Chronic Nausea

[twosonmom]

I have been suffering off and on for about 8 years with chronic nausea, no vomiting but come close.  I have recently had a gastric emptying test done which was completely normal as well as a battery of other tests, upper GI, H-pylori, endoscopy and such with no answers.  Can anyone help me?  I am in desperate need of answers.

[boron]

I guess that really some research and appropriate investigations are recommended before undergoing any operation. Dyskinesia, besida HIDA scan, has to be evaluated by manometry tests of Sphincter of Oddi. Outcome of an operation greatly depends on status of this sphincter. Further operation of the sphincter is possible, but this brings some risks.

[az254]

I had a HIDA in 2003 showed Billiary Diskynesia --Gall Badder at 21--Dr recommended Removal--horrible post cholestectomy symptoms for 2 years--still not great, but better--In the long run Gall Blader removal helped maeby 25%--definitly not the panacea I was hopeing for but better than nothing

[boron]

Yes, as I said above it could be gastritis. If it is not H. pylori, than a bile from duodenum may leak upwards into the stomach and irritates it. Endoscopy is needed to confirm gastritis, but then you're again on the beginning (you've said one gastroscopy was negative already).

So:

You have confirmed diagnosis of biliary dyskinesia. Nausea is one of the symptoms, and gallbladder removal in 90% cures the symptoms, as said in this excellent article:
http://www.treatment-options.com/article.cfm?PubID=GA05-4-1-08&Type=Article&KeyWords=

[twosonmom]

What about Gastritis?  I have some of the symptoms but maybe Im grasping at straws?

[boron]

Biliary diskinesia itself may be the cause of nausea. Ultrasound and HIDA scan cannot confirm/exclude stones for sure. So, it is still possible that beside dyskinesia, you have stones or inflammed gallbladder. I'm not saying you have, just to tell you possibilities. CT would show stones or dense bile - biliary sludge.

Also, you should talk about this diskinesia - is it possible that it also affects your bile ducts and sphincter of Oddi. It would be dissapointment, if you get your gb removed, and nausea would persist due to duct problem.

[twosonmom]

H-pylori test was done via blood test. Hida scan showed no stones only biliary dyskensia. Im planning on calling my GI doc again thisweek, is there a specific test I should ask to have done?  Thanks so much for advice, you have been quite helpful!

[boron]

17% gallbladder function is really low and it CAN be related to nausea. Nausea is one of the most typical symptom in gallbladder disease. If ultrasound hasn't showed stones, this doesn't mean that there aren't any. Observe, if you have any upper right abdominal pain within an hour after the fatty meal - this speaks for gallbladder disease.

Morning nausea is typical for gastritis. What was the method to check H. pylori? You may want to have another test - breath test, which, I believe, is reliable. Well, again, heartburn, gastric burning and burping often accompany H. pylori infection.

Morning nausea is also in kidney disease. Blood urea would be obviously elevated in this case.


So, where to start?
Your gallbladder doesn't function properly - this is confirmed. You maybe need have a CT or MRI of abdomen which will show gallbladder much better than ultrasound.

[twosonmom]

I did have HIDA scan done in December which showed my gall bladder functioning at only 17% but have had many doctors tell me that that would not likely cause my chronic nausea.

[twosonmom]

No other symptoms except occassional constipation which is very normal for me.  I even wake up feeling very nauseaous.  I am at my wits end with this.  Not one doctor can seem to figure anything out.  I am so very tired of feeling like this..........

[boron]

Nasuea may be due to
- liver disease (blood test for liver enzymes would show that)
- gallbladder disease like gallstones. Upper right abdominal pain, mostly after a fatty meal is a typical sign. Ultrasound can show it (but not always, so HIDA scan may be needed in addition)
- small intestinal or colonic inflammation (you'd probably have diarrhea)
- kidney disease (bloodwork would show elevated urea)

So, any other symptoms except nausea? Changed bowel habit or stool color, pain, bloating, heartburn...?