help! suffering ongoing nausea...

[kani]

Hi. I am 17 year old guy. I currently live at home, and begin university in a couple of weeks. I don't smoke, I don't do drugs, and I've hardly been drinking at all lately for reasons given below.

Last August I got sick. I felt sick most mornings, and for a week or two I was too unwell to attend school before lunchtime. I vomited a few times, and felt generally lousy for a couple of weeks. I don't get sick often; only perhaps once or twice a year. Despite eating what I want (mostly healthy) and not excerising, I am in excellent physical shape (fast metabolism or something).

Ever since I got sick, I've had recurring nausea (and acompanying diorreha), most frequently triggered after a large and/or fatty meal (or even the smallest amount of alcohol). It is also triggered when I am nervous, especially when it's cold. Fizzy drinks don't help either. I still feel sick first-thing most mornings, but not as seriously as in last August. I burp lots, and occasionally have trouble swallowing. The nausea occurs most frequently first thing in the morning, and late at night.

After most meals, all I want to do is sit down for a few minutes. Twice I've (recently) vomited at parties (one after a beer or two, one without - I know the alcohol was not entirely to blame), where I have had nausea creep up on me. Nausea is possibly worse than vomiting itself; I feel sick, depressed, irritable and completely unmotivated. All else around me ceases to matter; all I want to do is remain completely still and stop moving, thinking and speaking. People close to me (ie, friends standing around etc) annoy me; I just want them all to shut up and leave me alone.

I've seen my doctor a few times about this whole thing, and each time I've come away with (progressively strong) antacids. Suggested causes for the nausea include gastro reflux, a hiatus hernia and even glandular fever. Currently I have a jar of pills called Ranitidine; I understand it's an antacid stronger than Gaviscon (the last one my doc prescribed). It doesn't seem to be doing much.

This whole nausea thing has not interfered with my work or study. It has however interfered with my social life; I can't stay out late at night with my friends, and even tonight I had to leave them early to go home, because I felt rotten. It has definitely degraded my quality-of-life.

Has anyone heard of anything like this before, or better yet, can offer a solution to my problem? It has been ongoing for 6 months now, and I'm uttlerly sick of it. Help!

PS: I HAVE been to see my doctor about it. Read the post. :P He also had me take a blood test (twice, once in August, once a couple of weeks ago); both came back negative for everything they tested for.

[zuzu8]

Kani-
It seems the doctor suspects, as you mention, GERD (gastroesophogeal Reflux Disease) which is incredibly common, and untimately treatable. Ranitidine is a well known treatment for it. However, since nothing seems to be working for you yet, have you considered seeing a gastroenterologist?
That would be my next step. Six months of fooling around with antacids with not much relief is 5 months too long! See a gastro specialist.

zuzu xxx

[butterflytrans]

Just to add to zuzu's beautiful post:

one thing that still can be tried before the gastroenterologist is consulted (they like it better if you try to characterize the problem before sending it...i.e. at least try to do some investigations). Ranitidine an H2 blocker which works well for some people, but it is not the best choice to treat uncontrolled GERD--assuming that's what you have. Your doctor should do a therapeutic trial with a PPI (proton pump inhibitor) like omeprazole or pantoprazole (Losec and Nexium I think is the second one's brand name). These drugs are stronger because instead of "dimming the switch" of the "machine" that makes acid in your stomach, it totally turns the machine off. This is better for people with extreme GERD. But once again, I'm not totally convinced that you have GERD.

Do you have a chronic cough?
Is the nausea worse if you lie down?
Do you ever get heartburn?
Do you drink coffee or drink caffeinated sodas?

The other thing that piqued my interest is what you said about your body's reaction following a fatty meal. You might want to get some liver enzymes done (specially alk phos and GGT) to see that there isn't something going on with your gall bladder.

Have you lost a lot of weight recently?
Do you ever notice oil droplets in your stool?
Has there been any change in the colour of your stool or urine? (i.e. lightening of the stools and darkening of the urine).
Does the diarrhea go away if you stop eating?

There is so much that can be going on, and these things should be ruled out.

One awesome thing that you have on your side is the fact that you're 17....that makes more serious things less likely.

Could you please answer those questions for me?

[butterflytrans]

...though I must comment that you DO have some of the symptoms of GERD, so I just want to make it clear that I'm not saying that anyone's wrong for thinking that! I just think it's important to rule out other things.

...and in the future if anyone ever tells you that you have irritable bowel syndrome (which is also a possibility seeing as you're saying that being nervous makes it significantly worse) you should make sure that they have considered other possibilities first.

[zuzu8]

Just a note to Butterflytrans-
Awesome post! Your questions sure seem to cover all the bases. ( I Hope Kani's physician asked the same!). Now I know who to come to next time my gastrointestinal system decides to play havoc with me!

zuzu xx