What's my deal??

[justmeonline]

Hello-- I am 26 and for the last 1.5-2 months I have been having some tummy problems. Initially I had loss of appetite, but felt ok. Then a couple weeks later I began having extreme nausea (no vomiting),no appetite and fever of around 99.8. I went in to the doc and was told I had a 7-10 day stomach flu that caused those symptoms. My stool was very dark with a slight flourescent green tint? I was given Prevacid and after a few days of rest the extreme nausea went away. I felt better--but not myself. A week later I went back feeling weird-- like there was a rock or stuff just sitting in the top of my stomach. I was given Nexium and told my tummy was still irritated and to take it for two weeks. A week later I called my doctor and told her I still just felt like I was fighting something off and I had a couple 99.8 temps again.
She scheduled me for an Upper GI with small bowel follow through and if that finds nothing, then I will have a gallbladder ultrasound. The upper GI was yesterday so as of now I am waiting. I am now taking AcipHex daily--I have a month's supply of it.
  I am confused as to what this could be. I have NEVER had any stomach problems, no heartburn even. The last time I vomited was 20 years ago.
  As of now, I have a feeling at the top of my stomach like there is just something sitting there. Sometimes I will feel like I am going to throw up, like a heaving feeling out of nowhere really, but my stomach isn't nauseated at all. It's in the center, at the very top of my tummy, maybe in my esophagus.
My stool seems normal, no diarrhea. When my stomach has the full feeling, 7 up usually helps if I sip some. Sometimes I feel a little shaky in the knees and inside (maybe nervous??). I still really don't have an appetite, more than before but nothing like before. I have lost 12 pounds in the last month.
Sometimes I feel worse after eating--like right after to one hour after. Sometimes I feel worse if I don't eat. This whole thing is so confusing and frustrating as usually I am so healthy. I don't really go out anymore because I don't want to get that nauseated feeling out in public. I get nervous and just wish I could be okay.
  I have a little cramping throughout last night and today, but I think it is from the Upper GI. I was told the barium may cause a little of that. My right upper side is achy but only when I walk or move, when I am laying down, it feels fine. (muscle spasm??)
  My doctor said it may be a hiatal hernia, ulcer, gastritis, or something with my gallbladder. I had a hepatic function panel, TSH, lipase, and h. pylori antibody drawn and they were all normal.
  I am starting to get a little worried here, and was wondering if you could give me some insight on this. Thank you very much for your time.

[yoshi]

you said seven up helps??
too much of a good thing-prevacid,nexxium,prilosev.
if your problem is not too serious,all these medications shut down your acid producing capacity and you have a hard time digesting,and so you will have a heap of half digested food in your stomach waiting for the next marching order!!
i keep cranberry juice,fruit popsicle in my ice box just in case.

[4gpact]

I agree that the gastric emptying scan would be a good test to have done. It's not invasive, and will give you some good information. I have gastroparesis, and it went undiagnosed for years. Your symptoms are certainly consistent, but the gallbladder could be another culprit.

[surgeon]

An online diagnosis from afar will not be anywhere near as useful as the evaluation you are already getting. Gallbladder is high on the list. If the ultrasound is normal, it may be that the next step is an appointment with a gastroenterologist.

[Kevin Pho, MD]

Hello - thanks for asking your question.

Your doctor gave a pretty good range of what it could be.  Dyspepsia (i.e. upper GI discomfort) caused by an ulcer, GERD, gastritis/esophagitis, or gall bladder disease would be the most likely possibilities.  

The upper GI series would evaluate for possible ulcers, GERD or hiatal hernia.  I would agree that the next step should be an ultrasound to evaluate the gall bladder.

If that is negative, I would suggest an upper endoscopy to evaluate for any masses or inflammation of the esophagus or stomach.

Another study to consider would be a 24-hr pH study to document any presence of GERD, or a gastric emptying scan to evaluate for gastroparesis.  

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.

Thanks,
Kevin, M.D.