Chronic Nausea

[AAliano]

I am a 21 year old female. I have a Heart murmur and Thalassemia Beta. I have been dealing with chronic nausea for approx. 6 months now, along with acid reflux and burping. Most days I have no appetite, and when I eat I’m full after a few bites.  Some days I will wake up with the nausea, other I won’t.  When the nausea starts it does not go away regardless of taking Pepto bismol, pepcid AC, or  after eating. I have lost about 25-30 pounds (and counting) since the nausea started. I have no diagnosis so far. I had an upper GI endoscopy on 5/20 that was normal. A gastric emptying study was done 6/3 and was normal as well. I had no nausea the day of the emptying study(they did the test over one hour). Normally I have no vomiting with the nausea, but about once a month the nausea will be severe and with vomiting. The vomiting will last anywhere from 8-16 hours straight, and I am unable to keep food, water, or even my own saliva down without vomiting. Last episode was on 6/1. Lasted about 10 hours and I was unable to eat that day or the next day due to nausea. 6/3 I woke with no nausea and I was starving? I have had no problems in the past with my stomach or nausea. I no longer take my iron supplement or folic acid supplement (for thalassemia) due to the nausea. I take no other medications/vitamins. The nausea does not seem to relate to when or what I eat, but I began a food/nausea log this week.

I have a GI doctor currently who does not seem too concerned with my nausea. The only time I spoke to him was ten seconds before he knocked me out for my endsocopy 2 weeks ago. Which is more frustrating than the nausea. Due to insurance I'm having trouble getting a new doctor. I work full time as a home health nurse (LPN) and work has become very difficult with constant nausea. My energy level is down to zero and no longer feel well enough or have enough energy to do anything but go to work and come home. Any suggestions will be helpful, Thank you so much for your time!

[sadhana123]

It seems that you are suffering from GERD. You should try to contact your doctor and try to get some proton pump inhibitor also.
It is also advisable that you contact Some good doctor. If you want online free advice regarding laparoscopy, you can contact Laparoscopy Hospital. This hospital also provide free online advice at http://www.laparoscopyhospital.com/FORM.HTM .

[Kevin Pho, MD]

You have had a pretty comprehensive GI evaluation for your nausea.  With the upper endoscopy and gastric emptying scan, that would exclude most of the major causes.

You can also consider an abdominal CT scan or ultrasound to exclude liver or gallbladder diseases.

If the tests remain negative, there are neurologic diseases that can lead to chronic nausea.  If these are suspected, imaging the head with a CT scan or MRI can be discussed with your physician.

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 Pho, M.D.

KevinMD.com
Twitter.com/kevinmd