Achalasia with these symptoms of positional vomiting?
Posted , 4 users are following.
For 1.5 years my teenaged child is struggeling with vomiting, nausea and lower abdominal cramping pain continuously, if everything worsens, there is no toilet business nr2 either anymore even if eaten just the day before.
As routine exams (appendix out, scopes normal with only mild chronic gastritis, calprotectin neg, no celiac or sugar malabsorptions) came back negative, but a gastric emptying study positive (delayed), her case was kind of 'given up' as motility meds failed and put into the reha draw. The only thing really obvious: if she lifts heavily or walks more, her abdominal pain becomes much more, so does her vomiting, for months.
All those general 'walk more' 'enjoy life' luhdiduh advices backfirering badly each time for months until moderate again and able to drag herself for few hours to school. E.g. we went after 13 months first time to beach on her birthday when she was moderate, she splashed around only to come out noticing that her belly cramping was going towards severe, her intestine as if stopped working, no nr2, no food held down, awful weeks with weight loss.
(tried all sorts of diets, trying all sorts of small meals and liquid meals nutrition and supplements to no avail)
Anyway:
A few months ago she started to have less vomiting straight after meals (half though must have gone through as we could still avoid tube feds), but always, always happening once lying down, it is forceful vomiting,
not reflux or reguritation.
No matter if stomach is empty or not. It's the full cycle of complicated vomiting with saliva (for tooth protection) building up just before forceful retching sets in, also in her sleep if finally fallen asleep just to wake her up again.
If something comes up it is clearly digested (more delayed gastric emptying indicating?) not fresh looking food, yet no other motility studies (small bowel, colonic transit) have been done to my disappointment or compression syndrome investigations of non-achalasia type (SMA, MASL, nutcracker..) and will press on for them as therapies are different, but with this age 2 adult neurogastroenterologists refused seeing her, and there are no paediatric such specialists, so reha doc came up with
simple barium swallow (not the small bowel follow through barium) to look for
achalasia, which would be only oesophagus concerning.
?
I am kind of confused as I do not find her symptoms fitting for achalasia, but rather compressions of any sort (arterial, ligaments) or functional further down.
Does anyone of you experience vomiting and increased nausea due to lying down (even half sitting not a solution, only full upright sitting preventing vomiting), no matter how long a meal was ago please, and achalasia the reason?
(her lower right sided abdominal cramping pain, that is crippling her sleep as much as the hourly vomiting, cannot be explained with it anyway)
(She is GM1-IgG positive after pleading with an immunologist to please order neuronal autoimmunantibodies - yet ganglionic AchR missing again-, GM1-IgG a neuronal autoimmuneantibody, yet again: dismissed and only offered to give cortison, not iv immunoglobulin. Going in circles, really.)
Thank you!
0 likes, 19 replies
Janeeyre sanya11314
Posted
On rereading your post, I noticed this time that the appendix was gone--so that can't be suspect. I wonder, though, how you got to the achalasia forum. Most people aren't even aware of this disorder. Did somebody suggest to you that your daughter has achalasia?
sanya11314 Janeeyre
Posted
Because the only more idea for an investigation the adolescence team doc (for rehab) had (before starting on just 'physio' and 'psychological councelling' as usual, when hearing about positional vomiting, was, to do a barium swallow to exclude Achalasia.
I thought like you, too, that this was kind of not making sense. ;-)