and convincing myself that the test was probably a bust, pain and distress for nothing. To my big surprise, I’ve got some very slow gastric emptying.

    I reject the term “idiopathic” in some contexts. Like yours. You have a pretty clear likely reason for it. And me. I have a long history of autonomic dysfunction. I think when they throw their hands in the air and say “idiopathic!” just because it’s not diabetes or surgery related, they are being kind of lazy.

    Reply

    • Thanks for your reply. Sorry to hear about what happened and why you had to wait longer for the results. It is nice to know have a diagnosis. But we all know that they slap on ‘idiopathic’ because they have run out of ideas to test for. It is something that caused the gastroparesis and I am not going to give up until I know why! Then and only then can we really try to treat out GP.

      Reply

  4. […] There is not much more to tell of my story.  Last you would have read was how horrible my GI Dr was in Part 2  (https://melissagpfight.wordpress.com/2013/06/03/my-gp-story-part-2-1st-gi-dr/).   And in Part 1 (https://melissagpfight.wordpress.com/2013/06/02/my-gp-story-part-1/) was the process was for me to finally be diagnosed with gastroparesis and my theories as to why I have gp.  I also posted about my experience with the Gastric Emptying Study and my thoughts of why I do not feel this test is accurate (https://melissagpfight.wordpress.com/2013/06/03/my-digestive-study-gastric-emptying-study/). […]

    Reply

  5. Youre so cool! I dont suppose Ive read anything like this before. So nice to find somebody with some original thoughts on this subject. realy thank you for starting this up. this website is something that is needed on the web, someone with a little originality. useful job for bringing something new to the internet!

    Reply

    • Wow.. thanks for that! It’s just my quirky personality while venting on a subject. My other blogs may be a little ‘boring’ for you, but hopefully you will find something that is of interest to you!

      Reply

  6. GradingforseverityofdelayedGEbased onthe4-hvalueingroupsrelatedtotheSDofthenormal resultsis:grade1(mild):11–20%retentionat4h;grade 2(moderate):21–35%retentionat4h;grade3(severe): 36–50%retentionat4h;andgrade4(verysevere):>50% retentionat4h

    Reply

  7. […] The 2 hr test was done by the 1st GI Dr and based on the results I was diagnosed with GP.  Click here for my blog on that.   But this GI Dr does not believe in any results of a 2 hr GES.  She made that clear the first […]

    Reply

  8. […] a blog on 2hr vs 4hr, as I do not feel the 2hr is good enough to diagnose with GP.   Link is HERE.   But don’t really want to have to pay for this test ‘again’.  It was several […]

    Reply

  9. My test was 45 minutes (and they told me from the start it would only be 45 minutes). I knew right then that they wouldn’t get it right..

    Reply

    • That’s a very odd time. I wish all places would do it the same, so we could get consistent results. My 4hr test came back ‘normal’, yet I still have gastroparesis. All that did was make it easier for SSD to decline my disability request. Maybe someday we will have a better way to officially dx gp.

      Reply

  10. Posted by Siggy on December 23, 2015 at 7:37 am

    Couldn’t keep the test eggs down they tasted so bad!!….was told I would have to get another appointment and they would try test cornflakes….(what a thing to do to patients having stomach problems!)
    Plan on calling my doctor to see if she will give me a trial of reglan and if my symptoms improve then we know it is GP…….

    Reply

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