Melissa's 2hr Gastric Emptying Study
Copy of original post by Melissa of GP Fight - telling the story of the GES Gastric Emptying Study and results.
In this blog, I will outline the Digest Study I had done and the results. "Digestive Study" is what my GI Dr called it. The proper name is a Gastric Emptying Study (GES).
From my research, the GES is performed differently across the country. Ranging from 2 hours to 4 hours, and different ‘food’ options are given. I had expected consistency across the US for a medical diagnosis test, but I'll take what I can get (or what I am given -to be more precise).
The meal options were an egg salad sandwich or oatmeal and toast. I dislike both, but the oatmeal is worse on my stomach. Okay, egg salad sandwich it is. The staff member then asked if I could consume the full sandwich or prefer 1/2. I thought, yes, half! Then I found out the 1/2 sandwich would still contain the same amount of egg as the full. Making it doubly 'gross' (in my opinion), so I decided on the full.
Drinking 12 ounces of water was also required. This did not put me in a good mood. My stomach always hurts so much when consuming food and water!
It took me about 20 minutes, and I had not eaten it all when the staff member said we need to start the test now.
At the time of the test, my stomach could only consume a small fraction of a sandwich like this. I prayed the food would stay down. If not, I was told I would have to reschedule. For the record, it stayed down. But I felt as if I was going to gag at any moment.
The ‘food’ you are given contains radioactive material. So they have to document how much you ate and do whatever it is with the numbers they have. I ate all but the crust.
My GES Test
Then, I got to lay down for 2 solid hours on a hard 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 would be a new picture of my stomach and the food in it. It looked more like an ultrasound picture than anything! But besides counting the tiles on the ceiling, there was nothing else to look at.
After 30 minutes I was asked if I needed to quit or just walk around. I was not a quitter and going to do this! My stomach was bearing with this too.
Another 30 minutes later the gal checked on me. She said most people had to quit at 30 – 45 minutes... and that it is okay to stop. They can work with those numbers. In my mind, I didn’t see how ‘accurate’ that would be. Her insisting felt as if the staff wanted to go home early.
After 2 hours, my butt was numb, and parts of my legs. I sat up slowly, ready to go home. But no, I had another test to do.
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 lay back down.
GES With Reglen
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 was able to tell her how I was feeling as the Reglen test was being performed. 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. The staff checked on me a few times. 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 population's time would be for the same thing. It took me 4 times longer. My test showed me having an emptying time of 250 minutes versus a ‘normal’ person at 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 a small dose of Reglan. My processing time was 30 minutes! No wonder I felt like I had the worst case of food poisoning.
Therefore, I was diagnosed with Idiopathic Gastroparesis.
Now you know a little about the Gastric Emptying Scan in general and how mine was done.
Here are my concerns with the GES test/study:
The Gastric Emptying Study is supposed to be a 4-hour test. How can the logarithms for anything other than that be accurate? Especially if the place I went to is okay with just a 30-minute 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.
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 time of day our stomach processing time will be different. Even eating something different will change the study… for your test. Or maybe food from the day before is still in your stomach. There are too many variables.
Knowing the gastric emptying rate will give you the diagnosis of gastroparesis. But, does it help knowing how slow we are? It does to a certain extent. You will know after you ‘eat’ a real meal when it will potentially be out of your system. Then, if your 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 the only test (GES) that we have to diagnose gastroparesis is a joke! We need something better and more accurate. Yes, it is a good jumping-off point.
I was sent to do a 4 hr GES. Here is more info on the difference between the two that I experienced. Click HERE.