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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 31250
Experience:  Over 20 yrs of Family Practice
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CYCLICAL VOMITING SYNDROME I am a 38 year old female that

Customer Question

I am a 38 year old female that has had cyclical flu-like symptoms for around three years. The episodes are very cyclical occurring between 5 to 10 days; I can't identify a trigger except that it is on a cycle. The symptoms are of almost the exact same intensity each time ad although the cycles seem to change over the three years. They stay on the same relative cycle for a few months. For example, sometimes I could almost predict the day and the hour the episode will occur. The amount of activity I do does not seem to influence the symptoms. The symptoms are almost a step below the flu. I am nauseated but I can hold down food; I do not vomit. I am more fatigued but not as fatigued when I have the flu. I have chills and feel feverish but my temperature usually is normal or at most an extremely low grade fever. I have increased bowel movements but not diarrhea. Only sometimes will I have a mild headache. Outside of that I have no pain. The most severe symptoms I would say are the nausea and fatigue.
I do get this slight sometimes pulsating ear pain before the other symptoms come. The ear pain is not bad it just seems to be a precursor to the other symptoms
I have had almost every tests you could imagine and treatments for gastritis and my gallbladder removed. During the tests they also found out I had thyroid cancer and my thyroid was removed. I was diagnosed at the Mayo Clinic with central sensitization disorder a disease related to chronic fatigue and fibromylagia. After the Mayo Clinic I changed doctors to an internists that was more familar with chronic fatigue and prescribed Cymbalta as suggested by the Mayo Clinic. It may be to early to see if the Cymbalta is helping. However, the internists is perpelexed he has never seen cyclical symptoms that seem to occur on a set schedule with chronic fatigue or fibro. He has never seen nausea being such a factor in chronic fatigue and my fatigue is not nearly as severe as people with chronic fatigue. He ordered some heavy metal screening and was wondering if something in my body was getting inflamed so he had me take some advil when the symptoms were starting.
I've ran across this disease called cyclical vomiting syndrome. At first I did not think it applied to me because I did not vomit. However, as I read further its characterized by cyclical flu like symptoms which usually includes vomiting. Lethargy and fever could be part of it. Like with my symptoms the episodes usually have the same intensity, occur at the same time of day, and between episodes the person feels normal.
Do you think my episodes could be a minor form of cyclical vomiting syndrome since I have nasauea but there is no vomiting. If so are there any tests that could confirm this?
Thank you for your time
Submitted: 1 year ago.
Category: Health
Expert:  Dr. Chip replied 1 year ago.
Hi--two questions--

Did you have a gastric emptying study and did you have an MRI of your brain?
Customer: replied 1 year ago.

I did not have a gastric emptying study. The only two things GI related I had was an endoscopy and a HIDA scan. Results were gastritris with the beginning of ulcers and a low functioning gallbladder (10%) Treatments were a gallbladder removal( and the gallbladder was diseased when they took it out). I also took omeprazole for my gastritis. In both treatments symptoms went away at first but than came back. However, the nauseau was never quite as severe as it was before they removed my gallbladder.

I had an MRI of the brain a few years before I the symptoms started due to a central vestibular irregularities. The MRI was probably like 5 to 6 years ago.

Expert:  Dr. Chip replied 1 year ago.
just to be sure--absolutely no abdominal pain with this?
Customer: replied 1 year ago.

No abdominal Pain whatsoever. Never any abdominal pain. Not any pain at all except the mild headaches and mild ear pain.

Expert:  Dr. Chip replied 1 year ago.
OK Laura.

I think the most likely diagnosis for you here is abdominal migraine without the abdominal pain. In general this can last from hours to a few days and it can be difficult to diagnose since there really are no specific tests for it--just going by the symptoms alone.

Migraine medications like Imitrex or tricyclic antidepressants like imipramine are usually prescribed for it.

Ask your doctors if they think I've nailed the diagnosis here and let me know if you need any more information