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My husband has been dealing nausea since his back surgery 3…

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My husband has been...

My husband has been dealing nausea since his back surgery 3 years ago. He had been to our regular doctor and a gastrologist. They did a scope down the throat and asaid their was a small hiatial hurnea but not bad enough to do surgery. They said every thing else looked good. He has had a colonoskpy and it was normal. He has been to a neuroologist for nuropathy in his ankles and feet. He was diagnosed with overactive stomach nurves. They put him on omeprazole in the morning and Nortriptyline HCL 10 mg 2 hours before bed. He also takes Ondansetron for nausea. They don't always work. He throws up and it is usually just foam. Neither of us feel like we are at the root of the problem and thought about coming to the Mayo Clinic. We live in Eugene Oregon. Do you have any suggestions?

Doctor's Assistant: What medications do you take daily? Are you allergic to any medications?

Not allergic to any. Other than the meds I already gave you he takes Valsartin.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

I think I have about covered it. When he had back surgery he was diagnoed with spinal steneous. They put a crows nest on 3 and 4. He has been on gabapentin and it didn't work. He went to OHSU and had a nerve conduction test which didn't show much of anything.

Submitted: 4 months ago.Category: Medical
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Answered in 2 minutes by:
3/19/2018
Doctor: Dr. Arun Phophalia, Doctor replied 4 months ago
Dr. Arun Phophalia
Category: Medical
Satisfied Customers: 38,756
Experience: MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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Welcome to Just Answer.
Answers here are for education and information.
I will respond shortly with an answer, or further information request.

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Doctor: Dr. Arun Phophalia, Doctor replied 4 months ago

The causes of nausea and vomiting are iatrogenic (doctor induced like medicines), toxic, or infectious causes; gastrointestinal disorders; and central nervous system or psychiatric conditions. Following are the main causes;

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. 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 computed tomography of the abdomen, should be determined by clinical suspicion based on a complete history and physical examination.

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