Gastric Motility Test Result?

I was diagnosed with SIBO-C in 2016 and began taking Motegrity (2mg.) in Jan. 2000. It has helped to some degree with my motility/constipation to some degree, although I have noticed that since it went generic (Prucaopride) a few months ago, I have had much more trouble with my motility, constipation, and the resulting GI pain, bloating, etc. has been worse. I am planning to ask my GI if there is any way that I can go back to brand-name Motegrity, but am not sure it's possible because insurance may require the generic (as you probably know, Motegrity is very expensive). I have had motility tests as confirmation, but they aren't necessary in order to determine the effectiveness of Motegrity. My only suggestion is to start with the lowest dose possible (perhaps 1mg, split the 2mg in half), to be sure you can tolerate the medication. I hope you find some relief!

Hi, @phxbarb - Tagging a few members who may have experiences with or knowledge of gastric motility tests @baywood @katiero123 @bborth @johnbishop @amalynne69 @elle1233 @ctrogan. Hopefully they can share what they've experienced or what they've read about a gastric motility test, what the results and the solution were if they had one, as well as whether they have tried prucalopride (Motegrity).

phxbarb - how has the prucalopride (Motegrity) gone for you so far?

I found the gastric motility test unpleasant but tolerable. I have done domperidone as my primary motility drug, but I have had less problems since I had a Nissen fundiplication and a simple ventral hernia repair. My symptoms are greatly minimized since both of those procedures, which were rough recoveries but worth it for me

@phxbarb, I don't have any experience with gastric motility tests but have recently thought about the test since having chronic constipation following a failed colonoscopy in 2022 and a bi-lateral inguinal hernia surgery in 2023. My primary care doctor hasn't offered any medications yet and I'm really not open to starting any new ones right now. Miralax stopped working for me and I now find that a senna tea and sometimes a few senna tablets help provide some relief for the constipation. I have another colonoscopy scheduled for June and hoping I get some answers. Mayo Clinic has some information here that might be helpful - Motility Clinic: https://www.mayoclinic.org/departments-centers/motility-clinic/overview/ovc-20357787

I had and x-ray, anorectal manometry (2nd one) and gastric transit testing almost 2 months ago. Constipation, no blockage, nothing concerning with the transit test. The anorectal manometry testing showed a coordination problem and I plan on a refresher with Mayo Clinic’s bowel evacuation disorder program. I went through this program after my first anorectal manometry testing a few years ago.

Since my testing I am taking MiriLAX and senna. I’m not very sure I have a handle on it yet. A work in progress, I guess.

@johnbishop I have questions for you…
What do you mean by a “failed” colonoscopy?
What did MiraLAX initially do for you? What was your experience with it?
Did you take senna with the MiriLAX or start it after?
What would you describe the difference between taking senna and senna tea?

I thought I did a great job with the colonoscopy prep but evidently I wasn't cleaned out enough even though I drank all of the prep and had clear liquid coming out at the end before I had the colonoscopy. The colonoscopy was painful which was a first for me as all of my previous ones were easy and I chose to go with the minimum anesthesia for the procedure and was a mistake in retrospect. They had to reposition me multiple times during the procedure if I remember correctly and each time was painful for me and difficult for them 🙃

I found the senna tea recommendation from another member in one of the constipation discussions and it worked for me but I use it as a last resort if I haven't had a movement in a few days - https://www.amazon.com/China-Slim-Extra-Strength-Women/dp/B003BL2IMI/. The Miralax was always hit and miss and didn't always work the next day then my PCP suggested taking a senna tablet in the morning and the Miralax in the evening. Her reasoning was that the senna helps the stomach muscles contracting and the Miralax brings the water into the stomach to add more liquid. This worked for awhile but it took more than the one senna tablet she suggested and I usually ended up taking 3 to 4 of them - https://www.amazon.com/dp/B0CMVZVW3T. The directions on the bottle say not to take more than 4 a day and not to use them for more than a week unless directed by a doctor. It also has some side effects listed that it's good to discuss with your doctor.

Bottom line for me which may or may not be the same for you, the senna tea always worked the morning of the next day when I drank it late afternoon or evening. I have learned not to let it steep too long (only a few minutes). The more it's steeped the stronger and greater laxative effect. The tablets are better at helping me keep the bowel movements regular. I'm still trying to use the Miralax but it doesn't always work for me. It used to work great and was all that I needed. I've never been diagnosed with IBS/IBD but I'm guessing it might be part of the problem.

Another thing I've been using but have found it difficult to get the correct amount in my system is Heather's Tummy Fiber. I also really find the fennel tea and peppermint tea help with the gas and bloating. https://www.helpforibs.com/footer/treatments.asp

Miralax gives me incontinence, no matter how much I decrease it. Just doesn't work for me. And, it takes 2-3 days for anything to work. It's never the next day. I learned that this is to be expected, so I don't worry if nothing happens the morning after a pill or two. I have found that Triphala, an herbal big pill helps me alot. Got it on Amazon.
Cannot tell you ingredients, but it works for me. 1000mg in each pill. Enough to get things moving.

Maybe you should try another doc for a colonoscopy. I have a twisted colon (tortuous) and never had a doctor tell me he couldn't do the test. They just push on the colon to get through it, and never have to do repositioning. Never heard of that before.

Are you thinking motility testing would provide information to help you make a decision about taking Motecrity, @phxbarb ? As far as prescriptions I have only tried Linzess and struggled with it. I feel what you are saying about MiraLAX. Since my latest testing I take it in the morning and am learning senna at bedtime offsets it some.

@johnbishop You have all the fun. I bet you are super stoked to try again in June. An ‘aha’ moment for me, steep the tea a shorter amount of time. I experienced the tea (I had picked up Smooth Move brand) being waaay stronger than the tablets so I think I’ll try your suggestion. That’s an easy thing to do, thanks!

Motegrity has been working great. I use to have at least 4 Gerd attacks a week. Used baking soda and water for relief. It has been two months. Not one attack. I am so thankful. Also used Good RX to purchase it otherwise it would have been around 800$