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Confusion about Ongoing Nausea

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Posted 11/27/2010 11:02 PM (GMT 0)
I'm from the Lyme forum, and I have a number of medical conditions as outlined in my signature below. I need some help today from you guys regarding ongoing bouts of NAUSEA, presumably from GERD/mild hiatus hernia. I'd like to know if it would be prudent to ask my doctor for some more testing, and what tests should be performed.

Here's a bit of history:
I have suffered from bouts of mild to severe NAUSEA since 2003. I rarely suffer from heartburn. I sometimes get regurgitation into the mouth. An Upper GI Series done in 2004 revealed "marked GERD."

I have been taking Prevacid since 2004. (Currently two capsules daily.)
An endoscopy done in 2009 revealed a "mild hiatus hernia." The GI Specialist who performed the endoscopy told me that my ongoing problem with nausea was probably related to the hiatus hernia.

I have not seen another specialist nor had any further testing done, aside from the colonoscopy which was performed on the same day as the endoscopy.

These bouts of nausea can last anywhere from a couple of days to nearly two weeks. The last time I asked my GP about how to control the nausea, he recommended Gaviscon + Xylocaine, which is somewhat helpful, but only for about an hour. The current amount of time between bouts is a couple of weeks at most. The nausea can be quite debilitating, which is why I'm reaching out to others on H/W for some advice.

Thank you for your help!
Posted 11/27/2010 11:19 PM (GMT 0)
spaztik,

Hello and welcome.

Gaviscon + Viscous  Xylocaine is an old cocktail we used to give to the patients in the ER to treat heartburn or epigastric pain.  To the best of my knowledge it never treated nausea.

May I suggest that you see a GI specialist as you were dx with GERD in 2004, going on 6 years ago.

You are sure to hear from other members re you concerns.

Kindly,

Kitt

 

Posted Yesterday 12:10 AM (GMT 0)
It sounds like your LES is weak. I'd go back to the GI and discuss your problems. Meanwhile you can prop the head of your bed up 6-8 inches. It will help with nighttime problems.
Posted Yesterday 1:13 AM (GMT 0)
Thanks, Kitt and Joy.

What I'd like to know: What tests are normally recommended? I know my problem is long-standing; however, this year, 2010, has been more troublesome than in the previous couple of years.

I have read the information posted on the forum, and I have read about others' experiences on this forum, but I need to know what tests a GI Specialist would normally order for my problem.

I have been unable to remedy the onset of nausea with changes in my diet; however, I have never been one to eat a lot of fat, sugar, spices, etc. so there isn't much wiggle room left. Gravol, Tums, herbal teas, etc. are ineffective. I was Rx'd Motilium and another drug in its class a number of years ago when I also suffered from IBS, but I suffered from an adverse drug reaction (more nausea, restless legs, agitation).

The GI Specialist I saw in 2009 did not give me much information at all, aside from saying that the nausea may be caused by the mild hiatus hernia. I have been reading about GERD and its relation to hiatus hernia online.

Joy, aside from taking drugs like Prevacid, or surgery, what else can one do about a weak LES. I don't get problems at night, but I am diligent about NOT laying down after eating. Even if I don't get problems during night time, would elevating the bed help with daytime nausea?

Thank you for your help, and I look forward to others chiming in.

Cara
Posted Yesterday 1:15 AM (GMT 0)
PS - The "Pink Lady" cocktail just numbs the stomach temporarily which slightly relieves, but does not cure the nausea. I'm smart enough not to use copious amounts.

Any recommendations for relieving nausea?
Posted Yesterday 1:23 AM (GMT 0)
zofran or phenergan. Since the nissen in 08, zofran has been my best friend. I still take it, because I still get nauseated, it's a chronic thing for me now; it seems, at least in my case, that it's a side effect from the surgery.
Kitt and Joy are correct; you need to get to a GOOD GI; what sort of tests? A 24 hr ph is standard as is manometry and a barium swallow; not be surprised if they want to do an EGD to check things for themselves. At the very least, though, is the 24 hour ph; an irritating, but very informative (for the Dr.) test that will help them proceed.
You mentioned no symptoms when your lie down; I didn't have any symptoms, yet that is when the maximum damage was occurring for me; it was silent.
Where do you live?, finding the right doctor, from the start, is important and if nothing else, call your family practice dr and get some phenergan or zofran.
Good luck.
Janice
Posted Yesterday 2:41 AM (GMT 0)
I hate to say it but the only thing to help a weak LES is the surgery. It's not closing proper so it needs to be tighten up. It will always leak until it's strengthen. A mild leak can be managed with medicine, but a major leak like you're describing can't be cured by medicine alone.
I had silent GERD. All I had was a constant cough with an occasional burn or pain. I had to cough because the acid was coming up into my lungs.
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