Severe Nausea and Now Vomting - Help!

[TracyCG]

My mother is a young, very active 75 yr. old.  Right before the holidays she started to cut back on her eating, not much, but a little.  Then in the middle of Jan. she fell and hit her head on the ice.  As soon as that happened she started taking pain medicine but started having severe nausea.  She has been in the hospital 4 different times and at 2 diff hospitals.  She has been sent home after staying in each time approx. 5 days. or more.  They say she is healthly.  They checked her head, her heart, , her stomach, have done numerous cat scans and MRIs, an endoscopy, blood work, everything - so they say.  

The problem is is that she has lost over 28 lbs. in the last 2.5 months.  And she has been SEVERLY nauseous since that time and has not been able to eat anything.  One neuro guy say the post conconsion caused it, one neuro said it was the pain meds caused the nausea (even tho a anesth said all the diff pain meds she was on would not).  She has been taken off all meds that she was on and now only takes nausea meds and pain meds when she needs them.  The 3rd time in the hospital she did have pancreatistis.  They send her home everytime and tell her just to 'limp' thru it.  She is now vomiting and cannot get down her required "Boost and water intake".  The latest test say no pancreatitis.  I asked for a colonoscopy and they said she doesn't need it.  They have scheduled her for a endoscopic unltrasound to look at the pancreas but that is 2 weeks away.  

They act like its no big deal that she can't eat and that she will be OK if she continues to drink 4 Boost a day.  She is SEVERLY nauseated and can hardly drink.  Depression has set in now so much that she finely said she wished we loved her enough to let her die - that is how bad she feels.  She has no gallbladder and no appendix, both were surgically removed many years ago.  Latest X-rays say that she does have a cyst on her ovary - this was not noted before.

What could possibly be causing this nausea and weight loss?  What tests should we be 'demanding' that she get.  I feel as if I don't specifically ask for tests or point these guys in the right direction my mom will die.  Please provide any input that can help me help her.  Before this happened she was up working out every morning at 5:30 am in the gym.  She can out clean out last all of us.  I'm afraid they are writing her off because of her age.  But there is something physically wrong with her.  How can we figure how what it is and to treat it?

[Kevin Pho, MD]

It sounds like a pretty thorough evaluation has been done - with the multiple hospitalizations as well as MRIs.  

I agree that a colonoscopy would be unlikely to be useful.  If there is constant nausea and vomiting, you want to look at the upper GI tract.

An upper endoscopy can evaluate for inflammation, ulcers or a mass - all which can cause nausea.  More specialized tests would include a 24-hr pH study with esophageal motility, as well as a gastric emptying scan (looking for gastroparesis).

These options can be discussed with your personal physician or in conjunction with a GI specialist.

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.
Medical Weblog:
kevinmd_b

[ozark]

have they checked her blood for any abnormal electrolytes that may be causing her the nausea and vomiting?

[MOONGLOW]

Sounds like gastroparesis.  She needs to have a gastric emptying study to at least rule it out.  It is a very easy procedure when you are not nausated or vomiting.  You ingest an egg and toast with radioactive material and have to lie still under a machine for 2-3 hours.  You cannot vomit or the test will not be accurate.  That might be a problem if she cannot keep anything down.  

Go to a motility specialist..usually at a local university or medical school.

Good luck.   A person with diagnosed idiopathic gastroparesis.

[TracyCG]

Thanks for the input.  She did have the gastric empyting study but she only got half way through due to the fact she could not get any more down.  She did have the endoscopy and she also had an endoscopic ultrasound of the pancreas - all came up clear.  They finally put in a feeding tube and she still has the nausea but it is manageable with some vomiting.  She has not had the ph study and that might be the next step - I will certainly ask.

[natural stuff?]

My mom, some how has advance stomach cancer, and she didn't vomit (or tell us about it). But she did loose a lot of weight. She had some test done and the last one, we had no hope. In fact she lost 11 more pounds. She is now doing natural medicine along with biomagnetic. I know that some of the natural medicine she takes she has kept, it doesn't make her nausea. She drinks a natural juice that she makes, has some aloe vera and some reverse osmosis water. She kept away from sugar, including fruits. But now she feels better and she gets up in the morning and does her routine. Most of the time, if the doctor visit is in the morning were at lunch by noon. Also, no catfish or shrimp, she is to eat fish like salmon and red snapper.  She sees a natural doctor in Louisiana, the biomagnetic here in Dallas. The only thing I can do is have faith in God and do what we can do to make my mom feel at ease. I hope the diet, or the natural medicine can help you in some way.