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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.
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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.

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A related discussion, sick daughter was started.
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I wanted to post a reply to matt...i too visited the carribean in 1988 ( specifically , St. Thomas Virgin Islands and Peurto Rico)  and came down with severe nausea, dizziness, and burning...My endoscopy showed gastritis but no helicobacter...finally they treated me for helicobacter...i got about 80 percent relief but a year later it returned ful force...i was wondering where you visited in the carribean...maybe there was a unidentified bug that we both picked up?  Would love to hear your response
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I wanted to post a reply to matt...i too visited the carribean in 1988 ( specifically , St. Thomas Virgin Islands and Peurto Rico)  and came down with severe nausea, dizziness, and burning...My endoscopy showed gastritis but no helicobacter...finally they treated me for helicobacter...i got about 80 percent relief but a year later it returned ful force...i was wondering where you visited in the carribean...maybe there was a unidentified bug that we both picked up?  Would love to hear your response
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i wanted to reply to Berry...i went to the carribean as well in 88 and returned home with constant nausea, dizziness, and burning in the upper stomach...doctors did an endoscopy and found gastritis but tested negative for Helicobacter pylori...i was sso sick and nauseated.  Finally they treated me for h pylori...caused some relief but about a year later it iss back with a vengeance...am very depressed now and docs are saying "you're anxious"  .  Very frustrating because i know that's not why i'm sick...yes i'm aanxious...but would'nt anyone be if you were constantly feeling like your going to throw up?
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I have put commits in about gastroparesis I am 41 I have it plus have nausea no vommiting wish I could I want to know what medication is good for nausea I have phenergan its not working anymore today I am misrable. I have no gallbladder numeorous stomach problems the nausea is hard to deal with  Any help would be appreciated.  Cheryl   ***@****
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Paula, (and others)

"This is some info I have read or heard from others"

