Problem solving for unpredictable nausea

I would be seeking an explanation of why you are suffering with this debilitating nausea at the end of the day. It sounds quite bizarre and not within normal expectations.

Jan

Hi Jan Dollar, I've been away from the site for awhile. It's good to know you are still here.

Yes, I am working with my GI dr. I will have another meeting with her this week. My symptoms are nausea day-after-day, initial vomiting, chills, sweats, no fevers, fatigue, foul-smelling flatuence, diarrhea, cold hands/feet. My sed rate is only slightly elevated, other labs are within normal range. Zofran doesn't even take the nausea away. The nausea seems mild but constant.

Got any ideas Jan?? Thanks!

Just the usual suspects: gallbladder, pancreatitis, dyspepsia, GERD, partial obstruction at the stoma site, SIBO (small intestine bacterial overgrowth). Those sorts of things.

Jan

Gastritis can also cause nausea, and the "end of work shift" timing might mean the stomach is empty, which (if true) could help pin down the diagnosis. But lots of things can cause nausea, including medications.

Jan,
I have reoccuring nausea (every 2-3 weeks) that has me vommitting for 2 days. At which point I'm very fatigued, muscles cramping, head aches, and dehydration.
When I go to the hospital, zofram and maxram can't control the vomitting and it's just a matter of time before I slowly regain an appetite.
I think I have some kind of overgrowth in my pouch/small intestine. How can you test for that so that I can know for sure? What is the treatment for SIBO. My other hunch is a partial blockage however, xrays have always come back negative for an obstruction. Can some blockages go undedetected???
This nausea has been going on for 9-12 months. My GI drs are puzzled and family dr doesn't have any solutions. I feel very unsupported in trying to figured this out.
Any ideas/thoughts would be appreciated. I really need some ideas about tests that could give insight. Bloodwork is always OK.

It would be very unusual for an obstruction to cause vomiting without pain. You could try 3-4 weeks of Zantac or Prilosec and see if it helps (since diagnosis is proving elusive).

Yes, a partial obstruction would not cause vomiting, unless it was very high in the GI tract, like closer to your stomach. There are tests for SBIO, with the hydrogen breath test being most common.
http://en.wikipedia.org/wiki/S...bacterial_overgrowth

Partial obstructions can defy detection by imaging, and even early full obstructions, but this does not sound like it.

Since treatment is antibiotics, you can ask for a trial course of Flagyl or Cipro (I recommend Flagyl to lower risk of C. difficile infection). Same treatment as pouchitis, but your symptoms are not consistent with pouchitis.

Then, you can maintain with probiotics and drastically reduce the carbs in your diet, particularly sugars.

It still could be gallbladder related, but eventually, that would become evident.

Jan

PS Jasper, after reading your PM, I see that you are a long term antibiotic user, so at increased risk for SIBO, particularly C. diff, so you need to rule that out before more antibiotics. A long shot, but worth considering, especially with your episodic presentation is CVS http://digestive.niddk.nih.gov/ddiseases/pubs/cvs/

I take cyclizine for nausea - zofran made me feel sick - especially the melts (yuk!!)

I started this post and want to update you. I had two episodes of sudden sweating, nausea about three weeks apart. After an extensive work up by my GI with CT scan of the abdomen, multiple blood draws to test for mono, vit d deficiency, CMV, sed rate, we did not find a specific diagnosis. My primary doctor said it could have been the stomach flu which can get better and then get worse again.