Chronic nausea and low appetite/GERD diagnosis?

  I have experienced chronic nausea, low appetite, and moderate weight loss for the last 8 weeks. The symptoms occur intermittently (4-8 hours each day) and do not seem correlated with timing of meals and/or food types. No vomiting yet, but the nausea seems to be getting worse.
  My physician ordered an upper GI series which indicated a diagnosis of GERD. However, I have never in my entire life (age 31) experienced even a single episode of heartburn, acid indigestion, or any other of the common symptoms of GERD. Only the nausea.
  Could GERD truly be my problem? Or might it be something else? (Tried first Zantac and currently Prilosec, neither seems particularly effective.)
  Given that the uppper GI clearly showed the barium swallow migrating from the stomach back into the esophagus, could it possible that I would not experience heartburn, acid indigestion, etc.?
  Thank you in advance for your advice.
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Dear David,
The demonstration of gastric contents refluxing into the esophagus does not necessarily indicate that this abnormality is the cause of your symptoms.  I would perform an upper endocospy looking for evidence of other possible causes of your symptoms, in particular causes of weight loss.  I would take small intestine biopsies as well as biopsies of the esophagus, if the esophagus looks normal.  These latter biopsies are needed to assess the degree of mucosa; imjury due to reflux.  I would also obtain a gastric emptying study, looking for gastroparesis as a possible cause of symptoms.
This information is provided for educational purposes only.  Always consult your personal physician for specific medical problems.
HFHSM.D.-rf
*keywords: esophageal reflux, gastroparesis, weight loss
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