Nausea and IBS

  I had a recent appointment with a gastroenterologist who suggested I have something he classified as IBS or traveller's diarrhea.  I have struggled with nausea for many months after becoming suddenly ill while travelling in the Middle East.  I naturally suspected some sort of food poisoning and was treated with Flagyll and Cipro.  It has been over 6 months now and my symptoms (primarily nausea that varies in severity) have yet to improve.  My doctor's suggestion was something to the effect that my intestines had been so beat up by whatever parasite or infection I had that it would take time for my system to recover.  In trying to research IBS I have found some consistencies with my symptoms, but I have no bowel problems and can link the beginning of my illness to a very specific event and time.  I have had countless investigations that have turned up negative.  I am a young male and in the past have rarely been ill (never seriously).  I am interested to know if my doctor's diagnosis sounds reasonable and if this is a not uncommon situation.  It has been a horrible few months and I am anxious to put this behind me, but have had little success with any treatments, so any suggestions or comments with regards to how long I may expect to live with this and if there is anything I can do to speed its demise would be greatly appreciated.
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Dear Shawn,
The relationship between your symptom of nausea and your travels through the Middle East strongly suggest that you acquired an infection.  If you have a change in bowel pattern, the possibility of infection would be increased.  Frequently, the diagnosis of intestinal infection is not made because the infectious agents are not present in all stool samples.  Additional stool cultures for bacteria, ova and parasites are always indicated for patients with a history like yours.  In addition to stool cultures, an upper endoscopy with small intestinal biopsy may provide the cause for your symptoms.
Your physician is correct that some patients with an infection of the gastrointestinal tract may have prolonged symptoms even after the infection has been cured.  This outcome is due, in part, to changes in the gastrointestinal flora and in part to changes in physiologic function.  For example, delayed gastric emptying (which can cause nausea) has been reported after intestinal infections.  It is also necessary to exclude the coincident development of other diseases that can cause the GI symptoms.  You may have Irritable Bowel Syndrome but this diagnosis should be made after the other possibilities have been excluded.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation.  Always check with your personal physician when you have a question pertaining to your health.
If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians' Office and make an appointment to see Dr. Fogel, one of our experts in the treatment of gastrointestinal disease.  He would be happy to meet you and to work with you regarding the cause of your symptoms and the best approaches to improve your sense of well-being.
HFHSM.D.-rf
*keywords: irritable bowel syndrome, traveler's diarrhea, nausea
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