Constant Nausea

In Aprill 2004 I went on a cruise to the Bahamas.  The week before I left I had a stomach bug.  Since I have been back from the cruise I have not felt well.  I would feel good for a couple of days and then I wouldn't.  I ignored this until March of this year.  In March one day I began with flu like symtoms (symptoms).  I was nauseated, weak to the point where I couldn't walk, tired, and had no appetite.  I went to the ER twice and came away with no answers.  I have lost almost 20 pounds.  Since then I am still nauseated every day with weakness on occasion and I also have a taste of blood in my mouth in the mornings.   There are days where it subsides in the afternoon but other days it doesn't.  I do not have any pain but I have noticed a lot of loose stools and diarrhea with no blood.  I seem to go about three times a day whether I eat anything or not.  My doctor put me on Reglan and Nexium which has not helped.  Could I have a bleeding ulcer or could I have gotten a parasite on the cruise?  I am at a loss and I can't keep going on like this.  I am scheduled to see a gastrenologist this week.  Any advice would be appreciated.

[Kevin Pho, MD]

Infection needs to be ruled out.  I would test the stools for ova, parasites as well as send it for a stool culture.  

Other options would be to obtain an upper GI series, looking for GERD, an ulcer, or any anatomical abnormality that can lead to your constant nausea.

An upper endoscopy can be considered if your GI wants a more comprehensive test.

I would also test for the liver and gallbladder.  Various gallbladder diseases can lead to constant nausea.  An upper GI series and liver function tests would be a reasonable approach to evaluate for this.

The GI consult is a good idea.  You may want to discuss these tests with your personal physician.

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.
Medical Weblog:
kevinmd_b

[yoshi]

I am surprised your doc did not check for Hector Pylori bacteria,commonly found in dirty water and spoiled food.
A breath test in the doctor 's  office will tell you if you have it or not.