chronic nausea and lower abdominal pain

By JcMcT
My wife has had chronic nausea and abdominal pain for many years but it is becoming worse. This past year a real push was put on to solve it. She had colonoscopy, gastroscopy, barium swallow, esophageal motility study, CT Scans, abdominal ultrasounds, numerous x-rays and blood tests to name a few. She had a balloon dilatation of her esophagus in December 2007 and a subsequent barium swallow indicates all well.She had her gall bladder removed New Year's Eve 2007. Supposedly there is not any gastroparesis. After all this the symptoms remain the same to worse. She seldom has the desire to be out of bed. She wants to be better! Lying down helps the pain. Has lost 57 pounds.
What is next to get to the bottom of this?

[Kevin Pho, MD]

I agree with the testing thus far, and it has been comprehensive.  

In fact, I can't think of any further tests that I would consider.  There are some cases of Sphincter of Oddi dysfunction leading to chronic abdominal pain.  If this is considered, an ERCP with Sphincter of Oddi manometry can be considered.  

Another opinion at a major academic medical center should be considered.

Otherwise, you may want to consider looking at neurological causes for the chronic nausea.  An MRI of the brain would be a reasonable start.

These options can be discussed with your personal physician.

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 patients education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com

[sfm_2000]

I seem to have the same symptons as this lady above does exept mine hasn't lasted as long as her's, I have had on and off cronic (chronic) nausea from augest 2006-spring of  2007 and i seemed to be doing good i got diganosed with GERD and i was takeing ranididine and some anti depressents cuz i was depressed and had alot of anxiety. but ya now my symptoms are comming back and they seems to be alot worse than last year, i just thought u or someone else may be able to answer why this is happening and if it is similar to the lady about

thanks
shane

[John2155]

I am the JCMcT who wrote the original question above.

FYI - We have now had a nuclear gastric emptying test. It tuns out that the muscles and nerves in her stomach are "just not coordinating".

She next sees a higher up Specialist with a view to getting a gastric pacemaker installed. Drugs will not work for her. She already has successful deep brain and spinal implants from Medtronic for back pain control. She will truly be bionic!   It will be her 51st surgery.