Brief Answer:
chronic nausea

Detailed Answer:
Good evening and thank you for re-posting your question. Sorry that you haven't gotten a satisfactory answer but it does sound like you may be getting some studies done to determine what your gastric emptying function is doing which may help solve your problem. It turns out that the problem you are having most of the time resides within the GI tract itself and most likely is found to be a situation such as either peptic ulcer disease, GERD, GI tract obstruction of some type, or gastric motility problem.

Since you have had the gastroscopy which was reported as normal then, we can be sure it is probably not any of the first 3 choices. You are still being worked up for the gastric motility possibility so we will need to wait on that to see what pans out.

However, as far as causative neurological entities one of the most common reasons for chronic nausea with or without vomiting would be increased intracranial pressure. Usually this manifests itself not only by nausea in the individual but also by way of headaches, dizziness, vertigo, and possible cranial nerve signs. If you wish to be seen for this aspect of things then, I recommend you seek out a neurologist who can do a thorough examination to discover whether or not there are positive neurological signs of deficiency to warrant some type of imaging study of the head such as an MRI, MRA, CT, or CTA of the brain to see whether or not something as hydrocephalus or intracranial hypertension might exist. Other signs of a central nervous problem could be constant or intermittent blurring of vision, double vision, or what are termed visual obscurations (things suddenly disappear and reappear especially when bending at the waist or doing anything that raises pressure in the head). There are also structural abnormalities that can cause blocks in the flow of CSF through the drainage system of the brain and if blocked can cause raised pressure and eventual nausea and vomiting. There is also a group of entities known as Chiari malformations involving the lower part of the brainstem and cerebellum getting trapped in a place called the foramen magnum causing these symptoms.

This would be my initial thought on what could be causing your problem from a neurological point of view, however, in my opinion since you already have an appointment with a GI specialist to look at GI motility issues (more common than brain issues when it comes to chronic nausea) I think that if it were me I would wait until getting the results from that test before trying to see a neurologist.

One other thing to consider may be an EEG of the head which is an electrical study that looks for epileptic discharges which may not be enough to cause any lapses in your status of alertness or seizures of a XXXXXXX nature but may be present enough to stimulate the brainstem and especially the floor of the 4th ventricle where the nausea and vomiting center resides.

Again, the fact that you're actually throwing up bile suggests to me that the trigger and stimulus to cause the nausea in the first place is coming from somewhere in the GI tract as opposed to originating in the brain but it is still worth thinking about.

I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. Feel free to upload more specific information regarding lab tests and diagnostic studies if done and I'll be happy to look at them in the context of your question.

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This consult request has taken a total of 52 minutes of time to read, research, and respond.

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