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Re: - gastric emptying

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,

The medicine you are talking about is cisapride which is banned in

the US except for compassionate cases (we have at least one here that

I know of). However, it is acceptable abroad and I believe 's

original post stated that Finlay is already on it.

Judith, Steve, (RSS) and (non RSS) 4 year old twins

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,

While what said was true, I do disagree with one thing.

The medication to increase gastric emptying is Cisapride/Propulsid.

It used to be approved here in the US, but it is no longer available

except with compassionate clearance. There were some studies done

that apparently showed that under certain circumstances that

medication could affect the heart.

Max was on Cisapride when he was under a year old. In fact, he was

in a double blind study before it was approved by the FDA (Food and

Drug Administration). He took that medication for years and then

did not seem to need it anymore. There were no noticeable side

effects other than it helping him feel more comfortable with eating

and helping to control reflux because it increased the emptying

speed of his stomach. Then a few years ago Max began to have

terrible difficulty with GE again, so Dr. H. went through all the

paperwork and red tape to get the medication for him and a few

others. It has been a godsend. While Max still does have delayed

GE and will need another study so that she can increase the dose

(she needs permission from the FDA), we will not stop using that med

unless absolutely necessary. It costs us nothing except testing on

a regular basis.

What testing is required? There is some bloodwork and he must have

an EEG every other visit. There is also a list of medications he

cannot take while on this med, one of them being Zoloft which was a

medication that really helped his anxiety. But we have learned to

live without it and use other methods instead. He also cannot eat

grapefruit, which does not bother him, but it bothers me. I love

grapefruit. I won't buy it, though, because I don't want to have it

around here and then have Max be tempted to try some. We already

are a milk-free household, so one less food makes no difference.

The other thing I wanted to point out is that Dr. H. does use Barium

when Max has the GE testing done. It is mixed in with some awful

pineapple drink he has to consume. Usually she uses milk with

Barium, or so she told us, but due to Max's allergy, it is not an

option. The other thing that is sometimes used is scrambled eggs

with Barium mixed in. Dr. H. will not allow that, though, because

she says that these kids drink mostly liquids and liquids are more

apt to show reflux if there are any episodes during the study.

So, even if Finlay does have the delayed emptying, it really does

not change anything unless you are going to have access to

Cisapride/Propulsid and a doctor who is willing to prescribe it. I

don't know if it is available in NZ or not. This dysmotility thing

is such a worrisome thing and our kids get so uncomfortable from it

and it affects so much of their lives. And, as said, it

does not go away. In fact, for Max, it is worse.

On a good note, however, since we have stuck to a totally milk free

diet, Max is feeling MUCH better. The stomach pains are still

there, but not as severe and he can put up with them without feeling

like he cannot make it through the day. His hiccups are better,

too. I guess between the diet change and the Transcop patch he

wears behind his ear, we are on a roll!!!

Jodi Z.

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Thanks, , Judith and Jodi for your advice.

Finlay is on cisapride - its available here on prescription -

although he had to have an ECG before he started and our pharmacy

ahve a list of the incompatible medications. The cisapride really

does help with his vomiting - especially overnight.

It will be really intersting to hear what Dr H has to say about the

results of the DGE test. Finlay has a nissan and a g-tube but no

pyloroplasty.

Thanks again for your help

New Zealand

Finlay, 4, RSS, g-tube, cisapride

> ,

>

> While what said was true, I do disagree with one thing.

> The medication to increase gastric emptying is

Cisapride/Propulsid.

> It used to be approved here in the US, but it is no longer

available

> except with compassionate clearance. There were some studies done

> that apparently showed that under certain circumstances that

> medication could affect the heart.

>

> Max was on Cisapride when he was under a year old. In fact, he was

> in a double blind study before it was approved by the FDA (Food and

> Drug Administration). He took that medication for years and then

> did not seem to need it anymore. There were no noticeable side

> effects other than it helping him feel more comfortable with eating

> and helping to control reflux because it increased the emptying

> speed of his stomach. Then a few years ago Max began to have

> terrible difficulty with GE again, so Dr. H. went through all the

> paperwork and red tape to get the medication for him and a few

> others. It has been a godsend. While Max still does have delayed

> GE and will need another study so that she can increase the dose

> (she needs permission from the FDA), we will not stop using that

med

> unless absolutely necessary. It costs us nothing except testing on

> a regular basis.

>

> What testing is required? There is some bloodwork and he must have

> an EEG every other visit. There is also a list of medications he

> cannot take while on this med, one of them being Zoloft which was a

> medication that really helped his anxiety. But we have learned to

> live without it and use other methods instead. He also cannot eat

> grapefruit, which does not bother him, but it bothers me. I love

> grapefruit. I won't buy it, though, because I don't want to have

it

> around here and then have Max be tempted to try some. We already

> are a milk-free household, so one less food makes no difference.

>

> The other thing I wanted to point out is that Dr. H. does use

Barium

> when Max has the GE testing done. It is mixed in with some awful

> pineapple drink he has to consume. Usually she uses milk with

> Barium, or so she told us, but due to Max's allergy, it is not an

> option. The other thing that is sometimes used is scrambled eggs

> with Barium mixed in. Dr. H. will not allow that, though, because

> she says that these kids drink mostly liquids and liquids are more

> apt to show reflux if there are any episodes during the study.

>

> So, even if Finlay does have the delayed emptying, it really does

> not change anything unless you are going to have access to

> Cisapride/Propulsid and a doctor who is willing to prescribe it. I

> don't know if it is available in NZ or not. This dysmotility thing

> is such a worrisome thing and our kids get so uncomfortable from it

> and it affects so much of their lives. And, as said, it

> does not go away. In fact, for Max, it is worse.

>

> On a good note, however, since we have stuck to a totally milk free

> diet, Max is feeling MUCH better. The stomach pains are still

> there, but not as severe and he can put up with them without

feeling

> like he cannot make it through the day. His hiccups are better,

> too. I guess between the diet change and the Transcop patch he

> wears behind his ear, we are on a roll!!!

>

> Jodi Z.

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