Guest guest Posted June 12, 2002 Report Share Posted June 12, 2002 All of my children have delayed gastric emptying. My 5 yr. old's is the worst of them and his does not empty at all. My 9 yr. old only empties about 2 tsp in 24 hours. They have had surgery but surgery seldom helps children with delayed emptying when the problem is the muscles and nerves (physiological) versus anatomical. The only time surgery will help is when the delay in emptying is mild or there is something anatomically not right. (as in pyloric stenosis in infancy). At this point they are intravenously fed although my 9 yr old tolerates about 20% of his calories by j-tube (into the intestimne and by passing the stomach) My girls have minor problems with delayed emptying and for them a combination of medications and changes in eating have helped. They do not do well with too many dairy products or high fat meals and they do best with many small but frequent meals rather than 3 large meals a day. I would say this is the same for me. If your child eats orally that may help. if your child is G tube fed already, many children do best with slower and longer feeds versys short bolus feeds. Unfortunately one of the best meds out there for gastric emptying is now off the market unless your child has severe problems. However, one of my children has been on reglan for many years and that does help. It can have many side effects if the dose is not appropriate and has to be watched carefully but all in all it has been around a long time and can be safe in many situations. Anne Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2002 Report Share Posted June 12, 2002 All of my children have delayed gastric emptying. My 5 yr. old's is the worst of them and his does not empty at all. My 9 yr. old only empties about 2 tsp in 24 hours. They have had surgery but surgery seldom helps children with delayed emptying when the problem is the muscles and nerves (physiological) versus anatomical. The only time surgery will help is when the delay in emptying is mild or there is something anatomically not right. (as in pyloric stenosis in infancy). At this point they are intravenously fed although my 9 yr old tolerates about 20% of his calories by j-tube (into the intestimne and by passing the stomach) My girls have minor problems with delayed emptying and for them a combination of medications and changes in eating have helped. They do not do well with too many dairy products or high fat meals and they do best with many small but frequent meals rather than 3 large meals a day. I would say this is the same for me. If your child eats orally that may help. if your child is G tube fed already, many children do best with slower and longer feeds versys short bolus feeds. Unfortunately one of the best meds out there for gastric emptying is now off the market unless your child has severe problems. However, one of my children has been on reglan for many years and that does help. It can have many side effects if the dose is not appropriate and has to be watched carefully but all in all it has been around a long time and can be safe in many situations. Anne Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2002 Report Share Posted June 12, 2002 Jeannine: I'm glad the surgery helped your girls. As you know there are not any absolutes in medicine and your girls are a good reminder of that! However, in general changing anatomy will not change physiology when it comes to GI motility. As always what is most important is what works for your child (children in your case) and there will always be kids who defy generalities. I'm glad your girls did but I hate to see children go through either this surgery or a fundoplication without knowing and understanding the realities of mixing these surgeries with motility disorders. These are surgeries that can and often do make children worse who have pre-existing motility disorders. I wish I could say my boys are an isolated example of this but they are not. At our hospital,unless the need for surgery is life and death (i.e.. aspiration, bleeding esophagitis) they generally will not do it anymore without motility testing because of the motility not getting better with surgery issue. Thanks for reminding us that absolutes are notably absent in the field of medicine and most especially from this group of diseases. It's so awesome to know that for Caitlin and Genny the surgery helped despite the severity of their motility problems. Do you feel the IVIG had anything to do with Caitlin's improvement in motility? I feel it has helped Zachary's but not Sammy's. Anne Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2002 Report Share Posted June 12, 2002 Jeannine: I'm glad the surgery helped your girls. As you know there are not any absolutes in medicine and your girls are a good reminder of that! However, in general changing anatomy will not change physiology when it comes to GI motility. As always what is most important is what works for your child (children in your case) and there will always be kids who defy generalities. I'm glad your girls did but I hate to see children go through either this surgery or a fundoplication without knowing and understanding the realities of mixing these surgeries with motility disorders. These are surgeries that can and often do make children worse who have pre-existing motility disorders. I wish I could say my boys are an isolated example of this but they are not. At our hospital,unless the need for surgery is life and death (i.e.. aspiration, bleeding esophagitis) they generally will not do it anymore without motility testing because of the motility not getting better with surgery issue. Thanks for reminding us that absolutes are notably absent in the field of medicine and most especially from this group of diseases. It's so awesome to know that for Caitlin and Genny the surgery helped despite the severity of their motility problems. Do you feel the IVIG had anything to do with Caitlin's improvement in motility? I feel it has helped Zachary's but not Sammy's. Anne Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2002 Report Share Posted June 12, 2002 Betsy, My son Lucas has delayed gastric emptying. He is 6 yrs old. He was orally fed until about 1 1/2 yrs ago when he was vomiting 10-12 times after each meal. He is now J-tube fed and still has problems with reflux. We elected not to do a fundoplication and still do not believe it would have helped. At the time of his delayed gastric emptying we discovered he was hypothyroid due to pituitary not functioning properly. Now he is on Synthroid but his emptying has not improved. He still has problems with very small amounts of oral feeds. I have equated it with a plugged sink. When the sink is plugged it can cause an overflow and things must come up if you fill it too much. Hope this helps. Loriann Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2002 Report Share Posted June 12, 2002 Betsy, My son Lucas has delayed gastric emptying. He is 6 yrs old. He was orally fed until about 1 1/2 yrs ago when he was vomiting 10-12 times after each meal. He is now J-tube fed and still has problems with reflux. We elected not to do a fundoplication and still do not believe it would have helped. At the time of his delayed gastric emptying we discovered he was hypothyroid due to pituitary not functioning properly. Now he is on Synthroid but his emptying has not improved. He still has problems with very small amounts of oral feeds. I have equated it with a plugged sink. When the sink is plugged it can cause an overflow and things must come up if you fill it too much. Hope this helps. Loriann Quote Link to comment Share on other sites More sharing options...
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