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Nausea at Meals
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Nausea at Meals

My daughter from time to time, at the start of meals feels very nauseated. This happens  during any number of meal times i.e. breakfast, lunch or dinner.  She starts to eat and then shortly thereafter has to vomit.  She feels fine about 10 to 15 minutes after vomiting.

She is 21 years old in her junior year of college.  This has started in the last 2 years and we thought it may be stress related, but her nature and demeanor in no way indicates she is stressful.  She has dealt with a variety of leadership type roles most of her life along with stressful situations that she has handled well an no demonstration of excess stress.

We sent her a gastroenterologist who performed an upper endoscopy, which showed only minor irritation.  She
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As has been suggested below, the next test I would do would be a gastric emptying scan which can look for delayed gastric emptying.  This is typically manifested by nausea after eating.  

If negative, I would consider tests for H Pylori - which is a bacteria associated with inflammation and ulcers and perhaps tests for pancreatitis.  This can be evaluated with an amylase/lipase level and abdominal CT scan looking for pancreatic calcifications.

A more esoteric test would be a HIDA scan with CCK stimulation to look for a decreased gall bladder ejection fraction which can mimic these symptoms.  

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.

Thanks,
Kevin, M.D.
10 Comments
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just curious -abnominal ultra sound,what is the purpose of that??
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As I understand it this is what if done to rule out a gall balder problem. The procedue is done much like an ultra sound when the physician checks a pregant woman's child prior to birth, except this is done in the gall balder area.
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YOu might want to check for delayed gastric empyting.  There is a test they can order for this.  It turned out to be my problem.
Gastroparesis is the technical term.
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Avatar_m_tn

  Delayed gastric emptying is a possibility. Also what is only minor damage seen during endoscopy?   She could have atypical gerd symptoms-- a ph test should be performed to evaluate for acid reflux disease. Doctors who diagnose gerd on endoscopy alone are wrong 50 percent of the time.
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  Also a hida scan can detect gallbladder problems that an ultrasound cannot.
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I have been having the same thing happen to me.  however, i just can't eat.  i feel really sick if i eat and i always feel like i have to throw up after i do eat.  i can only eat very small amounts of food, and sometimes i feel better after i throw up and sometimes i don't.  i have not gone to a doctor yet because it has only gone on for a little over a month, and i first thought it was due to stress.  however, now i have minimum stress ( no more than the average person) and not too much to deal with in my normal life.  i too am 21 and in college and really don't deviate from my day-to-day activities.  should i see a doctor?  is this something that is common?  i guess i am writting this because i just need some advice.  
thanks!
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Avatar_m_tn

  Think you definately need to see a doctor, and should have a upper GI series , as well as an h pylori blood test for starters.
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if you eat out a lot,you like exotic food-mexican,chinese,etc etc,you swim in pool which may not be well maintained,you have traveled to foreign places where water may be an issue.you should get tested for hector pylori bacteria.
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Has your daughter been tested for intestinal parasites? It's often overlooked in the US, but can be a problem for those who are symptomatic. You must have very specific testing from a reliable lab - often more than once to detect them. I have just found out I have Dientameba fragilis - an intestinal parasite. I have been through a year of hell without proper diagnosis. I encourage all who have ongoing gastro problems to be aware of this. This site has a lot of info about these critters: http://www.badbugs.org/
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Grounder,
You should also get the GES test the MD, Kevin, mentioned above.  You may also want to talk to your doc about orally dissolving Zelnorm.  I have gastroparesis and use it for nausea, it works great.
Nicole
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