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Thread: a similar bowel problem question for sci nurse or anyone

  1. #1
    Senior Member lunasicc42's Avatar
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    a similar bowel problem question for sci nurse or anyone

    I have had a very queezy stomach for a while and I am wondering what might be the cause? At first I just chalked it up to like a stomach-flu or something but the illness persisted. I have been taken off reglan a while ago and I am now wondering if it's possible that all the effects of the reglan could just about now be leaving my system? I looked to see if reglan withdrawl existed. It did, and I had a bunch of the symptoms like I have a very upset stomach, loss of apetite but at the same time I feel the effects of hunger and I keep crapping my pants which is unusual for me. And I threw up a few times. I even took some pepto bismol but I threw that up as well. I am looking into going back to the doctor that first perscribed it to me ask for it again. I need help

  2. #2
    Are you also getting full quickly? It is common for some people with higher SCIs to have a form of gastroparesis, which makes stomach emptying very slow, and can lead to nausea and vomiting. Reglan is generally the drug that this used for this, and many people do have to continue on it for an indefinite time period.

    Why was your Reglan stopped? How long were you taking it? Who decided to stop it? While this drug does have the potential for some significant side effects, it is also currently the only effective medication we have for increasing gastric motility and emptying.

    (KLD)

  3. #3
    Senior Member lunasicc42's Avatar
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    I have been taking it for years. I forget the exact reason the doctor gave for taking me off it but I remember thinking "damn thats stupid ". Something like he said that there is a very slight chance of bad side effects and he doesn't want to take the risk anymore (like that makes any sense ).... Whatever. It's just a pain-in-the-ass and I am pissed off because it caused me to get very sick and my Mom has to find a new doctor that will perscribe it to me. Thanks

  4. #4

    for sci nurse again

    Hi this is Ant's mom. His regular Dr. (internist) said he would not prescribe his reglan anymore because of the side effects that reglan can cause. Even though I told him quadrapelics usually have to take this for the reasons you stated he won't budge. Said I had to make an appt. with a GI Dr. if we wanted to continue getting reglan. He was taking 10mgs twice a day.

    I haven't found a new Dr. yet because Anthony was ok except for some accidents but not sick until about the beginning of March and I have been out of town for about 2 weeks. He has been off the reglan since about Jan 27th. He started getting the nauseaus feeling, loss of appetite about the beginning of March.

    Anthony is stuck on the idea that he is having reglan withdrawals, is that possible?

    After reading your e-mail (thank you) I think we need to understand that by him not taking the reglan is making him sick so i can explain to whatever Dr. I talk to next. I have a message in to his physiatrist so hopefully she will prescribe it to him so I don't have to find a new Dr.

    Are physiatrists familiar with this problem? She sees alot of quadrapeligics.

    Other question for members:

    1. Does anyone on here also have take reglan on a daily basis or get sick?; and

    2. How long have you been taking it?
    Cindy Waters
    mom to Anthony, right c5, left c4 (24yo)
    injury march 2003

  5. #5
    I would also recommend discussing this with his physiatrist who should be very familiar with this problem, and then based on their advice, you may also want to see a gastroenterologist.

    Reglan can have significant side effects with long term use (tradive dyskinesia is a very serious condition), but there are some that cannot manage without it. I suspect his symptoms have nothing to with "withdrawal" but with his now untreated gastroparesis.

    (KLD)

  6. #6
    just got a call back from his physiatrist and she said she would prescribe a months supply but then we need to find another internist or GI Dr. to follow up, whatever.

    I guess I understand because of she is a rehab Dr. really.
    Cindy Waters
    mom to Anthony, right c5, left c4 (24yo)
    injury march 2003

  7. #7
    Senior Member lunasicc42's Avatar
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    An update. A few more things

    for some reason the doctor isn't budging and he won't perscribe the reglan, and now my Mom is trying to downplay if reglan withdrawl even exists. She trying to chalk it up to a uti. At first she was trying to claim that it's from a faulty stomach tube so she got an appointment for me to have the stomach tube changed (which was yesterday ). and some strange things happened while they were changing it, they had like this real-time x-ray over my stomach and saw that my bowels were almost totally still full, even though the bowel program was the night before. and I have been refusing to eat much. Then when they took the old stomach tube out a huge burst of gas came wheezing out.
    Now I just hear that my Mom is trying to get the reglan from another doctor but she is basically refusing too.
    I need help badly. Can you suggest anything else that I could possibly do? I am totally sick to my stomach all the time and I have no appetite

  8. #8
    Senior Member lunasicc42's Avatar
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    I guess that we were all writing our reply at the same time. Can you please tell me exactly what gastroparesis is exactly.
    Thanks alot. You have helped shed light on this situation

  9. #9
    Gastroparesis is a condition that can be associated with either spinal cord damage (for some) or damage to the peripheral parasympathetic nerves that supply the stomach and cause food to move from the stomach into the small intestine. Peripheral damage can occur with peripheral nerve damage such as that which can occur in diabetes or alcoholic neuropathy.

    This means that the stomach will empty much slower than normal, and food may sit in the stomach for a long time, causing fullness and nausea. Vomiting may occur if it is severe.

