Continuing Upper GI Probs/At Wit's End!!

[Christine__0__0]

  I've posted several times before and I apologize for the frequency.  I am just very troubled and cannot seem to get anything solved.  
  34 y/o female. Since early July experienced loss of appetite/mucous diarrhea/gas/lots of abdominal noises/weight loss of 10 lbs.  GI doc suspected giardia; however, tests later came back negative.  Improved substantially on Flagyl treatment;however, was left with residual upper GI discomforts (early satiety, some foods bothersome). No more diarrhea.  Appetite returned and weight was maintained; however, I've never been able to regain my once robust eating habits.  Over a week ago, I lost my appetite again and subsequently lost another 4 lbs.  I don't seem to be losing any muscle and people tell me that I look good.  The appetite loss was directly attributed to a stressful event.  Began taking Pepcid AC.  A few days later began to feel nausea, predominently starting about 3 a.m. and lasting until about noon.  Took a larger dose of Pepcid which seems to alleviate most of the nausea; however, after using the Pepcid for a few days began to notice dizziness.  Revisited GI doc with my concerns.  He did a physical exam of stomach--everything felt normal.  Prescribed Reglan to take before meals.  I don't really notice much difference in my ability to eat more.  I do notice that I feel very weird on Reglan and I feel my stomach twitching/spasming kind of.  I don't like how I feel on Reglan.  Anyway, during my appt. with GI doc, he said that he felt there was nothing wrong with me--just some residual problems from my GI infection in July, or maybe it was stress.  I told him I was worried about cancer with the weight loss.  He said that with the weight loss I've had (14 lbs) I would probably be in pain if I had cancer.  He said if I was concerned he would do an endoscopy and a CT scan if the endoscopy was negative.  I really don't want to do these tests as I would like to trust my doctor.  The man has his degree from Harvard and Duke and comes highly recommended.  I guess I just need another opinion about what this could be.  My primary care physician believes it is reflux esophagitis (I have no heartburn though).  Basically, my symptoms are:
  occasional nausea starting early a.m. but pretty much gone by evening
  early satiety leading to decreased food intake and weight loss
  lack of appetite for sweets, fatty foods etc. (I do experience hunger)
  Unable to tolerate dairy or rich, creamy foods (get mild ache in upper stomach area--not chest).
  Belching
  When nausea exists bottom of throat feels like there is pressure
  As I said earlier, acid controllers tend to alleviate my symptoms; however, long term use seems to cause side effects.
  Tests:  Flexible sig, CBC (twice), and Chem 24 -- all normal.
  Do you think an endoscopy is necessary?  I hate to do it without dr. recommendation and am wondering if I am being a hypochondriac?  I do get very upset about all of this and it tends to worsen my stomach condition.  I'm not even sure testing (and finding nothing) would ease my mind.
  Thanks so much for your help.
  Christine
    
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Dear Christine,
Although I doubt that your symptoms are the resultof cancer, I do think that you should nbe investigated because of the effect of your symptoms on the quality of life.  In addition to the tests mentioned in your posting ask about the possibility of gastroparesis and the utility of a gastric emptying study.
This information is presented for educational purposes.  Always ask specific medical questions to your personal physician
HFHSM.D.-rf
*keywords: abdominal pain, Giardia
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