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Gastroenterology (Expert Forum)
Chronic nausea situation
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Chronic nausea situation
by mattrobinsonn, Sep 21, 2006 12:00AM
For about 6 months, I have been suffering from on and off chronic nausea. I had the following tests: endoscopy with
mild redness but no ulcer or esophagitis, body ct -ve with no pancreaitis, head CT -ve, bloodwork for liver enzymes and nml negative, stool studies -ve, small bowel follow-thru -ve. I was on Nexium/Prilosec for 10 weeks with no relief. My stomach area internally gurgles/makes noises often and twitches on the inside. Most of the time I get an empty/pain/ache feeling in the stomach that wakes me up around 4-5 am. I get back to sleep and wake around 7 and eat breakfast but the feeling persists thru the morning and sometimes into the afternoon.
Also, around suppertime I get a real famished/empty feeling in the stomach with gurgling. I have adjusted my diet to eliminate all the foods/drinks that we are told to stay away from when I was started on the Nexium. I stopped taking the Nex. 3-4 months ago, but have continued with the strict diet.
Lately over the past week or so, the nausea has come after eating breakfast and lunch and persists for several hours. Prior to eating I sometimes feel an empty stomach or feel ok.
Over this entire period my appetite has almost been nil. Since I thought that I wasn't eating enough calories initially I have increased my daily caloric intake to where I have gained 20 lbs over the last 6 months. My life is on hold since I have functioning in a normal capacity. Also, I have read many of the posts and have not come across any mention of any relation to Paxil and stomach issues. Previously, I was on Paxil for 5 years and stopped gradually over a period of 4 months last summer '05. Once my present condition started, I tried Nexium/Prilosec with no relief, I restarted the Paxil for about 12 weeks since I was wondering if my body just needed it. The nausea seemed to worsen during that period. What relation can Paxil and stomach is there. I have read alot of write-ups of some connection, but they all say that the nausea doesn't persist for as long as mine. I also read that the stomach has serotonin in it and Paxil works with serotonin. Also, what sort of tests would a neurologist do in relation to my condition? I saw my primary recently and he refused to ok a neurologist visit until my GI doc took another look at me. He can't get me a visit for 2.5 months and really doesn't what to do. I talked to him on the phone and he is at a loss. Until I see him, I can't see a neurologist unless you can provide possible causes and then I can go to my primary with some reason for him to ok it. Every single over-the-counter drug does not work for me. Why should I get nauceous for several hours after I eat, even though sometimes I'm feeling fine prior to eating? Help! I am a normal size adult male 6'1" and 195 lbs.
mild redness but no ulcer or esophagitis, body ct -ve with no pancreaitis, head CT -ve, bloodwork for liver enzymes and nml negative, stool studies -ve, small bowel follow-thru -ve. I was on Nexium/Prilosec for 10 weeks with no relief. My stomach area internally gurgles/makes noises often and twitches on the inside. Most of the time I get an empty/pain/ache feeling in the stomach that wakes me up around 4-5 am. I get back to sleep and wake around 7 and eat breakfast but the feeling persists thru the morning and sometimes into the afternoon.
Also, around suppertime I get a real famished/empty feeling in the stomach with gurgling. I have adjusted my diet to eliminate all the foods/drinks that we are told to stay away from when I was started on the Nexium. I stopped taking the Nex. 3-4 months ago, but have continued with the strict diet.
Lately over the past week or so, the nausea has come after eating breakfast and lunch and persists for several hours. Prior to eating I sometimes feel an empty stomach or feel ok.
Over this entire period my appetite has almost been nil. Since I thought that I wasn't eating enough calories initially I have increased my daily caloric intake to where I have gained 20 lbs over the last 6 months. My life is on hold since I have functioning in a normal capacity. Also, I have read many of the posts and have not come across any mention of any relation to Paxil and stomach issues. Previously, I was on Paxil for 5 years and stopped gradually over a period of 4 months last summer '05. Once my present condition started, I tried Nexium/Prilosec with no relief, I restarted the Paxil for about 12 weeks since I was wondering if my body just needed it. The nausea seemed to worsen during that period. What relation can Paxil and stomach is there. I have read alot of write-ups of some connection, but they all say that the nausea doesn't persist for as long as mine. I also read that the stomach has serotonin in it and Paxil works with serotonin. Also, what sort of tests would a neurologist do in relation to my condition? I saw my primary recently and he refused to ok a neurologist visit until my GI doc took another look at me. He can't get me a visit for 2.5 months and really doesn't what to do. I talked to him on the phone and he is at a loss. Until I see him, I can't see a neurologist unless you can provide possible causes and then I can go to my primary with some reason for him to ok it. Every single over-the-counter drug does not work for me. Why should I get nauceous for several hours after I eat, even though sometimes I'm feeling fine prior to eating? Help! I am a normal size adult male 6'1" and 195 lbs.
Doctor's Answer
by Kevin Pho, MD, Sep 22, 2006 12:00AM
, Sep 22, 2006 12:00AM
A neurologist will look for non-GI causes of nausea. There are a variety of brain and central nervous disorders that can lead to chronic nausea. These can be evaluated initially with brain imaging - like an MRI.
However, I would also consider further GI evaluation. A gastric emptying scan and a 24-hr pH study with esophageal motility studies can be considered to evaluate for gastroparesis and motility disorders respectively.
Although possible, I am not aware of Paxil commonly causing chronic nausea.
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 patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
However, I would also consider further GI evaluation. A gastric emptying scan and a 24-hr pH study with esophageal motility studies can be considered to evaluate for gastroparesis and motility disorders respectively.
Although possible, I am not aware of Paxil commonly causing chronic nausea.
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 patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
http://www.medhelp.org/forums/gastro/messages/37115.html
and the person's on-screen name is "romel". Please comment to this thread if you are that person, I would like to ask some questions to see if you've got any answers that might help me.