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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 34672
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I have been nauseous and dry heaving for almost a month now.

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I have been nauseous and dry heaving for almost a month now. I have been seen by 4 different doctors with no results. I can't eat or go to the bathroom and I am very fatigued. I have had pregnancy tests and blood work by all doctors I have seen. What is going on with me?

Greetings Michelle .

I am sorry about your prolonged symptoms.

Do you have seen any specialist?
Any abdominal pain, tenderness in abdomen, headache, dizziness, evening rise of temperature, weight loss?
Any significant past medical history or surgery?
Are you on any kind of medications / herbs / supplements?

Dr. Arun

Customer: replied 4 years ago.
I do have lower adominal pain, no fever of any kind and frequent headaches. I have not seen a specialist, only ER doctors and my Primary Doctor. No major past medical history.
Customer: replied 4 years ago.
Also, significant weight loss. I've lost 25 lbs in the past 3 weeks.
Hello Michelle,

Following are the main causes of your symptoms (nausea, dry heaving, headaches) according to the various body systems;


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.


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.


Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

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Dr. Arun Phophalia and 4 other Health Specialists are ready to help you

You may do following;

1) Seek a referral for a gastroenterologist initially. IBS, gastroparesis are one of the likeliest causes for your symptoms.

2) Also get a referral for a neurologist and internal medicine specialist.

Your primary care physician meanwhile can get the blood work, CT scan of abdomen and MRI of brain.

Thus while waiting for the appointments, your initial screening would be complete and hopefully diagnosis would be achieved.

It is privilege assisting you.

Please feel free for any further questions, anytime. Follow up questions do not incur any further cost.