Im sorry to hear your having trouble.I have had ideopathic gastroparesis for over 2yrs now (symptoms began after gallbladder,appendix surgery).Your symtoms sound like gastroparesis? Have you seen a Gastroenterologist who deals
with motility disorders? Some doc's dont have as much exposure
to motility disorders so they are slower at getting to the
diagnosis and proper treatment.A gastric empty scan would be the
best test to start with,it will show if your stomach is emptying
in a timely manner.Other blood tests for thyroid or adrenal gland
problems should be done to rule those causes out.Some people get
a stomach virus and it does not resolve, possibly nerves were damaged or the pacemaker activity of the gut is "thrown off"
and dysfunctions either case can cause gastroparesis. This
scenerio is usually called viral gastroparesis and I have read
that it may resolve over time,usually symptoms are severe at the
onset and progressivly improvement can be seen,it may take 2+ yrs.The prior info I read on the internet. Some people have GERD that seems to progressivly get worse and then it seems to coinside with gastroparesis.Some women notice worsening symptoms around there menstrual cycle (hormone fluxuations can worsen symtoms for some).Some people just "get it" they may have had
IBS or other stomach problems ie:constipation and then things
just slow down and don't work? When there is no identifiable
cause it is called ideopathic gastroparesis.There are some medical conditions that can cause gastroparesis like as you
mentioned diabetes, also thyroid,lupus,schelderoma sp?? there
may be others.I know how hard it is to eat when it causes so much
discomfort and you know the reprecussions.Its a double edged sword.
Some things I eat that Ive been able to tolerate have been potatos,Ensure,yogurt,chicken broth,bananas,pudding...small portions.I hope you are feeling better soon! I would ask your doc to rule out the gastroparesis. I hope this info helps.....if you need to talk or have any questions feel free to mail me at:
  ***@****
I am on disability so I have free time to help :) Good Luck!
A site you may want to look into is: www.dailyfutures.com/gastro.html
Jeannine
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Avatar universal
Hello everyone.  I have read everyone's posts with great interest. I am a 41 y.o. female and for the last month I have been having many of the symptoms listed in this forum.  It very first started when I woke up in the middle of the night feeling like I had to vomit.  Earlier in the evening I noticed that the food I ate during the day seemed to be sititng in my stomach and not digesting.  Anyway, I got up to vomit but I never did vomit; Hello everyone!  I have read with great interests everyone's postings here.  I have been having a problem for a bout a month now and my symptoms sound just like what the people here are suffering from.  It all started when I woke up in the middile of the night and was extremely nauseated.  Earlier in the evening I noticed that the food I ate during the day just seemed like it was sitting in my stomach and not emptying.  Anyway, I never did vomit; I had to go to the bathroom (but not diarreah) and I ended up passing out!  It was very frightening for my husband who thankfully has been very supportive.  Anyway, I felt sick for a couple days after that and I thought I just ate something that didn't agree with me or I had a virus.  Then the same thing happened to me a few days later.  My husband took me to the e.r. and they ran some blood tests which were all normal.  I went to my doctor the next week and he thought I might have gastritis or a dumping syndrome, or possibly gallbadder disease so he ordered an ultrasound which was normal. Now he's wondering if I have an ulcer and I go for an endoscopy next Thursday.  My biggest symptoms are inability to eat, constant nausea, fullness in the stomach and I've lost 10 lbs.  This has been going on for about a month.  I was beginning to feel like I'm going crazy and I was wondering if I was making myself sick because I'm afraid to eat because of how violently ill I got that one night.  So I basically force myself to eat something and within 10 minutes I feel like I've eaten a big turkey dinner and then I get really nauseated.  I'm only eating about 1/5 of what I normally eat. Prior to this I was always very healthy and never have stomach problems!  I'm beginning to wonder if I have this gastroparesis.  I am not diabetic and I have read that 85% of people who have gastroparesis are diabetics.  Does anyone know why someone just gets this disease out of the blue?  I am quite frightened.  Thanks a lot everyone!
