“Somewhere, something incredible is waiting to be known.”—Sharon Begley.

I began trials of a number of different agents to get the gut going again.

Prokinetics like metoclopramide, domperidone, erthryomycin, mosapride, itopride, pyridostigmine. I didn’t really try Iberogast, a herbal concoction, and I don’t know why. Once again, it was a case of the never ending, “no effect detected”.

As I described earlier, the migrating motor complex cycles from phase I to II to III and then it begins again. I surmised that after the fed state ended, phase I and then phase II occurred, it skipped phase III, and it repeated this for about three cycles until the gut “realized” its mistake and re-engaged it on the fourth cycle, so by 5 AM or so, causing the gut “start back up”.

In December 2007, Dr. Henry Parkman did an antroduodenal manometry and essentially confirmed my hypothesis was more or less correct!

However, doing a gastric scintigraphy study in the way it is normally done by just looking at a meal after a prolonged fast will not show an abnormal result, so in my case, I had to prime the gut by eating a meal four hours prior to the exam to get to the point where the phase III would ordinarily kick in. It fails, triggering the non-emptying state, then I consumed the scintigraphy meal. That worked! (By the way, I never told Dr. Parkman I did that.)