Persistent Nausea

[DANIELE__0__0]

  I am a 27 year old female who has had significant digestive
  and nausea problems since my return from Honduras 8 months ago.
  The first symptoms occured within three days of being in
  Honduras: nausea severe heartburn, burping, some diarrhea.
  I was treated while in Honduras with an anti-spasmodic and
  antinausea medication. Upon to return to the States, these
  symptoms have persisted. I went through a battery of tests on my
  return(stool and blood) which came up with nothing.
  In January, I spent three nights in the emrgency room
  with significant cramping and pain along with severe nausea.
  They did the pelvic exam, ultrasound, and came up with nothing.
  I proceed to see an infectious disease specialist who
  identified that I had e-histologica?? amoebas in my system.
  I was given Humatin and a course on antibiotics.
  That provided only temporary relief. I am now in my third
   course of antibiotics and second of Humatin.
  I have gone to the GI doctor who has conducted another round of tests
  which include endoscopy and small bowel series. once again comes within
  normal range. On the doctor's recommendation, I went to a lab which specializes in
  international travel. they found some parasitical activity but the doctor feels this
  level of activity should not produce the level of discomfort I am currently experiencing.
  I just finished a course of Flagyl for 15 days (2225 mgs) per day. I am saddened to report
  not much has changed. I am frustrated and do not want to give up on this.
  it has interrupted my life significantly. I am a runner and this has severely inhibited any physical activity
  My doctor seems to want to chalk it up to IBS and stress, but I am am postive this is not the case.
  I don't want to give up. I am currently managing by cutting out caffeine, taking no drugs ( I went off the Pill six months ago
  and I am not pregnant. I am sick of living on soup, rolaids, Dramamine and crackers. Please help.
____________
Dear Danielle,
My first thought on reading your letter was that you had acquired an infection while in Honduras.  Despite the extensive investigation and courses of empiric treatment, this possibility still exists.  As a first step you should consider additional cultures.  
Anytime young previously healthy individuals develop diarrhea, we must consider the possibility of AIDS.  Do you have any risk factors for HIV infection?  We often suggest to our patients that they have an HIV test to exclude this possibility.
Other gastrointestinal diseases must be excluded.  I am certain that your physicians have checked for Crohn's Disease.  One possibility that is often overlooked is gastroparesis which can cause some of your symptoms of nausea and nonspecific pains.  A radioisotope gastric emptying study should be considered.
This information is presented for educational purposes only.  always consult your peronal physician for specific medical questions.
HFHSM.D.-rf
*keywords: infection, irritable bowel syndrome, diarrhea, abdominal pain
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[BeckyPe]

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