Waking at night with nausea, lightheadedness and bowel movement

[let]

I am in my mid-forties and female.  Off and on for the last 3-4 years (maybe once or twice a month), I will awaken at night, nauseated and lightheaded.  I'll get to the bathroom, rest till the dizziness passes and then need to have a bowel movement(not necessarily diarreah.) Then, I'll go back to bed and usually be just fine the next morning. I had all kinds of tests done..colonoscopy, barium this and that, CAT scan, gall bladder test etc. but, nothing turned up. I altered my diet at night (since this just seems to happen at night)stopped drinking red wine, carefully avoided rich fatty foods/ice cream etc. (In the meantime, I developed migraines particularly during my menstral cycle although I don't notice a headache, necessarily, when I wake up in the night feeling sick but often do have one the next day.)  Anyway, I thought I had it handled with diet since I didn't have an "episode" for a number of months when wham, I've had three such events in the last two months!(I am also on Elavil for my migraines..) The doctors suspect IBS but I know it's odd to be awakened by symptoms.  Any ideas??? By the way, I am a "fainter" particularly when I am shocked emotionally or when I've had a bad GI bug. One doctor says my "lightheadedness" may be due to vasovaga (?)and may do a tilt table test for a final determination. But that doesn't explain needing to use the bathroom at night, does it? My weight is ok and I generally feel just fine during the day.

[Kevin Pho, MD]

The episodes of light-headedness after going to the bathroom may be explained by a vaso-vagal reaction.  A tilt-table test may help with this.  

As for the nausea, initial testing should include an upper GI series and/or upper endoscopy if they haven't already been done.  More specialized testing including a 24-hr pH study with esophageal motility as well as a gastric emptying scan can be considered as well.  These can look for esophageal motility disorders and gastroparesis (delayed gastric emptying) respectively.  

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

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

[slkennedy]

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[asease21]

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[idkwia]

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[lrahbar]

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[cometfl]

You should have your blood sugar levels checked for diabetes if you have not already.

[ozark]

have you had a cardiac workup?  could possibly an arrythmia that may cause your symptoms...maybe a holter monitor for 24 hrs?