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chronic nausea and weight loss

  i am writing in concern of my friend. she is 40, has one child (male, 15 years old). she has been nauseated since oct 97 and continues to lose weight. she started at 145 lb and today "might" be 100 lbs. she says that if/when she eats it feels as if the food "just lays there". she has been to every type of doctor imagineable. she has had several visits to the cleveland clinic and has had test after test done-with no indication of what her problem is or how to treat it. she has also been seeing a psyciatrist who put her on a "mile" anti-depressant. she can consume 3 ensure liquids and 1 white (small) boiled potato per day-that is all she's eaten since oct. last week her md told her that unless her nutritional intake increases, a feeding tube may be necessary. she has had to quit work (fast-paced, high stress communications field). cleveland clinic said they believe the timing is off in her stomach and that it may take 3 years for it to get back into sink. the holistic doctor feels there may be a problem with the lining of her stomach-told her to drink aloe juice. the md's are at a loss-they simply want her to eat more.  
  none of this makes sense-please advise before it's too late
Dear Cathy Apple,
The profound weight loss and nausea is worrisome.  I am certain that the Cleveland Clinic has done gastric emptying studies,  They should be able to state unequivocally whether there is a delay in gastric emptying (gastroparesis) as the cause of the GI problem.  If gastroparesis is identified, the physician must look for the specific cause while initiating treatment with a prokinetic agent e.g. Propulsid.  The art of treating this problm becomes evident if the Propulsid does not relieve the discomfort and allow your friend to eat a regular diet.
If gastroparesis is excluded, then the problem becomes more difficult.  Other possibilities to consider include mesenteric ischemia and pancreatic disease.  The investigation of these possibilities would involve more testing including an angiogram and ERCP, an endoscopic test.
This information is provided for informational purposes only and should not be considered a formal medical consultation.  Always consult your physician for specific medical problems.
We would be happy to see your friend and to review her medical records, if she wants another subspecialist opinion.  She should call the Physician referral Line of henry Ford medical Group at 1-800-653-6568 and ask for an appointment with Dr. Fogel, one of our experts in the diagnosis and treatment of abdominal pain.
Best of luck.
*keywords: abdominal pain

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