Re: Nausea (Incapacitating)

Posted By HFHSM.D.-rf on August 22, 1998 at 07:41:05:

In Reply to: Nausea (Incapacitating) posted by Mary on August 21, 1998 at 13:22:25:






I am a 30 year old, 5'6", 153lb, healthy female.  For the past two months I have been suffering from severe nausea and it does not appear to be related to specific foods.  The occurences are random and sometimes occur in the morning or evening, however, these bouts never wake me at night.  Sometimes they are debilitating and one time it took a shot of Fenergan (sp?) to help me.  I am now taking Fenergan pills but a cause has not yet been identified.  The only other possible related symptoms I may have are difficulty breathing for about a year(but using an inhaler has helped and at time I suffer from fatigue. My doctor has tested me for H pylori and has tested my liver and kidney which all appear to be fine.  My hemoglobin came out to be slightly low at 11.9 but the doctor said that was negligible.  The only change in behavior I have had is actually eating more healthy (rice, chicken, egg whites, vegetables...) and starting to work out at a gym 3x/week, about 3 months ago.  Also, I am NOT pregnant (which everyone keeps asking).  This has been ruled out by a couple of doctors and I have been having semi-regular menstrual cycles and am presently having one.  Other medical issues I have been treated for but probably are unrelated include Polycystic Ovarian Syndrome (symptoms are irregualr periods and severe headaches); Pleurasy (sp?)in Jan. 1998;  I have only one kidney because the other was given for a donation; anemia when I was younger;and fusion of C4,5,&6 due to a car accident in 1990.
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Dear Mary,
Persistent nausea can be due to several different causes.  It is important to know whether you also suffer from vomiting and if so, what are the characteristics of the material that you vomit. Do you vomit before breakfast?  Do you ever bring up food eaten more than 4 hours previously?  Is there bile in your vomit?  Does the vomit smell like feces?  Also do you suffer from loss of appetite? weight loss? abdominal pain?
In general terms, nausea without vomiting can be due to conditions of the stomach, intestine or central nervous system.  Gastric problems can include narrowing of the outlet of the stomach due to structural damage e.g. scarring from previous ulcer disease.  Gastric causes of nausea can also be related to gastroparesis, a condition in which the stomach outflow is normal but because of impaired muscle function of the stomach there is delayed gastric emptying.  Gastroparesis can be due to conditions such as hypothyroidism, diabetes mellitus, abnormal concentrations of electrolytes or as a consequence of certain medications. Usually, however, the cause for the gastroparesis is not identified.
Obstruction of the small intestine can cause nausea but the usual presentations are abdominal pain or vomiting.  Finally, diseases of the central nervouis system, can on occasion cause nausea.
The first investigative steps are an evaluation of stomach and small intestine by X-ray or endoscopy and a gastric emptying study, a test in which you eat a meal that contains radioactivity.  The test determines the rate at which the radioactivity leaves your stomach.  If gastric emptying is prolonged and there is no evidence for mechanical obstruction, then you have gastroparesis and will require investigations for this problem.
This information is provided for educational purposes only.  Always consult your personal physician for specific medical questions.
We would be happy to see you at the Division of Gastroenterology of Henry Ford Health System if you would like to be evaluated at our institution.  Please call our Physician referral Line at [phone] and request an appointment with Dr. fogel, one of our experts in the diagnosis and treatment of gastrointestinal motility problems.  He can review your records and help identify the cause of your proble as well as develop a treatment plan.
HFHSM.D.-rf
*keywords: nausea, gastroparesis, obstrruction
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