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Digestive Tract Shutting Down
Jul 29, 2002

Dear Ms. Fields-Gardner,

I have written to you before regarding my niece and your answers have been extremely helpful. She is back down to 77 lbs.(fluctuating between 78-80 for the past 2 months, with 74 lbs. being her lowest). My question is this: She is beginning to throw-up at night, 1-2 hours after her last meal, with her food not being digested. The doctor describes her condition as the "stomach is not being emptied", but he couldn't say why. Since her weight is so low, could this be her digestive track starting to shut down?

The doctor has prescribed a couple of new medications to help with the vomiting and appetite (Reglan?) and a hormone (Oxandrolone) to increase her weight and muscle mass. She continues to try to eat more, frequently drinks Ensure, etc., but with his new condition (her stomach feels full and she doesn't feel like eating), we are concerned about why her stomach is not emptying. Is it possible that her digestive system is trying to shut down? Why is her stomach not emptying?

Thanks so much for your help,

Sleepless in Orangevale

Response from Ms. Fields-Gardner

Dear Sleepless,

There can be many reasons for your niece's loss of appetite and delayed emptying of the stomach while not indicating digestive tract "collapse" or shut down.

While it sounds like you have learned a great deal more about your niece's condition and that she must get in enough nutrients to recover her weight, strength, and health, it will be most important to talk with the doctor about the diagnostic tests that may reveal why she is vomiting routinely after eating. Ask your niece if you can talk with her doctor and nurse educator to discuss the diagnostics they went through and are planning to get a better picture. It will be more realistic to start there than with a lengthy list of the possibilities without knowing your niece's complete case. Chances are that a gastroenterologist or other specialist has been requested to provide some insight about this problem and recommendations for treatment.

In addition, depending on what is really happening with your niece, it may be worth getting a specific and tailored diet strategy put together to reduce vomiting and improve nutritional status. See if your niece is amenable to having a referral to a dietitian who works with her doctor.

Best wishes on this! -- Cade.

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