Gastritis: Complete lack of appetite

[Charlotte.]

Hi all,

I have finally had my gastroscopy and it showed gastritis again (first diagnosis in 2014, no h. pylori, symptoms disappeared and came back a few times, ended up in A&E in October, so now I finally had the scope done). I kind of got used to the constant pain, especially after meals (gastritis in the antrum) and I don't feel any hunger at all. Of course, I notice when my stomach is empty and would like some food but I just don't have an appetite for anything, so I normally end up having some millet porridge in the morning, vegetable soup, rice, vegetables with some linseed oil (steamed, so very low in fat, only the omega-3-oil), sometimes rice pasta or buckwheat pasta, rice cakes in the afternoon and some bread, homemade vegetarian sushi or whatever I feel like for dinner. Guess what, I don't gain any pound, at least I stopped loosing, but it does not feel nice forcing myself to eat when I feel super nauseous, don't have appetite at all and suffer from stomach pain, especially for the next two hours after a meal.
I take esomeprazole 40mg (in the morning, I was allowed to take it twice daily but only for a week) and gaviscon after meals (one or two tablets per meal).

I'm just wondering if someone has had the same problems concerning eating and the same lack of appetite? Eating was such a nice aspect and now it's something that needs to be done but which is not nice at all. Super annoying.

 

[my little penguin]

Have they done a gastric emptying test?
You sound a lot like Ds ( also gastritis and no appetite )
He was dx with Gastroparesis

Tagging maya142

 

[Charlotte.]

Thank you, my little penguin, honestly, I have been thinking about that myself as well (as my pain is different now and I haven't been dealing with lack of appetite when I have gastritis normally, but maybe it's just more severe this time), but I haven't asked my doctor about gastroparesis yet. Last time I saw him was right before the scope. When symptoms don't improve soon, I will definitely need to talk to my doctor.

Isn't gastroparesis extremely seldom or is it just underdiagnosed in the population because doctors are not aware of gastroparesis that much?

It seems as if my stomach must have been empty at noon when I had the scope done, as I haven't heard of any issues that they saw food or anything. I had some small dinner at 8pm the day before. Wouldn't there have been some food left in the stomach if it was gastroparesis as well?

Was is the breathing test that DS took or the X-Ray test?

 

[my little penguin]

Nuclear scan
For Ds he had inflammation in his duodendum a long time so it is believed that cause the vagus nerve to not function as well
No issues on food found on scopes or anything
But the gastric emptying scan was abnormal
Or slow
So he takes erythomycin prior to each meal and eats about 1200 calories from food and 1000 calories from formula
Liquids empty normally for him so when his crohns flares or GP he goes liquid only

 

[Maya142]

My daughter also has Gastroparesis. We are not sure if it's due to Crohn's but it could be. She was also diagnosed with a gastric emptying scan. It is a relatively easy test - you eat a meal that is mixed with a radioactive tracer and then they take pictures for 4 hours or so to see how it empties from your stomach. If 10% or more of the meal is left in your stomach at 4 hours, you have a diagnosis of GP.

She has also been on several motility meds - Erythromycin, Bethanechol and now Domperidone. Erythromycin worked for a while, but not so well for her.

Domperidone is not approved in the US but is used a lot in the UK and Canada. It has REALLY helped her.

She also has a feeding tube (GJ tube - into her small bowel) and is given formula through it, since she isn't able to eat enough to maintain her weight.

Her symptoms with Gastroparesis were extreme nausea, fullness (even after eating just a couple bites of food), no appetite, stomach pain after meals, weight loss etc. She would even sometimes throw up after meals and could not tolerate NG tube feeds.

She also has gastritis pretty often (diagnosed by endoscopy) and is treated with Carafate and PPI's. In her case, the gastritis was not bad enough to explain the kind of nausea and stomach pain she was having, which is why we did the gastric emptying scan.

I'd definitely at least ask your GI about it.

 

[Charlotte.]

Thank you so much for your experience, my little penguin and Maya142, I really appreciate it.

After I read the diagnosis in the letter I was given after the scope, I wished I had the chance to talk to my gastroenterologist but he was too busy unfortunately. Last time I had gastritis of the antrum I did not have these complex issues, only pain, so I was surprised about the exact same diagnosis with so different symptoms now.

I received domperidone for my nausea by my GP but it did nothing for my nausea. Does it help quite rapidly for gastroparesis so that I might see a difference if that is an issue for me as well, when taking it just for a day or two?

Oh, and I always feel better when I go on elemental diet exclusively (it might help with any issues I was thinking, as it does not need any digestion process), but I can't enjoy the taste at the moment, I would just love to eat solids again.

 

[Maya142]

Hmm...I don't know to be honest. When M started Domperidone, she started it two or three times a day and has been on it since then (January 2016). I think we noticed that she was eating more within a couple days.

She uses Zofran for nausea as needed. She had gotten to the point where Domperidone was working so well that she didn't need Zofran at all, and then the Gastroparesis started bothering her again and now she is back to taking it several times a week.

In the past, with gastritis, she complained of stomach pain, heartburn and nausea. Now of course we wonder if the nausea was a sign of Gastroparesis all along, but who knows!

We have definitely changed her diet since she was diagnosed with Gastroparesis. Like my little penguin said, liquids are easiest to digest. Soup works well if her Gastroparesis is really bothering her (of course, she hates not being able to eat solid food too!).

Fat and fiber are also hard to digest so we avoid those. She also eats pretty bland food - nothing spicy.

Some people with Gastroparesis can tolerate liquids through their stomach, so can drink formula. It is possible that is one of the reasons you do better on an elemental diet. Of course, it could also be that that helps with the gastritis/inflammation.

Other people with GP cannot tolerate even liquids through the stomach (my daughter, for example) and so have to use NJ, GJ or J tubes. My daughter is also on an elemental formula - Neocate - we tried many and it's what worked best for her. She has finally gained weight on formula and after many years of being underweight, is at a healthy weight.

I would talk to your GI about your symptoms. He may have other ideas for the gastritis or he may want to do more testing for other causes. Good luck!!