What could this be?

[sherim]

We have been trying to diagnose my 12-y-o daughter's condition since 9/1/05. She is very nauseas 24/7, made worse by walking and driving. It's so severe that she hasn't been able to go to school yet this year. She initially presented with nausea + pain below the ribs. She has tested positive for H. pylori and is being treated (almost 3 weeks now) with 2 antibiotics and Prilosec (generic). The pain, for the most part, is gone but the terrible nausea remains.

She has had CT scans of upper GI & head, MRI/MRA of head, blood tests, urine analysis, stool cultures (all negative). She has been to a pediatric Gastro, ENT, and neurologist all here in NJ. Everything, they say, is normal. She's been scoped and I'm waiting for the scope results. The gastro saw nothing visually that raised any flags during the scope. My dtr has an appt with a gastro at Children's Hosp in Philly, but not until January, and a diagnostician at Children's in April.

One add'l symptom may be due to stress: when the nausea is at its worst, she says it feels like someone is pressing on her throat, making it difficult to breathe. X-ray of lungs & throat are clear.

Any suggestions you can offer are greatly appreciated!

[sherim]

Could H. pylori alone produce severe nausea along with her other symptoms? If so, how long after meds are completed might the symptoms go away?

[ozark]

has she had a 24 hour ph probe done?? this could help rule out reflux which she may have...goodluck

[Kevin Pho, MD]

There has been a very comprehensive evaluation with multiple studies and referrals.  

The scope would be quite a comprehensive test to evaluate the upper digestive tract.

If negative, you can consider a gastric emptying scan to evaluate for gastroparesis.  Another consideration would be a 24-hr pH study with esophageal motility studies.  This can evaluate for GERD and esophageal dysmotility respectively.  

These options can be further discussed with your gastroenterologist.

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.
http://www.straightfromthedoc.com