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I have the same sx as most of the clients Ihav read the GI doc has ruled out gastroparesis but I continue being severly nauseated the sight and smell of food makes me nauseated. I wake up nauseated. my tongue is often coated white and I hav a bad taste that I can't describe I have ony vomited on two occassions one was in Dec when the nausea began the other was this past Saturday when I vomited 4 times and only mucus came up. I cannot eat anything on most days and very little some days. I have lot about25 pounds since Dec. I have had EGD, Colonocsopy and much lab te only thing elevated was me Eosinophil coun in Dec and again 2days ago
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Since December of 1999 I have had problems with my stomach. For about 1 1/2 weeks in december I could only eat fruit, salads, and soups. I had a banana for breakfest and then i was full.  Then as i started to go eat for lunch i would get nauseated, I eventually found that eating 1 apple i was fine and full.  Dinner, was always bad anything fried or greasy i could not eat and when i did eat, i was always throwing up afterwards.  So, I stayed on 1 banana for breakfest and 1 apple or soup/salad for lunch and either nothing or something small for dinner.  I loss 20 lbs doing so.  Then I started eating what ever I wanted mid-Jan. and i was fine.  But, then It started over again and i went back to my fruit,soup, and salads. Then i was able to eat anything after 3 weeks of that.  But, now it has started again.  Everytime me and my husband started out to go it i would get nauseated and even to the point of throwing up.  My stomach burns some and I just fell trouble.  Sometimes I just don't feel like eating and at other times I'm afraid to eat.  I'm not at point were i'm under weight, actually i'm just a little over weight.  I don't done what this is or what to do for it?  Pleas help!!
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Concerned husband. You sound like a loving and caring man/husband.  I am sure your wife is very frustrated by now.  These symptoms can truly get you down and confused.  Giardia and IBS does come to mind as well.  My father-in-law had Giardia and it lasted a long time with quite a bit of nausea.  
    In a comment made on a previos comment before this, a woman explained something that may bring something to mind.  She had stated that her bowel would close off once a month causing her to be ill.  According to her there is a name for this.  Sometimes it closes off and others x's it does not.  
   Another suggestion would to re-post your message as an original message.  (You asking the first question).  A doctor will write you a message back if you are the initial poster.
   I also know a female who is allergic to flour and almost died because Doctors could  not find out the problem of constant nausea and other symptoms.  I am unsure what the disease or allergy is called, but she has to be extreamly careful or she will become VERY ill and possibly die.
   Don't give up on you quest to find answers.  Nausea is a sign of so many things.....but she can not continue this lifestyle.  She is not crazy either, so don't let a physician tell you that it is in her head.  Support her and encourage her.  This is getting me through gastroparesis symptomology and intially when they were unable to find a diagnosis.  Best of Luck.  If you have any questions, please feel free to e-mail my husband or I.
***@****            Lisa
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Hello, I'm new to the forum.  My wife has had some of the symptoms of gastroparesis described by many of you.  However, she has had the gastric emptying test and it came back normal.  She began to have chronic nausea after coming back from our honeymoon in the Caribbean in November '99, where we think she caught a traveller's bug.  She does not vomit.  She does not have diarrhea anymore (she had it for a month after coming home from the honeymoon; it went away only after two rounds of antibiotics).  The nausea never stopped.  She has had bouts of dizziness.  The only trend she can detect now is that her nausea seems to come in "waves" every three-four days or so.  We're ready to get our hands around this as you can imagine.  She has her first appointment with a GI specialist next week, after many months of frustrating appointments, tests and poor judgement by her primary doc.  Just so you know, the tests she has had are:  stool culture, brain MRI, gastric emptying test with small bowel follow-through, 3 pregnancy tests, numerous blood tests - all tests have been inconclusive.  Medicines taken include:  basic anti-acid OTC pills, pepcid, reglan, prevacid.  Have stopped birth control pills one week ago.  I'm hoping its just a mean paracite that we can't detect.  Can anyone shed light on these symptoms or suggest a course of treatment/questioning?  Some people have suggested that it may be irritable bowel syndrome or giardia.  We'd like to hear your thoughts.

