Unexplained CONSTANT severe nausea for months...

Digestive health
1

I feel so helpless and scared. I will start this off with the very beginning.. when I was younger, around 16, I would get the big bouts of nausea at night time. This had carried on until 18, and I had always joked and said I was a two year long pregnant woman with night nausea.. you know, to make light of the situation. But it progressively had been getting worse since that very first night at 16. I remember that night so clearly, and I have god awful memory.

Anyways (I am rambling), about.. hm.. 5 months ago; it stopped just being night nausea. It transformed into an ugly beast that I live with every day. I will give some backstory that could help give an idea of what it is. Late last year, I had been in a high stress situation and lost 20+ pounds in a month. I went down to 90 pounds, as a 5'4 girl. Now, I can no longer eat more than one meal. If I eat more than one meal of pasta or fries (low grease, try to keep everything bland), my stomach will send me into a crippled fetal position. I can no longer work at my job, had to quit due to not being able to stand for an hour without feeling insanely nauseous and light headed. I am not a vomitter though, and that is what puzzles me to no end. I don't vomit. The past month, it had progressed into a wave of nausea when I wake up, and it dies down a little when I eat, but after that digests, my stomach is in a frenzy. It feels like it's in some sort of overdrive. I can't eat anything acidic, or I will vomit acid in my mouth. It is very tiny amounts that come up every 5 minutes, just about, BUT I never full on vomit. Since it has been getting progressively worse, I did vomit for the first time in years the other day, and it was so much that I ended up passing out from the strain and exhaustion. I woke up and felt really good, like it had never happened. Ever since, every day I feel like I will vomit. It gets so bad, but nothing ever comes up. Just acid. It wakes me up every other hour of the night, and I have to sip water and pray that it dies down long enough to sleep.

With that being said, I can't even sleep fully due to it. No sleep has always worsened my nausea... but now the nausea is WAKING ME UP! I'm so lost. I can't keep a job due to this (I quit the day I ended up in my workplace's bathroom floor, unable to move from the pain and almost vomitting on myself). I don't know how I will ever be able to live a normal life. What in the world could be causing this at such a young age? I've cut out so many foods and drinks that could cause it, but I swear it is only getting worse. This constant severe nausea, fatigue, and occasional abdominal pain is wearing me down to my bones. I take Zofran, Promethazine, and OTC acid reducers daily, but nothing truly helps. I always end up having severe panic attacks, and that causes the nausea to worsen to a point where I am violently trembling and having hot flashes.

I did go to the Emergency Room recently, during one of my episodes, thinking I had appendicitis, but they did a CAT scan and didn't find anything abnormal, and sent me on my way with nausea medication... which did not work. I do not have any insurance, and will not be able to see a specialist any time soon. I am truly lost and terrified for my future. I do not know how I will support my soon-to-be husband and my family. I do not know how I will get a job and keep it. I do not know how I will support even myself.

Does anyone know what this could possibly be? Any advice on how to try to start living and functioning a little more proper with this weighing me down? Can I even come up out of the dirt from this?

2

I would like to add that my weight fluctuates like crazy, and that in itself is a little scary.

3

I am so sorry to hear of your struggles. Nausea is the worst thing ever. I've been suffering for a long time with it. I vomit sometimes....not often. Just know that you're not alone. In fact, right now, as I type this I am experiencing an episode. My stomach is upset. I've gone to the toilet twice and passed loose stool. I doubt i ate anything bad. It could be my gastritis acting up or stress/anxiety...not sure. I have a problem with excessive stomach acid and have to take proton pump inhibitors (omeprazole/prilosec). I would be ok for a few weeks and then suddenly have a flare up. I hope you find a way to get some tests done. Not knowing what's wrong can cause severe health anxiety and can stress you out immensely. Trust me. I've been brought to tears/depression by the worry of not knowing whats wrong with me. Dont lose hope. It will get better. You have to find out what's wrong and then seek treatment. I'm not sure what it could be....maybe gastritis. Research stomach conditions online and see which one is consistent with your symptoms. Dont start thinking worst case scenario. Most likely it's something easily treatable. Good luck. Keep me posted. For now, eat very small, bland meals often throughout the day. Leaving your stomach empty can have very negative effects. I know its hard to eat when you're nauseous but at least try to drink something. 

