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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29659
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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For the past five days Ive had almost constant nausea to

Customer Question

For the past five days I've had almost constant nausea to the point where I can't eat any solid foods. I had diarrhea the first day only. Now I can only drink liquids sometimes usually w/o getting nauseated. I've tried crackers and rice cakes but after a few bites I feel as though I'm about to gag. I had this same problem earlier in the year and was diagnosed with a few things...Lactose Intolerance, Bacterial Overgrowth, and inflamed intestines. I was put on Nexium for two months and an antibiotic for the Bacterial Overgrowth for two weeks. I was fine there after. Now it seems as though the prolonged nausea has returned. I've already lost 5 lbs in just these five days and am living off of water, soda, and tea with the occasional pretzel or cracker. I'm getting nervous because when I went through this before I lost 20 lbs in 3 weeks but I could barely get out of bed since I didn't have any energy. I have 3 children to take care of so I'd like to get answers ASAP. I'm making an appointment with the GI doctor on Monday to see how we should proceed but I'm worried he won't have any answers for me. I'm also starting to get headaches which I'm assuming are from not eating properly. Any idea of what this may be or what I should look into as far as testing. So far I've had an Endoscopy, Colonoscopy, HIDA Scan, and the Hydrogen Breath Test. Please any information at all would be greatly appreciated. This has become very debilitating and annoying.
Submitted: 4 years ago.
Category: Health
Expert:  Pauline replied 4 years ago.

Hello, can you list all your medication for me?

What was the antibiotic?

Any dizziness or other symptoms?

Customer: replied 4 years ago.
The only daily medication I take is Lexapro which I've been on for the last year. When I went to Patient First I was put on Dyclomine for two weeks. Then the GI doctor had the following tests run. Sonogram, HIDA Scan, Colonoscopy, Endoscopy, Pill Cam, and the Hydrogen Breath Test. From there I was put on Nexium for two months.
Xifaxin was the antibiotic used for the Bacterial Overgrowth.
I've had no dizziness. Other then only a very short bout of diarrhea the first day I've had increased gassiness when I do try to eat solid foods which is only a couple crackers or pretzels here and there. I suffer from migraines which I treat with OTC meds. The headaches have been coming and going more frequently so I've been taking Motrin to help aid in that so that they don't turn into migraines.
Expert:  Pauline replied 4 years ago.

I would like you to switch from Motrin to tylenol for the headaches, motrin can irritate the stomach lining and may be adding to the problem.

 

Nausea was a common problem with xifaxin, although you are no longer on this. The other thing to check is whether there is any possibility of pregnancy.

 

Start to introduce food slowly by using soups and milkshakes for calories. You may need to have another anti-emetic such as prochlorperazine added to see if this helps.

 

Customer: replied 4 years ago.
My husband has had a vasectomy so there is no possibility of pregnancy. My concern is I'm not sure where the nausea is coming from. I haven't been on the Xifaxin for over four months. I think the headaches are just a side effect from not being able to eat. Will Tylenol be better on my stomach for the headaches? Are there any other tests or conditions I can ask my doctor about?
Expert:  Dr. Arun Phophalia replied 4 years ago.

Greetings.

 

Chronic nausea is usually a pathologic response to a variety of conditions. Gastrointestinal etiologies include obstruction, functional disorders, and organic diseases. Central nervous system etiologies are primarily related to conditions that increase intracranial pressure, and typically cause other neurologic signs. Numerous metabolic abnormalities and psychiatric diagnoses also may cause nausea and vomiting. Evaluation should then turn to identifying the underlying cause and providing specific therapies. When the cause cannot be determined, empiric therapy with an anti vomiting (antiemetic) medication is appropriate. Initial diagnostic testing should generally be done by basic laboratory tests and plain radiography. Further testing, such as upper endoscopy (done in your case) or computed tomography of the abdomen, should be determined by clinical suspicion based on a complete history and physical examination. Apart from CT scan following may be prudent;

 

1) Gastric emptying time

2) Stool culture

3) Liver scan

 

The causes of nausea can be;

 

A. Central nervous system

1) Migraine

2) Space occupying lesion in brain (Mass lesion)

3) Labyrinthitis

4) Ménière's disease

5) Pseudotumor cerebri

 

B. Gastrointestinal symptoms;

1) Gastroparesis

2) Irritable bowel syndrome

3) Non ulcer dyspepsia

4) Peptic ulcer disease

5) Cholecystitis/cholangitis (gall bladder problems)

6) Hepatitis (liver inflammation)

 

C. Hormonal

1) Thyroid disorders

2) Diabetes

3) Adrenal disorders

 

D. Psychiatry disorders

1) Anxiety

2) Depression

3) Conversion disorders

 

E. Infections.

 

So, just your migraine can be responsible for the persistent nausea. Your physician may also consider blood work for thyroid and adrenal dysfunctions.

 

Please feel free for your follow up questions.

 

Dr. Arun

Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29659
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
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