Constant feeling of Nausea

[Robert Smart]

I have had this problem for 2 years.

I always feel nausea 24 hours of the day, to a greater or lesser extent.  Some days I can get by without taking any Motilium which is a anti sickness tablet, which appear to work (I cant realy tell!), while other days I take the maximum dose allowed. I have never been physically sick (it has come very, very close on many occations though!).

I have had over 40 blood tests, a ultrasound and an upper intestinal inspection via a camera which all came back negative (please see notes further on!).

Have you had any past dealings with anyone with a simular condition.  In my case I started to feel sick about 2 years ago, on and off for about 4 weeks and then I fell seriously ill and lost 5 stone in 8 weeks.  My diet is very limited as I can only tolerate items like, fish, Boiled/mashed potatoes, Veg, carbonated water and other bland items.  It took almost 4 months initally to even eat a meal during the day and not survive on just dry crackers, toast and jacket potatoes!

I have lost a faith in my current doctors (even diagnosed me with CFIDS for something to do!).  I am fortunate in that I own the company that I work for, so I can pace my workload around my condition, but I would be so gratefull if you could give some advice on what to do.   Before this illness I only had 1 sickness day in the last 21 years working with no past historical events.

The only postive result in all my blood tests were the Epsom Barr postive result and that my dead bloodcell count was high (excuse the spelling, but I think they called it mononuclious?).

Any advice would be most welcome.

Regards

Desperate UK sufferer.
Rob

[Kevin Pho, MD]

Hello - thanks for asking your question.

You note chronic nausea.  40 blood tests, upper endoscopy, ultrasound negative.  Epstein Barr virus positive.  

There are many causes of chronic nausea.  These include stomach disorders such as gastroenteritis, liver/gall bladder disease, cacner, medications, ulcers/gastritis, or neurological causes.  The ultrasound and upper endoscopy were good tests to start with.  A negative results suggests that ulcers, gastritis, or liver/gall bladder disease are not the cause.  I would also assume that the panel of 40 blood tests also looked at the pancreas which were normal.  

Other tests to consider would be a gastric emptying scan to evaluate for gastroparesis and an esophageal motility study/24-hr pH scan looking for GERD or motility disorders.  An abdominal CT looking for bowel obstruction may also be considered.  

If all these tests are negative, you want to rule out central nervous system tumors with a possible MRI.  

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.

Thanks,
Kevin, M.D.

[4gpact]

It sounds very much like you may have gastroparesis (delayed stomach emptying) The test to ask for is the gastric emptying scan, which is a simple and non invasive test that will take x rays of the contents of your stomach at timed intervals while it digests. What I would recommend is to take the Motilium on a regular basis. I take 30 mg, four times a day, but most that I know take 20 mg, four times a day. Take the dose that works best for you. Also, maintain a low fat, low fiber diet. Sounds like you have discovered this for yourself through trial and error. I also belong to an online support group for gastroparesis through Yahoo. We have members world wide. There are different reasons that cause gastroparesis, including diabetes, though up to 40% remain of unknown (idiopathic) origin. Often all other tests are negative, causing people to become frustrated, or led to believe "it's all in your head", or some other disorder. Many also suffer reflux or related acidity problems due to the stomach contents remaining too long, and take one of the PPI's (proton pump inhibitors), such as aciphex, protonix, prevacid, etc.
I would recommend doing some research and asking your doctor some questions about the possibility of gastroparesis.

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