persistent nausea and UC

Very first post here. I am at my wit's end! My daughter has had persistent nausea since 1st week in May. Every test under the sun has been done. H-pylori, US Abd/pelvis, Gastric emptying test, EGD (showed inflammation of esophagus and stomach but no ulcers), the full gamut of bloodwork. Started on Nexium and Protonix. Within 4 days of being on these meds she developed diarrhea, vomiting, fever, and was admitted into the hospital where she was diagnosed with UC after colonoscopy. After discharge from hospital she was weaned off steroids and taken off the protonix and Nexium. Within 10 days the nausea was back. Nothing helps. They have given her Reglan, Zofran and Compazine and restarted Protonix, Nexium and steroids. Sent for MRI Brain, Hida scan with ejection, and sinus x-rays. All negative. What is going on??? Can anyone help???

Please read the resources thread at the top of the page.

i presume the uc diagnosis was confirmed from biopsy samples ?

does she get the nausea at certain times of the day ? morning/bedtime/ , before/after BM ?

maybe she shouldn't have gone off protonix and Nexium so soon !

is she staying in bed or very relaxed/inactive for an extended periods ? activity could help with certain types of nausea

also adrenal gland suppression from steroids causes nausea and other symptoms, arcalion 200 could help boost her energy until the glands are back in action

Post Edited (Dreadsteel) : 10/10/2014 1:55:17 PM (GMT-6)

After biopsy she was diagnosed with Crohn's but the Promethius test said it is UC. She is currently in a flare up. She is definitely swollen in the rectum and has pain on left side and upper abdomen. She is on Azulfidine 2, 3X a day, Protonix in am, Zantac at night, VSL at night, Canasa at night, Compazine 3X day. Is currently constipated and feels like razor blades in rectum when a little does come out. She is unable to eat in the morning due to severe nausea. Eats ok in afternoon then very little at night again due to nausea. We have her on low residue diet and off dairy even though biopsy of EGD said not allergic to lactose or gluten.

soystud said...
hey mom - so sorry that you and your daughter are having to deal with this -

just one question - could you expand on this ?

"biopsy of EGD said not allergic to lactose or gluten."

i'm dumb as dirt so that's probably why this is news to me that they can do that ???

My original post is at top of page. This post was in reply to a question another member asked.😊

Hi..welcome to the forum.

I agree that the azulfadine could be part of the nausea, maybe a change in the oral 5ASA could help.

Another is that she's not on enough rectal meds to deal with her UC inflammation at this point. I'd suggest a retention enema at night and the Canasa during the day.

How old is your daughter?

What were the results of the liver function testing? Any of the readings high?

q

in addition to what others said

you just resolved it by saying 1-she's constipated 2- Eats ok in afternoon

sounds like the inflammation + constipation might be aiding in increasing her nausea

constipation :
-she could try some suitable laxatives (consult her Dr.), or even better eating iceberg it helped me
-motility regulators (also consult her Dr.)
-exercise even walking for 30min could help regulate the whole GI tract
-drink copious amounts of fluids

i have a feeling those low residue trends are actually worse to the colon, since she is not basically covering inflamed parts with medicine since mesalamine/mesalazine is a topical one and causing slow intestinal transit time.

inflammation :
- as others said oral 5ASA could help better than Azulfidine
- "Can you tell me what a retention enema is?" basically the anti-inflammation medicine ( mesalamine/steroids) in liquid form applied via a prepared bottled rectal syringe, which will help her tremendously also suppositories will help with rectal inflammation.


nausea :
- i am sure you know but i have to say it, zantac/protonix ..etc stomach medicines should be taken before food on an empty stomach and to not to eat after taking it by at least ~30min
- stay away from smelly foods/perfumes ..etc -if its nausea time-
- as i said previously exercise
- divide meals into smaller portions
- a multivitamin or anything to boost her energy (but not sugar)

Post Edited (Dreadsteel) : 10/11/2014 5:12:08 PM (GMT-6)

Seems a common topic lately. Yes, nausea can be a terrible consequence of UC. It affected my daughter greatly, and caused damage to her esophagus and teeth. Took Zofran in the tough times, and a PPI (still). It seems aligned with pain. The nausea control center is in the brain. Some have been even helped with antidepressants, tho I cannot remember the suppressive mechanism. Over time we blamed most every drug, and still not sure what the root cause was, but treating the symptoms helps to get on with the healing.
Sounds like the UC needs more aggressive treatment. Where was the inflammation, and why the UC/Crohns debate...because of the esophagus inflammation or other info from the colonoscopy?

Katmom - I am not totally convinced it is just UC because of the unexplained inflammation of esophagus/ stomach. Not one medication (Reglan, zofran, or Compazine) has helped. On PPIs as well. She has pan colitis and Canasa not entirely helping either. I can tell severity of inflammation when inserting Canasa. Just wish she could get relief from the constant nausea.

Just my two cents, but getting the UC under control will help the nausea. Pan colitis is a big deal. Is your GI working hard on this? Fever? Why... It's not the UC talking. Is it gone? All other blood work ok, ie SED rate? I feel your pain. Once when my daughter came out of an endoscopy, she cried that they didn't find much, she was so distraught that there weren't signs for the horrible puking symptoms. Something concrete is hard to find. I hope you are with a high level IBD GI. Young people tend to get an aggressive form of this.Glad you are here. Keep us posted.

As others have noted, nausea is a big part of UC for some of us. I have pancolitis & when flaring have severe nausea. Getting the flare under control helps the nausea lessen immensely. She may have had inflammation brewing for those 4 mos prior to diagnosis, hence the nausea. Also, constipation causes nausea. A low residue diet is easier on the stomach, but can be constipating. Of course when I flare I never get constipation (a sip of water has me running for the toilet), but I know several people with Crohns & constipation can be fairly common with crohns. Some of the drugs add to the nausea (prednisone) so it is good that she is on a PPI. To be honest, even when I'm not flaring I get mild nausea from time to time. Never had that pre-UC. Could be a side effect of the meds, could be just having UC has changed my digestive system. However, I think the debilitating nausea is due to the flare.

I think they are doing the right thing with running all the tests & prescribing appropriate meds for nausea. It is great that the tests are coming back negative, though frustrating b/c you want an answer. I had endoscopies done for my nausea as well. Revealed nothing but slight gastritis.

Do you have a copy of the pathology report? I'm a little confused. You say she has pancolitis but the colonoscopy revealed crohns. Btw...I would go with the dx from the pathology report. This is a little conflicting. Crohns has skip sections of inflammation. Pancolitis is total colon involvement. Was she checked for crohns in her small intestine? Could she have nausea & constipation due to a blockage in the small intestine?

I agree with others that state rectals twice per day. Canasa & an enema if she has inflammation in her sigmoid. If its just in the rectum then canasa is fine.