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Chronic Nausea
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Chronic Nausea

I am a 21 yr old female suffering from chronic nausea for 3 years now.  The first 2 years, it only occurred a few times a month and so I wrote it off as stress.  Then in June 2008, I began to feel nauseous constantly.  I’ve never thrown up, I’m just nauseous with loss of appetite and weight secondary to the nausea (I’m 5’7’’ and I dropped down to 107 that June, when I typically weight 125).  I had blood work done and an abdominal ultrasound, both of which were normal, and I tested negative for the H. Pylori bacteria.  I was then given Remeron (an antidepressant and 5HT-3 antagonist) to increase my weight.  The Remeron helped for a few weeks, but the nausea returned.  I then started Prilosec 20mg/day.  6 months later, I’m up to 134 lbs and have zero nausea when I take both Prilosec and Remeron.  But as soon as I go off one of them, the nausea returns.  It’s worse in the morning and when I eat fatty foods.  I’m having an upper GI in about a month to check for ulcers and “rule out something serious like cancer” according to my doctor, but I’m going crazy in the meantime wondering what’s wrong.  Do you have any idea what this could be?  Have you ever heard of a 21 yr old getting stomach cancer?  I have none of the risk factors and no family history of stomach cancer.  A friend of mine was nauseous all the time too and found out she has gastroparesis, but when I mentioned this to my doctor he said it was impossible because I never throw up, but my friend never threw up either.  I’m so exhausted trying to figure out what’s wrong with my body.  Any insight would be much appreciated.
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140029_tn?1393301742
Well the gastric emptying test is from what I hear is pretty simple test and that would rule that out, i'm like you ...nauseated 24/7 and i've thought about that test but i've never thrown up either..  nausea is usually caused by slow motility of some sorts.  I'm dealing with chronic nausea as well.  3 yeas :(

I've gotten the "it's IBS" junk for years but I feel like something still is really wrong.  I would for sure do an upper endoscope just to check it out.  Another idea i'm fooling around with is testing for SIBO.  You said the more fatty foods you eat the worse you feel.  Well usually that's IBS as well..buut sometimes you might be having problems with bacterial overgrowth.  I'm in Utah trying to find a testing place for it right now.  Simple breath test.  Treated with antibiotics.

Also heavy fatty foods makes the gallbladder work harder and..if you're having some sort of gallbladder issue then I'd test for that, but you said you weren't in pain.  Maybe your gallbladder isn't functioning very well or you might have sludge or something up.  A HIDA/Ultrasound of that would check for that, but the cheap route would be a simple blood test checking for elevated levels suggesting a problem.  And liver blood tests just in case you have some sort of problem there can cause nausea as well.

In the mean time i'd work on going back to your doctor and asking about all these things... about SIBO/gallbladder/liver/upper endoscope and see what he or she thinks... and do fiber and a pretty blah diet, low fat...in case your gallbladder really is falling behind.  

I don't think you have cancer..that would have showed up on imaging/blood tests and i've never heard of anyone getting stomach cancer this young but they'll look for that in the upper endoscope as well.

I don't know..just some ideas throwing at you.  No pain and nausea is hard one.. do you drink?  That can cause major problems..liver..pancrease ...nausea just has so many possibilities sadly :( that's what i've learned.
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140029_tn?1393301742
just realized you mentioned you had an ultrasound...sorry about that scratch that idea.

Well another thing to remember.. I did an ultrasound and it showed zilch..but then we did a HIDA scan and it showed my gallbladder only working like 12% so it's still worth maaaaybe checking into.

Good luck!
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Avatar_f_tn
Hey, thanks for your reply.  My doctor said my gallbladder was fine based on my bloodwork and ultrasound, but I'm hearing from other people that those tests could miss something.  I wonder why he didn't want to do the HIDA scan?  The idea of surgery terrifies me though, so I really hope my gallbladder isn't the issue.  Do they inevitably remove your gallbladder if it's not working well?  Did you have yours removed?  I take it it didn't help if you did, seeing as you're still nauseous =/  It seems weird that I'd be able to live with a nonfunctioning gallbladder for 3 years though.  I've also read horror stories about people having their gallbladder removed only to have their nausea get even worse.

I heard long term use of PPIs can cause bacterial overgrowth too, but I never used Prilosec until AFTER the nausea developed.

I'll see what the upper GI shows and then from there, maybe ask for a HIDA scan or gastric emptying study.  Thanks for the input.  It's nice to know I'm not alone in this =)

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Avatar_f_tn
Do you have any facial flushing and diahreah together? This might indicate carcinoid syndrome which is rare but could happen.
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Also how about headaches? Might you have any kind of problem there? Or female problems? My daughter lost 20 lbs in a year and was found to have a large grapefruit sized "mass" in her ovary. She had a lot of nausea non stop day in and day ot.. Of course it never got better because she also had a kidney problem and now we find she also has "something else". No dx yet.
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140029_tn?1393301742
Yeah the surgery wasn't bad... like for maybe 4 or 5 days I was in a good amount of pain, I know a few people without one and the only problem they have is if they eat something fatty or cheese they get diareera...hasn't happened to me.   The thing that hurt most was the hit to my wallet.  It cost me over $7K (I don't have insurance) and yup like you said it didn't fix anything...but it did need to come out because it was swollen and inflammed.

But yeah had a ultrasound tech told me "the billary tree looks great..no stones we can see.." and my bloodwork was totally fine but when I did that HIDA scan my doctor was a little shocked and wanted it out.  I think the gallbladder going bad was secondary and caused by my original problem of constipation/infection of some sort.

I still have a bad hunch after antibiotics (probably abused antibiotics) and nexium/tums/rolaids ect I have a bad cause of SIBO and my dorky doctors never even thought about testing it meanwhile making me test for extremely expensive tests (MRI's CT scans..Kidney xrays blah blah).  I have the CPT code and i've called around here in salt lake city but can't find a testing place.  Everyone thinks i'm crazy asking for a hydrogen breath test..*sigh* but i've read on here and other sites many people get tested for it so I KNOW it exists!

Anyway on your problem, if you have insurance i'd think about doing the HIDA just in case..it's a super easy test.  Just lay there and listen to an Ipod or something.  Pretty accurate test.  And the gastric emptying test I haven't done..I was thinking about it as well and you could try that, sounds simple..eat some sandwich or eggs and sit there and have someone check you with I guess a gieger counter..and then of course the breath test SIBO.  *shrugs*.  Not sure what else to think of..maybe test yourself and prep for a colonoscopy using ducolax/miralax whatever to totally empty out and observe yourself to see if you're still nauseated.  That would give you some hints if it's something else.  If you're still nauseated empty you might have some.. infection or .. could rule out gastric emptying if you're nausated then too.  (I dunno an idea so you can tell your doctor "it's NOT IBS!!!" like I am)


*to lil sunshine.. yeah I wasn't tested specifically for that but i've had a MRI/CT but I do get fash flushing.. usually after I eat..especially if it's a decent sized meal I get massive nausea waves after about an hour or 2.. and fash flush symptoms but I think it's either stricture that got missed on a barium xray or SIBO going bezerk... still trying to find answers before I go bankcrupt :S
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140029_tn?1393301742
one last "before i sign off" is to eliminate diary.. I know women need calcium and you can get calcium in pills but i've also read that a lactose intolerance can cause nausea like you said..i'm also trying that.  Another one is celiac disease but both of these usually cause loose stoold or diareera of some sorts but i'm trying to think of anything to help us out... *shrugs* it's also tested and cheap to test out..

good luck!
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