Constant Nausea / occasional vomitting

[TattooOfSun]

I'm a 26 year old female and I've been constantly nauseous for about 2 weeks now and I often vomit up bile because of it, and if I'm not vomiting, I'm dry heaving. I don't have health insurance but I do work full time and go to school, so this is really affecting me as I can't even make it into work. I have no desire to eat anymore (and haven't been eating, sometimes I can keep down applesauce but thats it), I barely can keep down water.

I saw my doctor and my blood work, abdominal sonogram, and breath test (for h. pylori) all came back normal. He prescribed me reglan and OTC prilosec which I can't take because I can't swallow/keep it down. I find i'm becoming extremely sensitive to smells, someone made coffee the other day and the smell (which I normally love) made me vomit.

I can't lay down so I cant really sleep. When I do pass out sitting up I wake up within a few hours still nauseous. I have shoulder and back pain but I always have that (from herniated discs in my neck) so I'm not sure if it is a symptom. My stomach right under my rib cage from the middle to the right is tender.

Any suggestions for what the cause is or how to prevent this?

[geminigirl1963]

Great news!!!

[TattooOfSun]

I think i'm back to being at 100%. I am going into work today and I feel great! So happy to be well again!

[geminigirl1963]

You're more than welcome and so glad that you're feeling better after getting some sleep!

You're probably right about the heartburn being from all the vomiting - and also lack of anything else BUT stomach acid in your stomach.  Definitely be sure to have the head of your bed elevated tonight so you dont' get a lot of reflux and make the heartburn any worse.

If you can take it and have some on hand, maybe try a little bit of Pepto Bismol tonight too - it will help with any lingering nausea and also hopefully coat your stomach a little to cut down on the heartburn.

Get a good night's sleep and hope you're feeling chipper in the morning!

[TattooOfSun]

While waiting for someone to wake up so I could get them to take me to the ER, I passed out and slept for about 5/6 hours and I felt great when I woke up. Nausea was gone, no headache, it was amazing. I had 2 pieces of toast, drank water and gingerale, and just had a little oatmeal for dinner.

I have some heartburn now, which I've never really had before. I am thinking its probably due to all the vomiting I've been doing which is irritating my esophagus.

I honestly feel so much better tonight! If I'm sick again in the morning I'm definitely going to the ER, I will ask about the PICC line. The doctors always tell me that I have good veins (I always donate blood when I can) so hopefully it won't be as much as a problem for me.

Again, thank you so much for your advice!

[geminigirl1963]

I think the right decision is to go to the ER - even for a virus, this seems to be going on for an exceptionally long time with no improvement other than a couple of hours.  Take it from first hand experience, you do NOT want to get seriously dehydrated to the point of them having to give you IV potassium.  I definitely don't want to alarm you, but IF you go and find out they do need to give you potassium through an IV, ask them if they could possibly give you a PICC line before starting the potassium.  A PICC line is basically a fancy IV that is inserted under xray guidance and can stay in place for extended periods of time.  They can not only give you fluids and meds through the PICC line, but they can also draw blood through it (it has two ports).  The reason I'm suggestign this is that IV potassium is VERY irritating to your veins and with a regular IV, they need to have the drip EXTREMELY slow or else you'll experience a lot of pain as the potassium goes in.  With the PICC line, you feel nothing.  I also like a PICC line because it means that it's one needle stick for insertion and then I dont' have to worry about additional needle sticks for blood draws, meds., etc.  I'm always a hard stick anyway, but if I'm dehydrated, it's even worse.  Dehydration definitely makes it harder for them to start an IV or draw blood.

I also am glad that you decided not to drink the Ensure or Boost after reading the post on them.  I honestly hadn't tought about the fat content in them, only if theyc ontained dairy.

At this point, I really am thinking that it could very well be gall bladder related, so if you go to the ER, please ask them if they could check your gall bladder.

I hope you get to feeling better real soon - it's no fun being sick, especially at this time of year.  Keep me posted on how you're doing :)

[TattooOfSun]

I think I jinxed myself. Now I can't seem to keep down water, I thought I was through the worst of it since I was able to keep down 3 pieces of toast yesterday. I will probably head to the ER once someone is awake to drive me. I'm so sure that I'm badly dehydrated. I keep having to put ice cubes on my head as well because it feels like its on fire but when I take my temp it shows 96.8.

I did not drink any boost or ensure because they looked like it would not be good for me at this point, and after reading Jax555's post I'm really glad I didn't. I prefer gatorade anyway.

I lost 6lbs in 1 week, best/worst diet ever. At least this has inspired me to take better care of myself and really be aware of what I'm eating now.

Again, thank you for sharing your knowledge, I really do appreciate it.

[Jax555]

I dont suggest Boost or Ensure, I have been struggling with this for 6 months now, I am scheduled to get gallbladder out, the Ensure made me vomit more and gave me bad pains on my right side (sometimes during HIDA scan they give you one of these drinks because they are high in fat to make your gallbladder react, so if there is a chance its gallbladder i do not suggest those drinks)

[geminigirl1963]

No need to thank me for anything - I'm just glad that you're feeling a little better this morning.

The dizziness does concern me a little - that could possibly be a sign that you're getting very dehydrated, so please do your best to get some liquids in, preferably something like the gatorade, boost or ensure that your mom suggested.  Those are good suggestions, however, make sure that they don't contain milk or dairy products, as milk and dairy can actually cause more nausea sometimes.  I've never used the Boost or Ensure myself, so I don't know much about them.

