Ok, what's with the nausea?

[vbc2000]

Hi Forum Friends :)
I have noticed that some of you have talked about nausea.  I went to lunch with my sisters today and enjoyed my seafood teryaki but then promptly threw it up.  Sorry but this discussion's a little messy-gross but I think you guys can handle it.  

Anyway, since my second weight loss surgery, my stomach is pretty small.  I'm glad about that but sometimes if I eat a little too much or I eat and drink too soon together, it comes up.  I pretty much have the "rules of the small stomach" down pat, but at times things go a little wrong.  

The nausea and vomiting I've been having aside from my stomach issues seem to be getting more frequent.  I've tried to link it to things that might be making me nauseas like being on the antibiotics recently, but it's happening way too often.  Sometimes when I've waited long enough after breakfast, I'll try to have coffee and I'll get sick.

So, I'd like to know, if anyone can tell me...how is the nausea related to the AD?  Thanks.
Stephanie

[enzymelover]

Hi! There are many triggers for nausea and vomiting including gastrointestinal, endocrine and vestibular disorders. Since you've had weight loss surgery, it may be that cell receptors in your gastrointestinal tract are involved, particularly histamine or acetylcholine receptors. These receptors can be stimulated by a variety of things including the acid/alkiline balance,  interaction with drugs and allergies to various substances.
Intestinal obstruction is sometimes the cause of vomiting with gastro issues. If your vomiting becomes severe, get it checked out asap.

As far as AD goes, there are intracranial pressure receptors that may be involved, and pain receptors can be affected too.

[Marinella82]

What antibiotics are you on because many can upset your stomach?  I think our AD nausea is more of a vertigo type of nausea.  Our brain does not get enough blood for normal function and it causes dizzy spells.  Do you get the dizzy spells and then throw up or is it more of a stomach upset that causes you to throw up?

[Heiferly]

There are two primary factors contributing to nausea in dysautonomia.  One is dizziness/lightheadedness/pre-syncope.  (Although, I'm going to differ with some here on terminology; "vertigo" is actually not the type of dizziness associated commonly with autonomic dysfunction.  Vertigo is generally associated with vestibular (inner ear) issues, whereas the type of dizziness more commonly associated with orthostatic intolerance disorders is thought to be due primarily to cerebral hypoperfusion, i.e., reduced oxygenation to the brain.  The symptoms are somewhat different, though the terms are sometimes used interchangeably, especially outside of medical literature.  Also, it's certainly possible for a person with dysautonomia to have vertigo, it's just not strongly associated with dysauto per se, and if one is experiencing vertigo that ought to be evaluated by someone like an ENT to see if something is going on in addition to or due to the dysauto that may be affecting the inner ear.)

The second cause for nausea, and probably the most common cause for actual vomiting, is actual issues with autonomic nervous system [ANS] control of the digestive tract itself.  Recall that the ANS innervates all muscles that aren't under conscious control (all of the "automatic" functions of the body are included here), which includes the smooth muscle of the digestive tract.  The contractions that move food through your digestive system ("peristalsis") may not work effectively if they're not getting the right "messages" from the nerves.  Many patients with dysautonomia find that they have gastroparesis (slowed digestion), which can lead to nausea, vomiting, and even malnutrition and severe weight loss in severe cases.  A gastric emptying study can help to diagnose this.  Many patients have issues with bowel motility and will have problems with constipation (frequently diagnosed as IBS or "IBS-C").  

If you ask around, you will likely find that many, many of us are on some combination of medicine for stomach acid (such as Nexium, Prilosec, Tums, Pepsid...) and/or medicine for nausea/vomiting (such as Phenergan, Zofran, Reglan ...) and/or medicine for bowel issues (such as Miralax, Dulcolax, Metamucil, Colace ...).  

[CHRISTYDRAKE]

My son's main problem has always been nausea.  He wakes up nauseated daily and that it what keeps him in bed.  They did every GI test they could and decided his nausea was neurological.  They believe it has to do with the migraineous process.

He used to have severe migraines that wouldn't go away without an IV of painkillers.  The migraines finally stopped, or so we thought.  They believe his nausea is related to silent migraines or just a symptom of the migraines without having a migraine.    

He tried a ton of anti nausea medications, both prescription and over the counter, and nothing helped at all.  He is still sick every morning, but while it used to last until 2 in the afternoon, he is now able to function by 10 or 11.  So we have made progress.

Christy

[LA1989]

I love your description of this problem. My son hasn't suffered with the nausea until recently and I believe it's tied to the fact that many of his other symptoms have increased at the same time. His pulse pressures have been all over the place and he has been much more shaky and suffering from a lot of joint pain. Your explanation makes a lot of sense--thanks!

[vbc2000]

Thanks for all your responses!  It is not a vertigo/dizziness nausea, it's defintely a physical, down in the gut nausea.

Enzymelover - I am 6 years out from my last weight loss surgery so I don't think an obstruction or adhesions are involved but it's definitely still something to keep in mind.  I have questioned for a while if I had another hernia on one side and if I keep vomiting, I definitely need to get it checked out.  Thanks for the reminder.

Marinella82 - I've been off the antibiotics for almost 2 weeks but they do make me nauseas so when I was on them, that's what I think it was.  I'm just questioning everything now in relation to the AD/NCS diagnosis.

Heiferly - Thank you for always giving such thoughtful and informative replies :)  You really do have to re-think everything after finding out you have this going on!  I was trying to explain to my sisters yesterday what the autonomic system does and I guess I really still need a little education too.  I have been so focused on how it affects my heart, BP etc, that I kind of forgot about all the other systems it affects too like digestion.  I already have issues because of the WLS now this is just another wrinkle.  I've been on Prilosec since the second surgery because my smaller stomach seemed to be kicking acid upward because it didn't have anyplace else to go.  Totally unrelated to the AD.  You've given me alot to think about though...thank you.

Christydrake - I'm so sorry your son is suffering so much.  I had migranes in my pre-teen years so I know how awful they are.  Thankfully I grew out of them.

Thanks again everyone :)
Stephanie