Abdominal pain and nausea

[Harry M]

I am a 25 yo male with no prior abdominal medical history nor any family history of gastrointestinal disease that I am aware of.  I've been experiencing extreme nausea for the last two to three months.  It usually happens in the morning after being up for an hour or so and then will come back at nonspecific times during the day.  Usually lasts from minutes to hours and is accompanied by occassional sharp pains that last for a few minutes, hot flashes and chills, sweating, and fatigue.  I have been on Cipro (for a week for possible gastroenteritis), been checked for blood in stool (negative), been on Paxil for two months (stress), and had various blood tests which have revealed a steady increase in liver enzyme levels (SGPT and SGOT), and a "normal but low" white blood cell count.  

As a child, I was diagnosed as an "asmatic cougher" and was on theophylline for several years followed by steroids and a bronchodilator to control the coughing.  This has led me to think I may have developed GERD as I also have indigestion quite a lot although I don't think my current problem is related to the indigestion.

I am scheduled to have an endoscopy and ultrasound in the near future to check for peptic ulcers or gallstones.  Is there anything else I should be considering?  (ie kidney stones)

[Harry M]

Nicee,

Dental problems huh?  Now that's a new one that would not have ever crossed my mind.  What exactly is an abcess?  Thanks for your help and advice...

Jeremy,

They've done a whole string of tests (CT, Ultrasound, EGD, and ERCP) and haven't been able to find anything but my doctor is convinced I have gall stones or gall bladder dysfunction.  My liver enzymes have been up and down and I'm going back in a few days for an update.  My symptoms have decreased a little but are starting to pick back up again.  He suggested that I consider the HIDA scan and maybe cholecystectomy if my symptoms don't get any better.  Having already been through all this, do you think it has improved your condition at all?  

Thanks
Harry

[Pooh]

I would question your DR about H Pylori while they are doing the scope. I had it in 1996 and a few weeks of meds called a Prev Pak cleared it up. I also have erosive GERD but it does not cause nausea and pain, H Pylori can.

Best of luck!

[nicee]

Well, it IS bizarre, but on two different occasions I had the same miserable exhausting and painful symptoms for months.  the first time I was run "through the medical mixer" by an excellent gastroenterologist who finally said "I find nothing...but when was the last time you saw your dentist?  the answer was 6 months ago.....HE SAID GO AGAIN!!  I DID..DENTIST DID FULL MOUTH XRAY AND FOUND TWO ABCESSES...HE (THE DR.) TOLD ME IF DENTAL ABCESSES WERE FOUND AND TAKEN CARE OF I WOULD HAVE A VIOLENT BUT FINAL SPASM OF THE PROBLEM. IT ALL HAPPENED EXACTLY THAT WAY....I AM NOW IN AN EXACT REPEAT SITUATION HAVING LITERALLY FORCED THIS DENTIST TO XRAY.....HE DID BUT ONLY 1/3.....DID FIND AN ABCESSED TOOTH...BUT SYMPTOMS PERSIST SO AM GOING ELSEWHERE FOR FULL-MOUTH X RAY NEXT WEEK TO ELIMINATE OR VERIFY OTHER POSSIBLE ABCESSES.  I THINK MY FIRST G.I.DOCTOR IS GOD OR EXTRAORDINARY.  IF YOU DO HAVE A DENTAL ABCESS WITHOUT ANY OF THE SYMPTOMS SHOULDN'T WE SUSPECT THAT THE POISON COULD BE CAUSING OTHER SYSTEMIC PROBLEMS?  I HOPE YOU CAN FIND A SOLUTION AS SIMPLE, BUT UNSUSPECTED AS MINE.    BUT MY CONCERN, SERIOUSLY, IS THAT MORE DENTISTS AND DOCTORS SHOULD BE MORE AWARE.  I WAS TREATED LIKE A SENILE FLAKE WHEN I   ASKED FOR THE X-RAYS AND SAID WHY....GOTTA GO TAKE MY ANTI-BIOTICS. I WOULD LOVE SOME COMMENTS FROM THE MEDICAL AND DENTAL COMMUNITY IN SUPPORT OF MY STRANGE STORY.  I"M NOT A MEDICAL SUPER-FREAK AM I?  THANKS   NICEE

[nicee]

HELLO GENTLEMEN....I WAS A FEMALE IN MY EARLY 20'S HAVING HAD 3 BABIES IN QUICK SUCCESSIONAND THEN THE SAME SYMPTOMS YOU DESCRIBE.    FOR ME IT TURNED OUT TO BE 2 DENTAL ABCESSES WHICH BEHAVED TOTALLY UNLIKE THEY SHOULD..NO USUAL SYMPTOMS....STRONG SUGGESTION...GO GET FULL-MOUTH XRAYS  GOOD LUCK & WARM REGARDS   NICEE

[Harry M]

I had an EGD and ultrasound friday and they found nothing.  

What's a HIDA scan and why did they take your gallbladder out?

[jwedward78]

HIDA scan is a nuclear medicine scan.  They inject a dye which is absorbed by your liver and fills your gallbladder.  They take pictures of the filling and then inject an enzyme that causes your gall bladder to contract and eject the dye.  Normally, your gall bladder should eject a minumum of 35% or higher.  Mine was only 10% in a half hour, meaning it was not functioning properly.  After removal they did find two stones that did not show on the Ultrasound or CT scan.  Gall bladder attacks can cause nausea, fever, and chest/abdominal pain so they thought that was the problem.  I must admit I do not feel as nauseous as I did before the operation, but my other symptoms continue.  Currently I am seeing an internist/endocrinologist to test for possible hormonal problems.

I think your next step would probably be an abdominal CT scan to make sure there is nothing going on anywhere in there.  Also, maybe a thyroid gland test.  Since both your liver enzymes are elevated it is likely that there is something going on with your liver.  Your doc should run Hepatitus and AutoImmune tests for your liver.

Good luck. I hope this helps.  Let me know how it goes.

Jeremy

[jwedward78]

I am a 23 year old male and have a lot of the same symptoms you describe.  Mine started around Mid-February and has been going on since then.  It occurs at non-specific times as well.  Sometimes I feel fine and at other times I feel extremely sick.  Nausea, fatigue, hot flashes, pains, and malaise.  Since February I jhave been through all kinds of tests.  HIDA scan w/ 10% EF so they had my gall bladder removed, chest and abdominal X-Rays, CT Scan, Ultrasound, ERCP, and numerous blood tests.  Only finding is slightly fatty liver with elevated SGPT at times and some acute gastritis in my stomach.  I am really tired of feeling terrible almost on a daily basis and am wondering if my condition is ever going to improve.  Right now I am still taking it a day at a time and trying to eat better and rest.

[jwedward78]

Harry,

[Harry M]

I left out a few symptoms....bad breath, LOTS of belching and gas, as well as some insomnia.
Thanks.