I have gastroparesis which is caused by hypermobile type Ehlers Danlos syndrome. The prokinetic medication Mestinon (Pyridostigmine) has been a miracle for me. It works by stimulating the vagus nerve and parasympathetic nervous system, which are in charge of digestion. As a bonus, the Mestinon also effectively treats my POTS/dysautonomia and fatigue. Since Mestinon was developed in 1945, it's highly affordable and has a long track record for safety.

Your lecture & All. The. Comments, each were enlightening. Thank you.

Thank you

Wonderful lecture 🙏

I never knew of any such condition as rumination syndrome. In medicine, we really learn something new every day! Thank you Dr. Strong.

Thanks!

Question. Is using a glp-1 1 week before a GES enough to register a grade 4 of 4 on the test?

This is a very interesting entity. I did not know about the isotopic diagnosis and the DDx. Thank you.

Question for you guys. Does the fact that food doesn't empty into the small intestine within a "normal" time frame cause malabsorption? Like i know our nutrients are absorbed thru the small intestine so does the fos rotting in the large intestines before eventually going into the small intestines cause less nutrients to be absorbed due to the "rotting" of food?

Great presentation. Thank you Dr

Thank you very much. Good lecture indeed.

Thanks

I have gastroparesis, secondary to Hypermobile Ehlers Danlos, although not nearly as badly as many others. I have seen benefit from focusing on a whole foods mostly ANIMAL-based diet, especially avoiding seed and veg oils, gluten, grains, nuts, seeds and excessive fiber. I think sunshine has helped my inner and outer skin, and thereby helped my GI issues, but my autoimmune stuff has improved a lot, too.

I have no idea how anyone is obese with this horrible disease. I am in pain and nauseous 90% of my day. The last thing I can ever think about is eating. I’m actually scared this is going to wind up killing me because I just can’t eat.

Wait weight lose only occurs in more severe cases?

I thought your lecture was very good. The only thing I would like to say is that what you have said about most patients being able to treat it and get back to normal lives is not the experience I have had. I’m every GP Facebook group you’ll find most people have had to permanently change their life in some way because of the condition, even in mild cases. For a lot of us it greatly impacts our everyday lives. I wouldn’t say that is true of just a small number of very severe cases. It’s definitely more than that. But I do appreciate you educating people about this illness. It’s not something many people have heard of.

Don't miss a chronic gastritis due to helicobacter pylori, an upper endoscopy is the first step, then perhaps a MRI if we suspect a disease of the small intestine, Gastric emptying scan is in practice the last exam to be performed. Azithromycin > Erythromycin Larson and al Neurogastroenterol Motil. 2010;16: 407-13

My gastroparesis has been caused by small fibre neuropathy ( diagnose by ienfd biopsy) ( although I have hypermobile eds, pots, dysautonomia etc)

Thank you alot

Thank you Dr. Strong for (another) very clear, concisive and useful video. Do you have any idea why Domperidone is not registered by FDA and European Medicines Agency (EMA)? I have been successfully treating GERD and gastroparesis with Domperidone for past 10 years. Metoclopramide is not my choice for a long run due to CNS side effects, including neuroleptic syndrome.

I have gastroparesis, I’ve had it for over a year now and I’m only a teen. It is really hard for me to deal with but I am much better now. I used to have to go to the hospital 2 times a week for testing and malnutrition. I don’t know my cause.

Thanks Dr. Strong for the excellent video once again! Is anything in the works to summarize symptomatic hiatal hernia in this category of topics? Kind regards!

Very nice video! I learnt a lot

I experienced gastroparesis caused by B12 deficiency related to pernicious anemia. Starting B12 injections reversed the problem. I'd suggest adding B12 deficiency to your list of possible causes. My pernicious anemia diagnosis was delayed in part because B12 deficiency was not associated with gastroparesis in the minds of my doctors. You mentioned dietary supplements as a treatment but this doesn't specifically address the fact that gastroparesis can be *caused* by B12 deficiency. Please help spread the word and please know that B12 serum tests can not always be relied upon to indicate the amount of B12 getting into the cells. Note - I also experienced dysautonomia which went away with my B12 injections. This was another connection that doctors don't seem to be trained to consider. I had a lot of B12 deficiency symptoms that were missed by a LOT of doctors. You don't have to be a senior citizen to have a B12 problem.

I was diagnosed with Gastroparesis. I was put on Protonix and it does help.

My test was much different. I took a pill with little radioactive circles in it. I went every day for a week. I also only have about 1 to 2 bowel movements a month.

Gastroparesis should be suspected in patients with nausea, vomiting, early satiety, abdominal pain or bloating. We perform upper endoscopy followed if clinically indicated by computed tomography/magnetic resonance enterography to exclude mechanical obstruction or mucosal disease as a cause of impaired gastric emptying. Delayed gastric emptying on scintigraphy is required to establish the diagnosis of gastroparesis

Excellent video, was recently diagnosed with this but i've been dealing with it since i was 17 (i'm 28 now) it's pretty much ruined my life. If you decide to follow up this video could you possibly cover the link between this and mental health? For a long time i've dealt with constant overall panicking daily along with waves of nausea and once i began taking Reglan for treatment after about a week i had a calm mind for the first time in a long while. I don't know if many other sufferers of gp had this experience but this was mine.

Can diphenhydramine be used as an antiemetic? Or did you mean to put dimenhydrinate instead?

Fibromyalgia is also a cause of gastroparesis. The intense stress, and holding the body tight

Im on resolor for tis..is that a good med?

Endoscopy normally

Gordon Ryan has this

My doctor never spoke to me about dietary changes. Straight to pills. No improvement.

They always forget dehydration. I'm always going to the er for severe dehydration.but I have controlled the nausea through dieting and meds.

That is a very *STRONG* video... The rock music sounds like some strong Alice in chains riffs and the guy's name is Eric Strong... Very strong, indeed..

Wife is a new sufferer of this since 2020. Broken teams of doctors couldn’t get it as right as this video does in one shot. Unfortunately, her only relief after failure of Reglan, Metachlopramide and Erythromycin drove her to the cannabinoid hyperemesis stage, she only feels better outside of the hospital that way. She’s probably going to die this way in her early 40s unless further understanding is spread.

Can you do an episode on climate crisis and health?? I remember you said in a video, if you are not a doctor, you'd probably study climate science.

radioactive egg whites haha.

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