Sincerely,
A concerned husband
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Just was wondering how the EGD went on 2/9.
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Hello, hello, how are you all?  I finished reading everyones updates.  You all have such big hearts and full of sanity!!!! Ug, more so than some of the doctors I have seen.  
  I totally have a new admiration for indiv. with medical issues.  It can truly thwart one's inner spirit.  I am determined to not let them KILL it.  We all know what we have been through don't we?  That is why I keep encouraging trusting your instincts.  I have known from the beginning this was not right.  The scary thing is that I almost started to think it was in my head and I am a therapist/social worker.  I think we give doctors way to much power and forget they are on our level as humans.  Not above us as many of them would like to think.  Their disbelief or neg feedback to you only let's you know they are not any higher than you as a person.  That is why we can NOT let anyone try to stomp on our beliefs and instincts.  When they do they are not validating who we are.  So who needs them then.
I am telling you Miss Jackie, if one doctor tells you something that you are sure is not the answer, becuase your gut is telling you otherwise, then keep trying.  I totally admire your belief in your daughter.  She has to feel so loved.  
  It took me totally unneed stress and money to find out what was going on.  ALL BECAUSE THESE MEN DID NOT WANT TO REALLY DO THEIR JOBS.  LAZY AND LET THEIR EGOS GET IN THE WAY.  Truly very sad.  But, I  can also contest to the doctor that I have. She is great.  She would not let any stone go unturned.  She believed me.  She was scared for me and angry at the doctors who were putting my life in danger.  Now that is a true physician.  I believe they are out there.  Sadly, there might not be many of her.  All of us are fighting for our lives and others.  Why would we settle for less?  
  A few questions, what can I eat?  My doctor was out for weekend when I left hospital so I did not get all the updates on this illness.  So, only mashed things, no meat, and LOW FIBER?  I thought we needed fiber?  Won't fiber help me with my severe constipation? Does anyone have any tips how to reduce the constipation?  It does make me sicker.  No fast food right?  How about breads?  I feel so lost with what I can eat.  I thought the meds would pretty much halt this.  I have since found out that is wrong.  I am still getting sick, just less frequent.  And acutally, other days are worse than others.  Is it trial and error with food.  Problem is that sometimes something will work and others I get ill. So what can I exactly eat?
  Jackie, I had the exact same headaches and dizzy/faint feeling.  It is a scary feeling.  What I found out was that this is causing stomache induced migranes. This is rare,but maybe they will one day find out that this is connected.  My doctor is so thorough that she sent me to a neurologist.  He did tests for other type headaches and it was trial and error to reach this conclusion.  Oh yes.....I do get extreamly nauseated without vomiting.  It depends, sometimes I do vomit and others I don't.  The headaches don't always come with the nausea.  Usually at those times I vomit, but NOT always.  I think there is ALOT that is not really know yet about this.  Remember, all of our bodies are made up different. NEVER have I had diarreah.  That is one symtpom that I was told is not for this illness.  Just the opposite.  So will I always struggle with constipation?  I will go weeks at a time.  Sometimes laxatives work, but usually I have to take other measures like supposatory or drink this fleet stuff.  You can do that everyday either, it will effect the muscles in the intestine.  
  Okay, okay, I will shut up.  I just have become so passionate about learning about this and helping others.  I do not want anyone to experience some of the things I have.  I know all of your tips have saved me a route or two.  Jackie, INSIST on a stomache empying test.  YOu can!!! See a gastrologist.  This is their specialty.  They understand it better than anyone.  If they try every taste (00ps...ha ha! must of been a freudian slip)test and comes out negative, Do Not stop looking.  Not all tests are 100 percent.  Your body may be different one day and not show up.  So go back and ask for another one a month or two later.  You have that right.  You are paying for it. I will recommend mine as well.  I went to one in Mont.  I am from Wyo.  I am not sure where you all are from.  This woman is one of the top in the nation.  I know who had a hand in helping me get in touch with her.  You are sound like wonderful and true spirited people.  Full of love and kindness.  For the ones who have e-mailed me.  Thank you.  Totally made my days.  I feel so alone sometimes.  the support is so nice and helpful.  ***@****           Happy Days!!! Lisa
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kim
When I get these "flare ups" I haven't vomited as of yet...I wish I *could* because it is so awful to feel nauseated and bloated.  And the rotten egg burps I get my GI doc told me is fermented food that is stuck in there.  The other day I kind of dry heaved, but didn't throw up.  I find the best thing I can do is eat tiny little meals.  Light and not fatty.  No fiber either.  I do ok with cooked winter squash, carrots and mashed things.  Soy milk is good, too.   Best of luck to you all and again I say I am SO happy to have found you.  This is very good for me to know there are others out there with gastorparesis.    Kim
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Hello there everyone! Jackie, thank you for letting us know how she's doing. If you don't think this problem is due to stress or depression, go with your instincts. Some doctors are going to look at your daughter's age and the fact that she's a cheerleader, they tend to stereotype. Like Lisa said, once they have that opinion, they become less objective. In the early stages of this illness my symptoms were VERY intermittent, later it became constant. There were times now and then I could manage to eat quite well, and I actually thought I was getting better. I would get my weight above 100 (I'm 5'2-1/2") and be thrilled, only to have symptoms return full force. The doctors are dead wrong about the vomiting thing, I wouldn't vomit after eating. (I would if I ate right now!:) I found ways to keep it down. I got to know my body's tolerance for food and I would eat accordingly, but not enough to make me vomit. I lived on maybe 300 calories a day and didn't push it, when you're that undernourished you know you'd better not vomit or you'll be in bigger trouble! As far as I know diarrhea is uncommon too, unless you have Gastroparesis with rapid motility in the intestines. If there is rapid transit (dumping syndrome) there would be diarrhea. I have such severe constipation I had to have surgery a few months ago after being clogged up for 2 and 1/2 months. Around this time my doctor put me on 4mg IV Morphine and thought that's what caused it, so I stopped taking it altogether but it keeps happening. No remedy works, even enemas! I didn't have severe headaches, unless it was around menstruation. I had dizziness but I would explain it as more of a lightheaded/ feeling faint instead of a rocking. I think the body's equilibrium is in the ears, does she have allergies or congestion? It might also explain the headaches. Gosh, I wish it all fit together like a puzzle. I would insist on the emptying study and go from there. You're doing a wonderful job, things will get better! If you have any more questions or need support, don't hesitate. Take care!  Jennifer :)
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Avatar universal
Hi,