    The other drug that can sometimes be used is Urecholine, but this can be problematic as it can cause high pressure bladder problems, and can effect the heart and blood pressure adversely.

    I would strongly recommend that you see a gastroenterologist.

    (KLD)

  10. #10
    I agree that nausea, vomiting, gas, stomach discomfort, and loss of appetite would all be signs of untreated gastroparesis as opposed to reglan withdrawal. Anxiety would be a more typical withdrawal type symptom, and resolves within a few days.

    It has always been known that Reglan has the potential to cause tardive dyskinesia, but the FDA has recently upgraded its warnings to "Black Box" status, and recommending that it no longer be prescribed for longer than three months. Physicians are free to ignore those recommendations, of course, if they feel the medical benefit warrants the use and they fully inform their patients of the risks. However, in today's environment where physicians are concerned about lawsuits and potential liability, I suspect many will be doing as your doctors have done and refuse to prescribe it anymore. Having patient's informed consent does NOT protect against being sued (anybody can sue if they so desire, whether they have a case or not), nor does it provide full protection against successful lawsuits. People will say they are willing to take on the risk, but when that risk becomes reality, their tune tends to change. I think about it like this....... a risk for death for a procedure may only be 0.00001%, but if you happen to fall into that 0.00001%, at the end of the day, that number is no comfort, you will still be dead. And trust me, tardive dyskinesia is one of those things that nobody wants to live with, and because it is usually irreversible, it IS something that has to be lived with. Working in psychiatry I have seen my fair share, in those treated with antipsychotics over the years. Depending on the part of the body affected, it can be grotesque and disfiguring (usually seen as involuntary facial movements, lip smacking and tongue type movements) or cause loss of function (hand movements). The ads are out there with attorneys looking for people who are claiming they now have TD as a result of being treated with Reglan.

    I am not saying nobody should use Reglan, I don't have any opinion one way or the other. Only a small percentage will develop TD, and I know if I were nauseous all the time I would be miserable, it is the worst feeling in the world. I used to suffer from chronic migraines, so I actually do have experience here....... and gave myself injections of Reglan on quite a few occasions, albeit with limited success (during a time when injectible compazine had become unavailable due to manufacturing shortages, vomiting and diarrhea prevented using other routes of administration, and compazine has a similar potential for TD)....... and it IS the worst feeling, worse than the pain, IMO. And because of my work, I was aware of the risk of TD, not only what the odds were, but the nature of the beast should I develop it. I am only trying to present some background information and think that people need to be fully informed before making decisions. It is imperative that if you DO decide to use reglan, you make yourself fully familiar with the signs of TD so that if you DO start to develop it, you can immediately discontinue the drug in order to maximize any chance of reversal, or at the least, prevent its progression.

    Here is an article about the new FDA warning issued on Reglan:
    Metoclopramide Drugs Get 'Black Box' Warning

    FDA Orders Warning About Abnormal Movements Linked to Drugs Containing Metoclopramide
    By Miranda Hitti
    WebMD Health News

    Reviewed By Louise Chang, MD

    Feb. 27, 2009 -- The FDA has ordered a "black box" warning, the FDA's strongest warning, for drugs that contain metoclopramide, which is used to treat gastrointestinal disorders.
    The boxed warning will highlight the risk of tardive dyskinesia, or involuntary and repetitive movements of the body, with long-term or high-dose use of metoclopramide, even after the drugs are no longer taken.
    Drugs that contain metoclopramide include Reglan tablets, Reglan oral disintegrating tablets, metoclopramide oral solution, and Reglan injection. More than 2 million Americans use these products, according to the FDA.
    Those drugs' labels already note the risk of tardive dyskinesia with chronic metoclopramide treatment. Now, that risk will be highlighted in the boxed warning.
    Tardive dyskinesia is characterized by involuntary, repetitive movements of the extremities, lip smacking, grimacing, tongue protrusion, rapid eye movements or blinking, puckering, pursing of the lips, or impaired movement of the fingers.
    These symptoms are rarely reversible and there is no treatment. But in some patients, symptoms may lessen or resolve after metoclopramide treatment is stopped.
    The development of tardive dyskinesia is directly related to the length of time a patient is taking metoclopramide and the number of doses taken. Those at greatest risk include the elderly, especially older women, and people who have been on the drug for a long time.
    Recently published analyses suggest that metoclopramide is the most common cause of drug-induced movement disorders. Another analysis of study data by the FDA showed that about 20% of patients in that study who used metoclopramide took it for longer than three months.
    The FDA has also become aware of continued, spontaneous reports of tardive dyskinesia in patients who used metoclopramide, most of whom had taken the drug for more than three months.
    Metoclopramide works by speeding up the movement of the stomach muscles, thus increasing the rate at which the stomach empties into the intestines. It is used as a short-term treatment of gastroesophageal reflux disease in patients who have not responded to other therapies, and to treat diabetic gastroparesis (slowed emptying of the stomach's contents into the intestines). It is recommended that treatment not exceed three months.
    The FDA encourages consumers to report adverse events to the FDA's MedWatch program. You can reach MedWatch by phone at 800-FDA-1088 and on the FDA's web site.


    SOURCES: News release, FDA.


    ©2009 WebMD, LLC. All Rights Reserved.

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