The Doctors seem at a loss. I feel I have been abandoned by them. as the day progresses my stomach fills with bile and I have to make myself sick to get rid. I have found that if I keep drinking this will dilute the bile and makes it less unpleasant to bring up. I am at my wits end. The Doctor told me that the emptying can be helped by taking Metoclopramide. I have been taking these 3 times a day for 5 weeks but no improvement. Has anyone else had this experience.
Alan
I am not sure whether you are referring to the team at the hospital where you had the surgery done, but I would advocate that you make an appointment with them to review your situation. Your stomach may not be emptying for a number of reasons, one of which might be that the pylorus sphincter at the bottom end of your stomach might need a stretch, or some other attention. This would be a fairly normal adjustment that they will be used to coping with.
Are you sure that it is bile, rather than unemptied stomach contents that is causing the problem? Bile is foul, and is also an alkali which means that acid suppressant medication won't work on it, but there are things like cholestyramine that might help. But the doctors will need to do a proper examination first to determine exactly what is causing the trouble.
You may find that an alginate like gaviscon may give a bit of marginal relief. It works for a few hours by creating a protective raft and is not dependent on whether it is acid or alkali. But it is the underlying cause that needs to be addressed.
You had your surgery as part of curative treatment, and whilst nearly everyone has a dip at this stage after a few months, life should be better than this and your hospital team should be able to improve things substantially for you; otherwise the surgery rather loses its point doesn't it. You have given the metoclopramide a fair run and it sounds like some change of medication may well be necessary.
It would also be worth keeping a food diary just in case there is something that is causing an upset. You sound desperate and it might be worth giving up on, say, dairy products for a few days to see whether that might make a difference.
So sorry you are going through this . Good points from Alan and I would second getting back on to the hospital . Do you have a specialist nurse you could phone ?
One of the very experienced surgeons where I had my op said that metaclopromide was a good drug but that it takes at least 6 weeks to work .
Wishing you better health ,
Thank you Alan and Violetqueen. The full story is that 2 weeks after leaving Hospital the Team said I could start to have more textured food. By now I was craving savory food, so I started on pot noodles (the noodles are very small). These went well so for next two weeks I had these and porridge and other cereals. along with danish bread toasted. Then I phoned the specialist nurse and she said stew would be ok. I asked if a chicken curry would be ok and she said yes as long as I chewed the meat fine enough. I enjoyed it enormously. I was able to eat a descent portion without discomfort. Two weeks later I went to see the team and told them. The Doctor was not impressed with the curry (I did'd tell him the nurse said it would be ok. I then had a sausage roll. The next day I started to feel sick. This went on all over the weekend. A week later, feeling a little better I had a small dinner (tablespoon each of, mash, Cabbage, cauli, beans, lamb). Then after 2 weeks of feeling sick I returned a huge amount of bile along with some of the cabbage from 2 weeks. I called the specialist nurse and she got me booked in for endoscope. My surgeon did it and said the was no blockage or narrowing. He kept me in for 2 weeks and had me on Metoclopramide and Aluminium hydroxide. still no better he sent me home. After another 2 weeks of this I had my clinic. When I told them I was no better they sent for the Doctor, he booked me in for another endoscope. Again he could see nothing and said to keep up with meds and all would be well. A week later I was in pain and feeling sick after drinking a cup of water or soft drink. The only way I could get relief was to make myself sick. I again phoned the nurse. I told her That as even fluids were not staying down and I was worried about dehydrating. All she said was to go and see my G.P. about dehydration. and that as it was only 3 weeks to wait for my next clinic. My G.P. was at a loss and said He would phone the nurse and ring me the next day. that was Monday gone and I haven't heard anything as yet. During all this I had a barium swallow. I watched as it was done, and saw that all went well into the stomach but stopped abruptly where it should leave. The doctors thought this was ok. I apologize for my long rant but am at the end of my tether and just hoping to find help. With thanks Alan
Hi, I had this same issue as you. When I had a barium swallow They found the liquid entered well but did not empty at my pylorus as it was tight , sounds that could be the case with you if you are vomiting food eaten some time ago. I had a stretch soon after which improved my vomiting greatly. Talk to them again and if no joy I would get a second opinion. Good luck
Oh Alan that all sounds dreadful .
Something is obviously not right and I'm shocked that you're still suffering . I think you need to really make a fuss with GP and specialist nurse . You can't go on like this .
They say they can't see anything amiss from the endoscopies . What I'm wondering is if it's something amiss with the vagus nerve rather than a tightening that they could see . As i understand it the vagus nerve is cut during surgery and as it controls the pylorus maybe it's stopping the emptying ?
As i understand it the surgery might cause tighteneing /stricture where the join is in the oesphageous . But it wouldn't cause a stricture /scar tissue at the pylorus . So they wouldn't see that would they ? Maybe your pylorus is sometimes sort of in spasm but not during the endoscopy ?
I recently had an endoscopy because my throat felt constricted on eating . Verdict was that very little wrong with area of join but they decided to stretch pylorus . Surgeon did that because food still in my stomach and I guess he thought that as I'd fasted before procedure that it should have cleared . See - he couldn't see that the pylorus was tight ,he made that assumption because food hadn't cleared .
Dont know if this makes sense . Do get on to all and everyone .
PS Why should your surgeon not be impressed with you eating curry ? If it goes down ok what's the problem ?
I think that sometimes the surgeons 'think aloud'.
Some surgeons perform a myotomy of the pylorus sphincter (the valve at the bottom of the stomach) - it is a cut of the muscles to loosen it and help the food pass through; other surgeons do not do it because it is quite straightforward, for them at least, to do a stretch of that sphincter afterwards if necessary. The risk is that if the pylorus sphincter is too loose you can suffer from bile. This is all speculation without the precise details of your surgery by the way. If you have been in for a couple of weeks I am sure that they would have sorted it out if it was as straightforward as I am saying. But the barium meal is consistent with what you have been saying, and the question you may have is why your pyloric sphincter is not working as it should?
It might be something to do with the nerve dislocation that has occurred, inevitably, with the surgery perhaps?
Sometimes the newly-shaped 'stomach' develops a pouch so that the pylorus sphincter does not end up at the bottom of the stomach in the best place for a 'drain'. This would be clarified from the barium meal etc.
More generally, sometimes our digestion revolts against things that we want to eat. So perhaps there might also be an element of coming to terms with the idea that you may not be able to cope with some sorts of food; this could be short term, but it might also be long term. Nearly everyone will have some food that causes them undue trouble because of the texture, the high sugar content, spiciness or general 'dumping syndrome'. Sometimes it is something that the food manufacturers put into the food that may, or may not be in the small print in the packet. But I know that you have reverted to very simple things.
So I think that you should try and get the doctors to explain the barium swallow indication as a priority.
Creon
Bile reflux after oesophagectomy in 2004
Bloating and Dumping
PEG FEED
