Nausea after Eating with NO appetite.

I am a 37 year old in otherwise great health.  I had a pretty major surgery December 3, 2003 for a tendon transfer in my foot for foot drop.  Immediately following surgery I was nauseous and had no appetite and was very sick.  After 3 days in the hospital on a Morophine pump I went home on Oxycotin and Oxycodone for 3 weeks and then 3 weeks of just Oxycodone.  I lost 18 pounds pretty quickly due to the sickness and have only put back on a couple pounds (leaving me at 108lbs at 5'5").  I have been off all pain meds since the beginning of January and my appetite has not returned.  I could go all day and not eat, never really getting hungry.  If I do get a twinge of hunger, nothing appeals to me and then I eat a little and am satisfied quickly but then get very nauseous shortly after.  It does not matter what I eat and I even get nauseous when I drink water or a smoothie.  I was always a belcher but do it constantly now.  Some days my nausea is less than others but I can count on it daily, I have tried to have a drink out socially and got very sick, and painful stomach(that was the only time I had pain in my stomach).  I have had a Upper GI, which was normal, blood work fine, stool culture for blood, normal.  And an upper GI was normal.  My doctor now thinks it is my Gallbladder, we know I have one stone but he thinks this may all be the cause, I am having an ERCP on Monday.  I have no stomach or back pain, can this really be causes for Gallbladder disease?  I have read about Gastroparesis, could this be something I have or would it have been picked up on one of the tests I have already had? Doesn't this seems to be realated to my surgery or pain meds since it happened right along with surgery?  Please help with what this nausea might be caused by,  I can't live like this.

[Kevin Pho, MD]

Gallbladder may be a possibility, but I agree - I would certainly consider gastroparesis as well.  Nausea after eating would be a common symptom of this disorder.  

Tests to consider would include an upper endoscopy - which would be the most comprehensive test to evaluate for any inflammation or anatomical abnormality that can cause nausea.  

Gastroparesis (i.e. delayed gastric emptying) can be evaluated by a gastric emptying scan.  

I am unaware of a tendon transfer surgery causing chronic nausea.  It may be possible that the narcotic pain medications can cause the nausea - since this is a listed side effect.

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.

Thanks,
Kevin, M.D.

[drop foot]

An addition to my question above, I had a barium swallow x-ray which was normal.  I also wake up every morning with no appetite and a nauseous stomach.

[MOONGLOW]

I have similar symptoms.  I have severe gastroparesis.  I just got out of the hospital again yesterday.  I came home with a picc line for dehydration and TPN for nutrition.  I am nauseated all of the time.  The morning is the worst.  Even if I drink water I get nauseated.  Zofran does help, but I have to take it around the clock.  A gastric emptying study will confirm if you have gastroparesis.  It is a very easy test to do so maybe you could mention that to your GI doctor.  I will be heading off to Cleveland for a referral to a surgeon who implants the Enterra pacemaker.  Hopefully I will get some relief from this.  Good luck to you.

[drop foot]

A question for Moonglow.  Did you have an upper endoscopy and it was normal?  I don't understand why my doctor is not even considering gastroparesis, or is this the normal path of diagnosis?? Or is it from the tests that I have had, gastroparesis is not likely?

[MOONGLOW]

I have had quite a few upper endoscopies.  A couple came back fine, but most of them came back with liquid and solid food in my stomach.  The doctor said the last one was very severe.  I have been told that gastroparesis can go in spells.  You might have a day when your stomach will empty fine and a couple of days later it will not.  It just depends on what happens that day when you have your tests.  I had one gastric emptying test that was normal and was still sick so he did another a week later and it was severely delayed.  I know it gets frustrating..I have been dealing with this for almost three years now and sometimes I feel I cannot go on any longer.  Today is not a good day for me.  The visiting nurse just came and said if I cannot start eating they will have to put the TPN back.  I don't even know what it is like not to feel sick....and they wonder why I am DEPRESSED.  I know what you are feeling, you just want a diagnosis cause sometimes the docs make you feel it is in your head.  Feel free to write back.  If you would like my cell phone number just let me know and I would be glad to talk to you.  Linda

[drop foot]

Question for moonglow.  My hida scan for gallbladder problem was negative so the dr. put me on raglan.  Wow, I got releif.  Not perfect but my nausea has gone way down.  Still no appetite though. Mornings are still horrible.  But I am no where near as sick as you.  Just general misery.  Here is my question, does gastroparesis ever go away?  Does it get better?  Do I have this for life?  I can't be on Raglan more than 12 weeks, then what?  HELP!