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What Is The Cure For Persistent Nausea?

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Posted on Tue, 17 Dec 2013
Question: Excessive nausea - history (its my wife) - 02/2012 started on vacation a cruise. Came back and saw our GP, he sent her to a Gastrologist, he did a stomach scoping, then a colonostipy and hen they settled on the XXXXXXX bladder removal. Non of which helped. She was on a by mouth cancer med and another gastrologist took her off the med. That seemed to help. It has been a year she was pretty good but not completely rid of the nausea. The beginning of Nov 2013 the nausea is back and out GP thought it was allergies but she has been on a generic Claraton now a couple of days with no change. Any ideas? (Never mind the spelling errors) They did try motion sickness meds but that didn't really help either. No Pain get the nausea. She is drinking ensure to stay hydrated. I attempted a call to the Gastrologist but the office is closed until Monday.
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Answered by Dr. T Shobha Deepak (2 hours later)
Brief Answer: aim for symptomatic relief with Ondensetaron Detailed Answer: Namaste Welcome to Healthcare-Magic Greetings of the day I do understand the difficult situation you seem to be facing . Till the time your Gastroenterologist is back symptomatic relief of her symptoms is important. Further investigation can later be carried out. I would suggest you to Put her on one of the antiemetic drug Like Tab Ondensetaron or Metoclopromide. Along with that addition of over the counter available antacid is also advisable. She will require further work up to rule out other causes of Nausea. Does she have only Nausea and no vomiting? As she has been thoroughly investigated by doing upper Gastrointestinal endoscopy to rule out gastrointestinal tract as the cause of symptoms, assessment of other systems which can cause similar complaints is advisable. I would like to know few more details to help me suggest you further 1. Is it just nausea without associated vomiting? 2. Have you found any relationship between symptoms and any particular posture like while getting up from bed? 3. Are there any associated complaints when she is experiencing nausea like tinnitus, ear ache, vertigo,dizziness, blurring of vision? Just isolated symptom of nausea could be due to affection of other systems too. Thorough evaluation of them may provide you with the etiology 1. ENT examination to rule out inner ear as the cause 2. Neurolgy examination- Intermittent raised intracranial pressure may also be cause of nausea I would suggest you to get her complete evaluation done by the Adobe specialist. It's unlikely that there might be any significant cause, but it will definitely provide the much needed reassurance. Wishing both of you healthy life Do get back to me if you have any other query Take care Regards Dr T Shobha Deepak MBBS MD
Above answer was peer-reviewed by : Dr. Shanthi.E
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Follow up: Dr. T Shobha Deepak (13 hours later)
Thank you for the input here is some more history and I recorded the last 1.5 years of this below. One thing I asked her this morning was "Do you fell better laying down?" She said YES. She also has diarrhea. History below as of today this morning: Wife Nausea symptoms and history status as of 11/30/2013 AM: Feb 2012 – Nausea started on cruise – lasted only a couple of days March 2012 – showed up again very bad – with vomiting April 2012 – GP started different meds addressing the nausea none seemed to work Weight loss now a concern no appetite forcing herself to eat. May 2012 – scoping by a local specialist of stomach – opened up the opening to small intestine in the stomach and noted stomach lining enflamed. May 2012 – colonoscopy performed – nausea still an issue, nothing bad found. May 2012 – XXXXXXX bladder removed after test showed only 14% working. Operation in XXXXXXX Based on results after surgery surgeon indicated it did not sound like the XXXXXXX bladder was the cause. Essentially no change in nausea occurrence. XXXXXXX 2012 – switched specialists XXXXXXX 2012 – new specialist isolated cancer med as a possible source of the issue. XXXXXXX 2012 – Cancer specialist took XXXXXXX off cancer drug. July 2012 – feeling a little better but was put on a nausea drug. August 2012 – seems to be better but not totally gone but better August 2012 through October 2013 – seems to be better but again not totally gone – motion sickness over the counter meds tried, Pepto-Bismol tried, Mylanta tried, tums tried nothing really helping. November 2013 – GP prescribed allergy med due to phlegm production – not really sure is this is helping Symptoms persist that started on or about October 15th 2013 (back to where we were in 2012): Diarrhea Loss of appetite Extreme nausea sometimes with vomiting Excessive phlegm All symptoms seem to be Morning Sickness in nature (she is not pregnant) Feels better lying down Habits: Drinks Lipton Raspberry Iced Tea Drinks Hazelnut coffee powered every day Takes non habit forming sleep assistance pill one a night (NON ASPRIN) before bed Doesn’t eat much – is currently 92 pounds previously 101 pounds or so. Now we have the weight loss again.
doctor
Answered by Dr. T Shobha Deepak (2 hours later)
Brief Answer: Suggest you Upper Gastrointestinal endoscopy Detailed Answer: Greetings At this point I would consider Gastroesophageal reflux as the likely cause of symptoms. When the scopy was done, was any biopsy taken to know any associated Helicobacter pylori infection as the cause of inflammation of stomach. At this point I would suggest you revaluation of her status. I consider doing upper Gastrointestinal endoscopy to be done again to rule out Gastroesophageal reflux and also know the severity of Gastritis and depending on it biopsy will be required from suspicious site and also histopathology examination for ruling out Helicobacter pylori infection. Cholecystectomy done for non specific symptoms not exactly attributable to gall bladder it's unlikely to respond following surgery. Do get in touch with your Gastroenterologist and discuss further management. Wishing her speedy recovery. Take care Regards Dr T Shobha MBBS MD
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Above answer was peer-reviewed by : Dr. Yogesh D
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Dr. T Shobha Deepak

General & Family Physician

Practicing since :2005

Answered : 1774 Questions

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What Is The Cure For Persistent Nausea?

Brief Answer: aim for symptomatic relief with Ondensetaron Detailed Answer: Namaste Welcome to Healthcare-Magic Greetings of the day I do understand the difficult situation you seem to be facing . Till the time your Gastroenterologist is back symptomatic relief of her symptoms is important. Further investigation can later be carried out. I would suggest you to Put her on one of the antiemetic drug Like Tab Ondensetaron or Metoclopromide. Along with that addition of over the counter available antacid is also advisable. She will require further work up to rule out other causes of Nausea. Does she have only Nausea and no vomiting? As she has been thoroughly investigated by doing upper Gastrointestinal endoscopy to rule out gastrointestinal tract as the cause of symptoms, assessment of other systems which can cause similar complaints is advisable. I would like to know few more details to help me suggest you further 1. Is it just nausea without associated vomiting? 2. Have you found any relationship between symptoms and any particular posture like while getting up from bed? 3. Are there any associated complaints when she is experiencing nausea like tinnitus, ear ache, vertigo,dizziness, blurring of vision? Just isolated symptom of nausea could be due to affection of other systems too. Thorough evaluation of them may provide you with the etiology 1. ENT examination to rule out inner ear as the cause 2. Neurolgy examination- Intermittent raised intracranial pressure may also be cause of nausea I would suggest you to get her complete evaluation done by the Adobe specialist. It's unlikely that there might be any significant cause, but it will definitely provide the much needed reassurance. Wishing both of you healthy life Do get back to me if you have any other query Take care Regards Dr T Shobha Deepak MBBS MD