Following are the main causes of your symptoms (nausea, dry heaving, headaches) according to the various body systems;
A. Central nervous system
2) Space occupying lesion in brain (Mass lesion)
4) Ménière's disease
5) Pseudotumor cerebri
B. Gastrointestinal symptoms;
2) Irritable bowel syndrome
3) Non ulcer dyspepsia
4) Peptic ulcer disease
5) Cholecystitis/cholangitis (gall bladder problems)
6) Hepatitis (liver inflammation)
1) Thyroid disorders
3) Adrenal disorders
D. Psychiatry disorders
3) Conversion disorders
Chronic nausea is usually a pathologic response to any of a variety of conditions as we had discussed above. So investigations like CT scan of abdomen, MRI of the brain are necessary for the further work up. Gastrointestinal causes 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. Pregnancy is the most common endocrinologic cause of nausea and must be considered in any woman of childbearing age, which has been ruled out for you. Numerous metabolic abnormalities and psychiatric diagnoses also may cause nausea and dry heaving. 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, hormonal evaluation or computed tomography (CT) of the abdomen too are necessary immediately with the significant weight loss.
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