Unexplained Nausea

My daughter has been suffering from nausea and a abdominal pain for the past 3 years (she's now 15).  It all started for her in about 6th grade, when she was 12.  She said she felt nauseous, and like there was something stuck in her throat.  Her general doctor said she had acid reflux, and prescribed Aciphex.  The medicine worked for about a year, but the nausea returned, along with heartburn.  She did not have heartburn before she started taking Aciphex.  Next she was sent to a GI specialist, who did a sonagram of her gallbladder.  Everything was considered normal, so she was given several new medications to try.  Prilosec seemed to work the best.  She took that for about another year and half, but then the nausea started up again, except much worse.  In 8th grade, her health was complicated by having PE right after lunch.  She also has asthma, and was expected to run the mile on a grassy field.  Once I got her out of PE, the pain was still there, along with the heartburn.  This is when we saw a new specialist, who did an endoscopy.  It showed some inflammation in the esophagus, and a biopsy did show stomach lining in the esophagus.  The doctor prescribed Reglan and a 20mg Prilosec.  She had a bad reaction to the reglan, so we stopped it.  We then went to yet another specialist, who performed a PH test, BRAVO test, and measured the muscle contractions of her esophagus.  He confirmed GERD and theorized that when the acid from her stomach touched the rings of the esophagus, they would spasm and cause nausea.  No medicines were changed this time.  However, we did begin to notice her symptoms becoming worse.  There was a time when anything she ate, no matter how mild, made her incredibly nauseous.  We then went to a pediatric GI specialist, who told her to take a tablespoon of milk of magnesia daily to regulate her BM.  He also had her do a Barium swallow, which showed nothing abnormal in her upper GI tract.  The milk of magnesia worked for a while, but she seems to have developed some type of immunity to it.  No matter how much she takes, it never works anymore.  

Now the nausea has gotten better since she has disciplined her diet.  She cannot eat anything too salty, too sweet, tomato based, chocolate, coffee, fried foods, overly fattening foods, spicy, or heavily spiced (such as cinnamon or rosemary).  There is also a new pain that is just below her ribs on her right side.  She also gets lower and upper back pain as well as a poking pain on her left side, just above her stomach.  

My questions have to do with the medicines she is taking, as well as what some of the doctors have told me.  She never had heartburn before she started taking the pills to stop heartburn and nausea!  Did the pills give her heartburn?  Also, a doctor told me that it is the acid touching her esophagus that makes her nauseous.  I don't understand that theory.  Is it even possible?  Most importantly, what is causing her poking pains?  Is any of this curable?

[Kevin Pho, MD]

To answer your questions:
1) It is unlikely that the acid reflux pills (i.e. Prilosec and Aciphex) gave her heartburn.  

2) Acid that refluxes into the esophagus may be responsible for nausea as a symptom.

3) It is unclear what is causing the pains.  Dyspepsia (i.e. ulcers, GERD itself, or inflammation) or gallbladder/liver disorders may cause pain in the upper right quadrant.

4) If there is demonstrated acid reflux on the 24-hr pH study and it is not controlled with medical therapy, you may want to consider surgery (i.e. Nissen fundoplication) as an option for treatment.  

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.

[Bamalisa]

Hi,
I was searching the web looking for someone having same problems as me. I had no idea I would find someone so young. I am 35 and have been battleing acid reflux for years. Here in the past two weeks I am having nausea and a feeling of a lump stuck in my throat. I try swallowing, but it makes it burn and hurt. I also have pain in my left side right at rib cage. Its like a sharp pain that comes and goes. It even hurts in right side from time to time but mostly the left. I think my cholestrol medicine has gotten mine flared up. I take prevacid every day, but that does not seem to work anymore. I tried taking zantac HB, helps some but not with the nausea. I hate this feeling of nausea. I am getting to where I do not want  to eat but when my stomach is empty it actually get worse. I am thinking of calling my dr and telling him it still hurts. I had a stress test done to make sure it was not my heart. I truly believe it is my reflux acting up worst now than ever. if you find any answers or something to help please let me know.
Thanks, Lisa

[Bamalisa]

Hi
this is Lisa again. You may e-mail me at ***@****

thanks and good luck

[Peg745]

A related discussion, Unexplained nausea and lump in throat/acid reflux/heartburn/indigestion was started.

[joelcarrubba]

Hey I know its been over a yer since you've had these problems. Are they still there? I have the exact same problems! Please email me at ***@****

Thanks,
Joel

[mac770]

A related discussion, Aria - Are you still there? was started.