Intestinal disorder(?) causing nausea, malaise

  For the past year I have periods of nausea (without vomiting),
  feeling sick to my stomach, no appetite, malaise,  
  and a tendency toward diarrhea (never constipation).
  The symptoms do not seem to be associated with eating and I have
  no digestion problems. They often last only half a day and
  occasionally have gone away for a week or so.
  On September 15, I had my gall bladder removed. The pathology
  report showed a 1.3 cm stone and signs of chronic inflammation
  and infection.  For six days after surgery I had no symptoms and
  thought that had solved my problem although, as previously
  mentioned,I had had remissions  before.  But now the symptoms
  are back again.  I have no doubt the gall bladder needed to come
  out. But it looks like that was only part of the  problem.
  I have a mild ache in my left side several inches below the
  bottom of my rib cage. It has been there there all along but
  seems to be getting more pronounced.  I usually feel worst in
  the morning and go back to bed and may feel better or even
  normal later in the day.
   I had a physical on September 2 and the blood work, hemoccult,
  everything was normal.  I have had an upper and lower abdominal
  CAT scan which was negative except for some diverticula in the
  sigmoid colon which no one seems to think is a problem. The gall
  bladder surgeon said he saw some evidence of adhesions in my
  intestines but did not look into it in detail. I am 60 and have
  had no previous abdominal surgery. I have another appointment
  with the gastroenterologist in a couple of weeks but would
  appreciate any ideas or clues as to what the problem might be
  and/or what test to have next. Thank you.
  Ron
_____
Dear Ron,
I agree with Mary that gastroparesis ( impaired gastric emptying) must be excluded as a cause for your symptoms.  A radioisotope gastric emptying study is an easy and convenient way to make the diagnosis.  If you have gastroparesis, therap with a prokinetic drug will be tried.  Propulsid, one prokinetic drug, has been associated with cardiac arrythmias in patients who take other medications ( some antibiotics, antidpressants etc) or who have a predisposition to electrolyte abnormalities).  The other drug in common use is Reglan.  There is a different side effect profile for this medication.
This information is presented for educational purposes only.  Always consult your personal physician for specific medical questions.
If you wish a second opinion, we would be happy to evalute you in the Division of Gastroenterology at Henry Ford Health System.  You can arrange an appoinment with Dr. Fogel, one of our experts in the diagnosis of gastrointestinal disease, by calling our Physician Referral Line at [phone].
HFHSM.D.-rf
*keywords: gastroparesis, gall bladder surgery
0.2