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Suggest Treatment For Malnutrition While Having Superior Mesenteric Artery Syndrome
Question: Hi, I have been having digestive issues, bowel issues etc since 2003. They really became prevalent after my first Nissan fundliplication. They worsened substantially after a second Nissen in 2007. I have been doctoring ever since and they can't seem to really figure out what the problem is. After my most recent visit to ER they think I have Superior Mesenteric Artery Syndrome. I am malnourished but I have not had excessive weight loss. Anyway the only thing my Dr offered was Reglan. After extensive testing they stated that from my esphagous down to the duodum was abnormal looking but all biopies cam back normal. I do feel that this condition was caused by a couple of incidents that impacted the abdominal area and the surgeries just made the issue worse. I am trying to figure out who I should go to now as I live in XXXXXXX and we don't have any specialist for this issue here. This is getting worse. What would you recommend. I will go anywhere. Thank you
Brief Answer:
Sorry to say but you need a Gastroenterologist's opinion and work up
Detailed Answer:
Hi! Welcome to Health Care Magic! Thanks for sharing your concerns with us. We will try to help you in best way possible. First of all, it is sad to know what you had gone through.
Based on the history you have shared, it seems quite possible that, you might be suffering from mesenteric ischemia but it can be due to multiple other issues too like gastritis or ulcer disease. As you mentioned that the work up up to the duodenum came a little abnormal and they took the biopsies which were normal so it is quite possible that the issue might he superficial like gastritis and they had found no evidence of any malignancies on biopsy so they would have labeled as normal.
Keeping in view the history of such malnutrition, the pancreatic insufficiency should also be kept in mind as it can also cause long term malnutrition and all other symptoms which you had been experiencing. For such chronic insufficiency one needs replace the vitamin D3, vit-A and K as their absorption may also be impaired. Blood work up may include serum amylase levels and lipid profiles.
Meanwhile taking nitrates nay relieve gut angina as they have suspected ischemic cause your case. I would suggest you to have a detailed gastroenterologist review and CT abdomen or MRI with contrast and a repeat upper and lower GI endoscopies. Meanwhile motility agents may not be used keeping in view the history of gut surgeries and suspected gut ischemia.
Wishing you a speedy recovery. If you have any more questions, feel free to ask.
Regards.
Sorry to say but you need a Gastroenterologist's opinion and work up
Detailed Answer:
Hi! Welcome to Health Care Magic! Thanks for sharing your concerns with us. We will try to help you in best way possible. First of all, it is sad to know what you had gone through.
Based on the history you have shared, it seems quite possible that, you might be suffering from mesenteric ischemia but it can be due to multiple other issues too like gastritis or ulcer disease. As you mentioned that the work up up to the duodenum came a little abnormal and they took the biopsies which were normal so it is quite possible that the issue might he superficial like gastritis and they had found no evidence of any malignancies on biopsy so they would have labeled as normal.
Keeping in view the history of such malnutrition, the pancreatic insufficiency should also be kept in mind as it can also cause long term malnutrition and all other symptoms which you had been experiencing. For such chronic insufficiency one needs replace the vitamin D3, vit-A and K as their absorption may also be impaired. Blood work up may include serum amylase levels and lipid profiles.
Meanwhile taking nitrates nay relieve gut angina as they have suspected ischemic cause your case. I would suggest you to have a detailed gastroenterologist review and CT abdomen or MRI with contrast and a repeat upper and lower GI endoscopies. Meanwhile motility agents may not be used keeping in view the history of gut surgeries and suspected gut ischemia.
Wishing you a speedy recovery. If you have any more questions, feel free to ask.
Regards.
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
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