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Severe Nausea and Vomiting With MS
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Severe Nausea and Vomiting With MS


  My wife is 35 years old and was diagnosed with MS four years ago.  She suffers from many of the usual symptoms when the MS flairs such as optic neuritis, bladder control, numbness in hands, arms, and legs, fatigue, ect.  However the most debilitating aspect of the disease for her is the severe nausea and vomiting she must endure.  She receives 45 mg of Zofran a day I.V. in an attempt to control the nausea but it is of little help.  She vomits up to twenty times a day and must be put on I.V. fluids and TPN to be sustained. The last time this happened a jejunmostomy was performed and within of 10 weeks the nausea and vomiting stopped, for 16 months.  Her MS has flaired again recently and the whole cycle has started again.
  I have done considerable reading on MS and have yet to find anyone who suffers from symptoms such as hers. Her doctors also seem to be at a loss to find a way to control the nausea. Can anyone steer me in the right direction to find a possible solution to this problem. Medical journals, conference notes, ect. Thanks
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You are correct that nausea and vomiting are not typical of multiple sclerosis and are quite unusual as symptoms due to MS.  A review of the literature does reveal case reports with nausea/vomiting attributed to ALS but no large case series have been reported.  The first thing I would makes sure of is that it is no way medication related. Several medications - interferons, steroids, baclofen (less commonly) - can cause nausea and vomiting. Could any be related?  Are then other symptoms related to the nausea - vertigo is seen in multiple sclerosis and can be associated with nausea so can significant headache.  In these cases, antivertigo or pain medications may be helpful.  Finally, it is possible for people to have two disorders; it does sound from you posting that other gastrointestinal causes have been evaluated for.  If none of these is the case, antiemetic drugs like ondansetron (Zofran), granisetron (Kytril),Tigan, or Compazine are the most commonly used agents.
Hope this is of some help.  Good luck.




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