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Digestive Disorders / Gastroenterology Forum
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Avatar universal

Severe nausea

My 17 y/o daughter has been complaining of nausea and early satiety for several months.  She has always been very thin and is now 5'10" and generally weighs around 110-115 lb.  She began complaining of inability to eat because of severe nausea and I just kept encouraging her to eat, thinking that her busyness at school and with cheerleading was the culprit.  However, her complaints of nausea and then fatigue became so severe that I took her in and asked for blood work for mono, anemia, etc..  All tests were normal with exception of bilirubin (2.2 - ULN 1.2) and slightly low potassium.  Ten days later, bili was 3.7, potassium WNL.  All other blood work including liver profiles normal. Amylase also normal.  Abdominal sonogram normal.  EGD set up for Feb. 3.  Because of her body habitus, I am often asked about eating disorders.  I see no evidence of this.  I am an at-home mom and have plenty of opportunity to observe.  She is now having problems with even fluids.  Though she has not vomited, she feels as though anything that goes down will come up.  She is now down under 100 lb (although the first 10 lb was more gradual over the last several months - which I had attributed to increased activity).  I am very concerned about dehydration, though I have been trying to force fluids. She has been drinking a couple glasses of Instant Breakfast and perhaps some apple juice for the last 2 days.  The only solid I have been able to get her to eat is perhaps 1/2 of a small baked potato.  She feels profoundly weak and stays in bed most of the day. Please help.
28 Responses
Avatar universal
Dear Jackie,
Because of the risks associated with eating disorders it is always appropriate to raise this possibility.  Additional causes of your daughters symptoms include mechanical obstruction of stomach or intestine, inflammation and gastroparesis (impaired emptying of the stomach).  An esophageal motor disorder should also be considered.  In addition to the tests that you mention, ask yopur doctor about the possibility of a gastric emptying study.
Avatar universal
Jackie,

It sounds like your daughter may have gastroparesis.Your
doctor can have a Gastric Empty Scan done to see how much
time it takes for the food to empty from your daughters stomach.
Delayed emptying can cause the early satiety and nausea.
Try mashed banana's for potassium and Gatorade to help prevent
dehydration. Keeping potassium levels up is very important.
There are medications that can help motility of the stomach
wich may help symptoms. Use caution before taking Propulsid
if its prescribed (ask Dr. about recent warning).Constipation
can worsen symptoms also.You may want to look at this web site
for people with gastroparesis it has helpful info and tips.
www.dailyfutures.com/gastro.html (at bottom of 1st pg click
to see info) I hope your daughter is feeling well soon!