Take whatever you decide to drink VERY slowly - even a couple of teaspons full every 5-10 minutes and being able to keep that down is better than trying to drink several ounces of liquid at once and then vomiting.

As far as the Gatorade popsicle, you can either make your own at home - it doesn't even have to freeze solid if you prefer it more slushy.  They also do sell electrolyte freezer pops usually in the baby food/children's aisle - these, of course, would also have to be frozen, but would give you the convenience of being able to just grab one ice pop at a time.  I usually just make my own Gatorade slush at home (I like it even when I'm not sick!)

If you start showing signs of severe dehydration:  little or no urine output (or VERY concentrated, dark yellow urine) for 8 hours, sunken eyes, your skin not "bouncing back" when pinched on the back of your hand, rapid heartbeat - then you definitely need to either be seen again by your gastro doc or go to the nearest ER - it could be that you would need an IV for IV fluid replacement.

I hope you continue to feel better!

[TattooOfSun]

I elevated the bed last night and slept through the night mostly! I already feel a little bit better this morning as I did not wake up at 3am to throw up, so that is a big improvement. I tried to drink water but it didn't stay down very long. I like the Gatorade popsicle suggestion, I'll see if I can get someone to bring me some since I'm so dizzy/weak from not eating. My mom is telling me to get some boost or ensure to drink for the protein.

Thank you so much for your help and concern. I really really really appreciate it!

[geminigirl1963]

So glad to hear that it appears that it's nothing serious and hopefully you're on the upswing of getting better.

Take it slow on the gingerale, as well as the applesauce - small sips often is better than drinking a lot at one time and possibly then vomiting it all back up.  Another good thing, if you can drink it, would be gatorade or something along that line - that will not only give you liquids, but will help you replace some of the electrolytes that you're losing with the vomiting.  Again, take it slow on that also.  I've even, in the past when I've been sick, poured some gatorade in a cup or bowl and frozen it and then eaten it like a popsicle, so that might be something that would add a little "difference".

When you're able to tolerate it, also start back on solid foods slowly - small amounts of soft, bland foods at first and then gradually work back to your normal diet as you can.  While it's frustrating to not be able to eat, it's much more important to drink and get fluids into yourself so you don't dehydrate.  Dehydration alone can make you feel nauseas and sick, so that can be a vicious cycle.

I hope you get to feeling better real soon!

[TattooOfSun]

Thank you so much, I actually bit the bullet and went to a gastro today. He said that he saw 3 other patients with the same exact symptoms and that it is just a virus going around and only lasts 10-14 days. I'm on day 12 now so I'm really hoping this will pass soon.

I am definitely not pregnant, so that was ruled out first by everyone. Definitely going to take your suggestion about propping up my bed. I'm also trying to stomach gingerale. I've been having teaspoons of applesauce here and there, but not more than one teaspoon full every few hours.

[geminigirl1963]

My first guess,and I'm presuming your doctor testing for it - would be pregnancy.  Pregnancy can not only cause nausea andvomiting, but also some women do report experiencing a change in sense of smell.  So first off, if you haven't already had a BLOOD pregnancy test, I would strongly suggest you get one.  I'm suggesting a blood test for it because if you are pregnant, but not very far along, the results of a urine test might not be accurate.  I realize you had an abdominal ultrasound, but unless this also included a pelvic ultrasound, a pregnancy probably would not have been detected.

Another idea I had is possibly gall bladder related.  That can cause the n/v that you're having, as well as shoulder and back pain.  A HIDA scan would be a more accurate test for teh gall bladder than an ultrasound.

I would definitely suggest following up again with your doctor and making sure that you get that pregnancy test done.  Did you see a gastro doc or your PCP (primary care physician)?  If you haven't seen a gastro doc, I would also suggest you do - they are more knowledgeable about problems with the digestive system (presuming your pregnancy test comes back negative).

In the meantime, if your doctor hasn't prescribed you anything for nausea, I would give him a call and ask for something - explain to him that you're even having trouble keeping liquids down and you're concerned about getting dehydrated.  There are many good anti nausea meds out there and some of them are very inexpensive.  One of the ones that works quite well for me is phenergan.  A couple of "newer" ones, Zofran and Anzimet, are both also very good, but they are expensive and not all insurances are covering them yet, so you may want to check with your prescription insurance coverage before you call your doc so that you know which ones they do cover - that could avoid having to go back to your doc, get a different script, back to the pharmacy, etc., etc.

Some non-medicinal things you can try for the nausea are definitely sticking with a soft, bland diet - gingerale, 7-up, broth, jello, applesauce, popsicles - start with those and then slowly add in things such as scrambled eggs, rice, oatmeal or cream of wheat.  Definitely stay away from caffeine, spicy foods, fried foods and acidic foods (such as oranges or orange juice)

I would also suggest elevating the head of your bed about 4-6 inches.  This could help if you've got any reflux going on (this can cause nausea and vomiting).  I suggest raising theend of your bed as opposed to just using extra pillows for a couple of reasons - the pillows tends to shift during the night so they may not be in the proper position to keep your upper torso elevated and also with using extra pillows in bed and using those to prop yourself up, your upper stomach area is actually in a crunched position, with some pressure on the abdominal area, which could actually increase reflux problems.

I hope you feel better soon - feeling nauseas all the time is definitely no fun!  Let me know what you find out!