Delayed gastric emptying — when to get a gastric emptying study

traveltech_sara said:

The escalation order that reflects the mechanism: water and salt first, then soluble fiber, then magnesium or an osmotic agent, then a stimulant only…

That reframing is the part I needed. Adding it to my notes with a link back to this thread.

From the other side of the consultation, briefly.

Heartburn management on constipation: Pepcid (famotidine) 20mg has been my savior. The delayed gastric emptying means stomach acid just sits there.

Don't ignore persistent heartburn — chronic acid exposure can damage your esophagus. If OTC remedies aren't cutting it after 2 weeks, see your doctor for something stronger. You shouldn't suffer through this.

Dr.PulmRoch said:

Gastroparesis symptoms with constipation: the delayed gastric emptying from GLP-1 agonists can cause early satiety, bloating, and feeling "full" for…

Drug interaction alert relevant to constipation: if you take oral levothyroxine (Synthroid), GLP-1 agonists can reduce absorption due to delayed gastric emptying. My TSH drifted up after starting semaglutide.

Solution: take levothyroxine on an empty stomach, 60 minutes before any food, and have your TSH rechecked 6-8 weeks after starting or changing GLP-1 dose. My endo had to increase my Synthroid by 12.5mcg.

Dr.GastroMayo said:

I added fiber, made it noticeably worse, and only later worked out that I had added the bulk without adding the water.

Sulfur burps on constipation — the most underrated side effect nobody warned me about. 🤢 The smell is absolutely vile and comes on without warning.

What finally helped: Gas-X (simethicone) daily. Also, eating smaller portions and chewing thoroughly reduces the gas production.

If sulfur burps persist beyond 2-3 weeks, talk to your provider — it could indicate gastroparesis that needs medical attention.

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