On going abdominal pain and nausea

Dear Drs.

I been having on and off again stomach issues for the past three years now. I am now 21. At 18 in 2006 I had a upper Endoscopy and it came back normal. In 2007 I had a CT-Scan which came back normal just showed swollen  Lymph Nodes. Three weeks ago I had a Gastric Emptying Study Test which came back normal and two weeks ago I had a HIDA + EF Scan that came back normal also.

I been having pain in the middle of my stomach that radiates to the left and right side. I been having nausea and some of the time belching and with certain foods I can smell what I ate when I belch or taste it up to a hour or 2  or more after eating. I mainly feel this symptoms within 5-25 minutes after eating I feel nauseous with pain in my stomach. I sometimes go to bed feeling sick or wake up feeling sick. I also go three days without having a bowel movement, and when I do, I am in and out of the bathroom around 10 times in like 2 hours.

I been getting test after test. It's affecting me that I am not in school or working. I use to have panic attacks and anxiety until around the age 17 which it calmed down after that. My parents say it's all stress and anxiety, but I am taking Ativan twice a day 1 mg morning and night and I tried working out to see if it would help if it were to be stress and I feel the same and been on many other anxiety and antidepressants which all haven't made me feel any better. I had a kidney infection in April of this year but got tested for it again in June while still feeling pain but it also came back normal. I know I am not pregnant for sure. I am not sexual active. I feel helpless and running out of options. Can you please give me your opinion on what I should do next or what you think it may be?

Thank you,

Suzette.

[Kevin Pho, MD]

You have had a comprehensive evaluation for your symptoms, and I agree with the diagnostic approach.

Other tests to consider would be a 24-hr pH study to exclude GERD and an esophageal motility study to evaluate for motility disorders.

Regarding the lymph nodes seen on the CT scan, you can consider a surgical evaluation to see if a biopsy is warranted.

If the GI tests remain negative, obtaining a neurological workup can be considered, as causes here can lead to chronic nausea.  Head imaging with a CT scan or MRI can be considered.

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 Pho, M.D.

KevinMD.com
Twitter.com/kevinmd