I have severe gastroparesis with terrible nausea and bloating and
NO vomiting. I know of others with this disease who also do not vomit.
It is very common to vomit, but NOT a must.  Also, diarrhea is not common
in gastroparesis.  The more common problem is constipation because
of food sitting in the stomach for so long...not running through
quickly.  Often, stools are white, but that is not in everyone...
actually, it's probably only in a minority.  Just because she is not vomitting
does not mean it's not gastroparesis.  I am an example!  My doctor
said I subconsciously have control of that muscle so I can't vomit
even if I get sick enough that I want to.  It's bad because I usually want
to get rid of food that makes me that sick, but I can't, so I'm
sick for days or weeks!  Insist on the gastric emptying test!

Good Luck.
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Thanks for all your kind encouragement and information. Here's an update. We went for EGD today just to find out she was only scheduled for an office visit.  EGD scheduled for 2-9.   Gastroenterologist seems to think it may be gastritis (of course seems to lean towards stres/depression).  Although she is a type A personality and a worrier, I am convinced this is NOT the problem, although may play a role. She seemed much better over the last couple days for a couple of hours at a time and even ate a couple pieces of pizza one night and a hamburger this afternoon.  But then soon afterwards starts feeling bad.  Went to school yesterday, but by nighttime was feeling rotten and woke with bad headache and nausea this morning.  She has been now having trouble with severe headaches down the back of her head and into her shoulders and back.  Does this sound familiar to anyone?  Also, when I asked her GP and the ER doc about the possibility of gastroparesis, they said if that were the case she would be vomiting or having diarrhea?  Is this necessarily true?  Have any of you had the severe nausea but no vomiting?  She's also experiencing dizziness when she has the headaches, not a true vertigo but more of a rocking back and forth like a ferris wheel that does not do a complete revolution.  Any ideas?  Thanks so much for all of your help and for caring enough to try to help us.

Jackie
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Avatar universal
Hi,

It definitely sounds like gastroparesis.  I am a 22 year old college senior and
have been suffering from it for
six years.  I also have a heck of a time with potassium and phosphorous.
Unfortunately, I also have a heart problem and have gone into cardiac arrest
a number of times because of low potassium.  Recently I was in the hospital because
of severe malnutrition, dehydration, and my potassium was 2.7.  I'm
lucky to still be alive.  All the symptoms you describe point to
gastroparesis. I suggest your daughter have a Gastric Emptying
test done.  It can be done at a number of hospitals.  I go to Hershey
Medical Center, a research hospital, and if there is a good research
hospital close to you, it would be the best place to go.  A lot of
community general hospitals don't know much about gastroparesis.  If
the gastroparesis is severe enough, they may consider nutritional support.
I have been on and off it for years... a Midline for TPN, and a J-tube,
and now I have in a PICC line for TPN.  Soft foods are the best.  Low fat,
low fiber, no meat (maybe white meat, it depends) and limiter fruits and
veggies (unless they are soft and low in fiber...try mashed bananas, etc.)
Some people try ensure or Boost (mix it with milk, frozen yogurt,
and instant breakfats for a high calorie shake...don't drink it all at
once, sip it throughout the day)  also, small meals or snacks work best.
Big meals take too long to empty.  I also miss a lot of school.  My
junior year of high school I missed 76 days, and my senior year I had to
homeschool. I still miss a lot of college classes because I am in the
hospital alot (not just for gastroparesis, but also for my herat problem).
If you have any more questions, feel free
to write me at ***@****.  
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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.
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Avatar universal
Hello again everyone! We have all had similar problems with doctors and "anorexia", and here I thought my ordeal was unusual! Everyone has given such wonderful advice, it's nice we can help others from our experiences.

I'm up and running at <***@****>
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Hey! It didn't post my address. Try this again... ***@****
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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
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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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