Jeannine

I have gastroparesis, if you have any questions: ***@****
Avatar universal
Hi, I'm so sorry to hear about your daughter and understand how worried you must be. I totally agree with Jeannine, it sounds like Gastroparesis. I am 23 years old and was diagnosed with "idiopathic" (no known cause) gastric and colonic atony almost three years ago. What this means is that the normal "peristaltic" contractions moving food through no longer function as in my case, or function poorly. For years I was misdiagnosed as having anorexia, it's very scary. It wasn't until I was sent to an eating disorder hospital with my weight in the 70's, when they discovered it wasn't anorexia and sent me to another hospital for tests. In my gastric emptying study they had me eat two hard boiled eggs (the only difficult part) previously injected with a substance they can see on x-ray, then I layed on a table for 90 mins where they watch the eggs empty into the small intestine. If they think her intestines may be involved, they might do a colonic transit study. I swallowed a capsule filled with tiny metallic o-rings, then had x-rays periodically to watch them move through the intestines. I will try to explain my symptoms as best I can. Everything I ate (even a few crackers) made me very full, and I had to sit down for at least an hour after eating because any movement would make it come up. I could never eat or drink laying down, I couldn't eat after 2:00-3:00pm because what I ate would come up that night or the next morning. I always slept propped up on pillows. I couldn't bend down after eating and couldn't burp without food coming up. My symptoms really worsened around my menstrual cycle. I lived on bland foods like mashed potatos, peanut butter, soups, and could only drink water- sip at a time. Even then I was desperately uncomfortable with pain, bloating, fullness, and felt like everything was in my throat. I was always dehydrated and had very low blood pressure. If the intestines are affected there's different symptoms. A lot of pain, constipation for weeks at a time, distended abdomen. Most cases can be treated with medications, or if the cause is found and eliminated or treated, it will make a big difference. My case is extreme and very rare. Because my entire digestive system is involved, I live on intravenous food and take all medications intravenously as I cannot take anything by mouth. However, I live a happier and more fulfilling life since my diagnosis. Before, I was very inactive because I felt so miserable, and I had to be to "save" the little calories I ate to keep weight on. Her symptoms could be many things, and the severity of Gastroparesis can really vary. I hope I have helped you and given you some direction. I was touched by your post and can understand how scared and frustrated you and your daughter must be. Don't let them doctors say anorexia! I will keep her in my prayers and hope she feels better soon. Take care and good luck!   Jennifer :)
Avatar universal
Jackie:  Hang in there I am going thru the same thing w/ my 17 yr. old son.  He had a stomach emptying study done which he failed miserably.  Keep on going with dr's and don't let anyone tell you it is stress or nerves.  My poor son was actually sooo relieved he failed the emptying study.  It sounds like your daughter could have gasteoparesis.  It has many causes one of which could be a stomach virus.  If you would like to continue talking about this or have any other questions feel free to email me at ***@****.  We can compare notes, also is she still able to go to school.  Take care, Laura
Avatar universal
Jeannine, Laura, and Jennifer....thanks for your input.  Just having someone with whom to commiserate is comforting.  Things are still about the same.  Had some worsening last night with severe headache, bodyaches, dizziness even when lying down.  Went to ER fearing dehydration.  No severe dehydration found.  All blood work normal (even bili now).  Occult infection found in urine but not felt to be culprit.  ER doc felt some "lump" in the lower right abdomen, too high to be cystic ovary.  So next step is GYN exam (frightening for a 17 y/o virgin), and then EGD on Wednesday.  To Laura.... no she has only been to school one day out of the last 10.  Will probably e.mail you after the EGD.  I did read some of your input about your son.  Sure sounds familiar, and very frustrating.  Hope he is better soon. On top of his illness, I am sure he is worried about school, as is my daughter.  Thanks again.

Avatar universal
Hi again Jackie! I have to tell you about blood test results and what a doctor told me when I was going through this. I had many visits to the ER during my ordeal with heart palpitations (from electrolyte imbalance, potassium was 3.5), dizziness, fainting, and profound weakness (from dehydration.) I eventually went to the Mayo Clinic because they feared something wrong with my heart, but all tests for that were normal. The blood tests I had were always normal, but they knew I was dehydrated because my blood pressure dropped to 70/35 when I stood up, from 90/60 laying down. I also failed a tilt-table test. They told me I was "hypovolemic" (decreased blood volume due to dehydration.) They explained when the blood volume decreases, blood tests come out normal because the blood becomes more concentrated when you lose fluid (hemoconcentration). With constant nausea I could never comsume enough to stay hydrated. Mayo said drinking only small amounts of water wasn't good because I'm not drinking anything with solute in it to increase blood volume. They suggested Gatorade or soft drinks with caffeine. I was also told another reason for normal blood test results is that the body compensates for the fluid loss, until the loss is extreme.

My heart really goes out to you, I remember how helpless and scared my mother felt. We have always shared feelings and have been inseparable through it all. I am thinking of setting up a free e-mail account as I don't feel right putting the family's address online, and I will post it here as soon as I do. Feel free to e-mail if you need to talk. Others with this illness are also welcome! I hope she will be feeling well soon, good luck with the tests and let us know how she's doing!      Jennifer  :)
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