Patient's Query
Hi doctor,
Is it unreasonable with grade two gastroparesis, extreme weight loss, and inability to maintain weight for a PEG-J tube at this point? I have been hospitalized for failure to thrive twice, and I have had GI issues for a long time. My first GES was not valid. My second one showed grade 2 gastroparesis. My sitzmark was actually seven days.
But I want a PEG-J tube with a Mickey button, as I cannot take Motilium since I live in the West, and all the other gastroparesis medications interact with my stiff-person syndrome medications. I take Valium 50 mg a day spread out on a schedule with an extra 10 mg for severe stiff-person syndrome attacks and Baclofen 40 mg spread out on a scheduled day. I also take IVIG Gamunex-C 40 grams monthly. I have done a gastric emptying study and Sitzmark colon transit.
Please help.
Thank you.
Hi,
Welcome to Icliniq.com.
I am reviewing your case history and attached files (attachments removed to protect patient privacy). I will get back to you in a while. Please wait for my detailed response. Please revert in case of further queries.
Thank you.
Patient's Query
Hi doctor,
Thank you for your prompt and detailed response.
My weight is 84 pounds current and I have been as low as 79 pounds this year. I am struggling to maintain and gain weight. I now have a medical reason when for a long time my GI and other doctors were saying it is psychological, except the hospital doctors who witnessed and treated my motility symptoms.
I cannot take or tolerate the medications for them with my SPS medicines. Please help.
Thank you.
Hi,
Welcome back to Icliniq.com.
I understand your concern.
According to your reports(attachments removed to protect patient privacy), there is gastroparesis and slow transient constipation. But, before moving to a surgical or endoscopic intervention like PEG-J (percutaneous endoscopic gastro-jejunal tube), one should put all his efforts into avoiding this, including adjustment of medicine. Considering the prolonged duration of your illness, inability to gain weight, and relatively compromised immunity due to inadequate nutritional status, you need nutritional buildup.
I can understand grade-two gastroparesis, but still the PEG-J tube itself should be on board or at least included in discussions. Give yourself some time to recover, try little lifestyle modifications, and try other prokinetics after consulting with a neurologist. In the meantime, ask your primary physician to discuss your case in an MDT (multi-disciplinary team) meeting and come up with a final decision regarding your health.
I hope this information will help you. Please revert in case of further queries.
Thank you.
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Answered byDr. Ghulam Fareed
Medically reviewed byiCliniq medical review team
Same symptoms don't mean you have the same problem. Consult a doctor now!
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