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Gastroenterology (Expert Forum)
chronic nausea
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/ Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
chronic nausea
by sammmm, Apr 11, 2005 12:00AM
Hello, I am a 34 year man who for the past three months has lived with chronic nausea.The nausea waxes and wanes throughout the day but is not noticeable at night, even if I waken I do not feel nauseous. However, when I get on with my morning routine I begin to feel nauseous. There has been times (days and as long a week on one occasion where I have felt fine) but then the nauseous returns. I have never vomitted nor do I really feel I have too. I have tried to keep an eye on the foods I am eating but no pattern has been evident. Bowel movements are the same. I have had several tests done including CT head, CT pelvis abdomen, ultrasound abdomen, small bowel follow through, barium enema, endosocopy, colonoscopy, blood tests looking at liver function, kidney function, general CBC, thyroid, growth hormone, magensium, calcium, stool samples etc, etc, One thing that was noted was a higher bilirubin but no other enzymes were out of range. Could this have something to do with it? I am at my wits end and was wondering where do I go from here? Also, could stress be responsible for this, my wife and I just had our first baby. I have tried gravol, ginger root pills and pepto bismal,and am currently on LOSEC all with limited success, are there other effective meds for nausea (without the sleepy side-effects) please let me know....I am currently seeing a GI doc, are there any questions I should be asking to get to the bottom of this????I think she believes it is stress related and worry maybe we haven't gone far enough.
Doctor's Answer
by Kevin Pho, MD, Apr 11, 2005 12:00AM
, Apr 11, 2005 12:00AM
An elevated bilirubin by itself - especially in light of the normal testing that you have had - would make it unlikely that it can cause your symptoms. Benign diseases like Gilbert's syndrome can lead to this finding.
I would consider more specialized testing - like a gastric emptying scan or a 24-hr pH study with esophageal motility studies - which can be arranged with your gastroenterologist. They can detected some uncommon diseases (i.e. gastroparesis) that can lead to nausea.
You can discuss this option with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
I would consider more specialized testing - like a gastric emptying scan or a 24-hr pH study with esophageal motility studies - which can be arranged with your gastroenterologist. They can detected some uncommon diseases (i.e. gastroparesis) that can lead to nausea.
You can discuss this option with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
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There are websites and groups out there that can give you much needed advice. Try BellyBusters for gastroparesis and take a look around at all of the good information everyone has to offer.
Good luck and I hope you at least will pursue the gastric emtpying study. It is a painless procedure.
Like you I am down to believing this is a stress/depression disorder and have begun going to a phyciatrist for help. He has tried a couple of anti-anxiety meds (I forget the names)that seem to have reduced the duration of this in the mornings, but have not succeeded in eliminating the problem.