4

I did an ultrasound and barium swallow. I will get some blood work done soon. 

5

I also tested for H Pylori bacteria which was negative. You should test for that. You might need to do an endoscopy. 

6

Hi there,

First, I’d like to send you some empathy, as nausea can be crippling. I’m so sorry to hear what you’re going through. I understand it is difficult to manage through everyday activities and tasks when suffering from constant bouts of nausea.

What you are currently going through sounds a LOT like what I was going through when I was 14 to about 21 years old (I’m currently 24 years old).

I was curious about a few things after reflecting on my own personal experiences.

Are you an emetophobic (irrational fear of vomiting), and/or do you suffer from high anxiety?

Why I ask is because you had mentioned that the ER performed a CAT scan on you, only to find nothing is internally wrong (thank goodness). The only thing I can think of is deep-rooted anxiety or chronic stress that can be the cause of you feeling physical discomfort (nausea and vomiting), as it is known to be able to affect your health in many ways.

 

7

I would try and save up to see a specialist because you need more tests to diagnose your problem.  Try cutting out pasta and fries since that seems to trigger your symptoms.

8

Hi TC

Have you tried keeping a food diary to find out what foods cause the acid?..also go gluten free, wheat free and lactose free you may have an intolerance to these..leave out greasy fatty foods and citrus fruits and fizzy drinks and hot drinks..drink warm also go caffeine free...take probiotic tabs and eat yougurt with cultures. Also eat small meals so your stomach will only release small amounts of acid..and try to cut down on antacids these can make the problem worse....

9

I just don’t.. feel stressed! I like to vomit when needed because it feels like my body is forcing out the bad stuff. I live a pretty simple life right now. No job, no school, and I usually lay in bed due to the  illness. So I wouldn’t think it was stress. 

10

Hi, I think your diagnose is pretty simple. You are lacking especially carbohydrates, lipids, vitamins, minerals - maybe also pritein due to your diet. Your body is a very complex system that needs all the above nutrients every single day to feed your cells and make your organs and GI work poperly. Even your are missing out on one vitamin over a longer period of time your body will start showing you (in your case - nausea) and the hoemone production won‘t function right (no ghrelin will be produced that shows that you are hungry etc) 

Take a good multivitamin that has vitamin A, E, D, B 12 about 100 %

Make sure it has iodine and iron as well.

Take a probiotic and take an extra supplement with calcium and magnesium- these are usually low in the multivitamin. Sometimes there are combined products with these together. Take 500mg calcium in the morning and 500 mg in the evening (if you have to break the pill in half)

Then start working on your diet asap!! Eat small meals more frequently- for example have oatmeal as a snack with fruits etc.

Eat salmon, lots of vegetables , brown rice..

And try to get enough healthy unsaturated fats.

Check ‚DRI‘ for carbohydrates, lipids, protein to see what you need every day.

And make sure to drink 2.7liters water over the day.

This helped me with nausea at night and day.. especially the extra carbohydrates.

I am 100% sure this will get you back on your feet!!

Good luck.

11

Hmm, okay. No known stress factors, test results seem fine... what it could also be is IBS. But again, I’m not a doctor, and the nausea doesn’t sound like just any kind of nausea. It sounds chronic.

I also suggest you research about ulcers and Helicobactor Pylori.

H. Pylori is known to cause severe nausea and vomiting, and it takes a cocktail of antibiotics to get rid of.

I’m really concerned you don’t currently have healthcare. Have you tried applying for low income health care through the state?

What you’re suffering is pretty serious as it’s stopping you from getting out of bed.

What happens when you eat bigger meals? Sometimes our stomachs doesn’t enjoy smaller meals, and it leads to nausea due to the over-production of acid. Have you also tried drinking some ginger tea?

I used to be on Zofran which did not do a thing for me, but the natural route was more effective with my nausea. 

Again, I’m so sorry to hear that you’re going through this... I hope you’re able to get a diagnosis and stop the nausea.

12

Very similar symptoms to my girl 

and she has

MALS (besides other compressions).

Median Arcuate Ligament Syndrome.

Very few GI docs know about it, yet it is a real syndrome. It will not be picked up in a routine CAT scan.

The diaphragm presses off one's coeliac artery, especially in lying, which causes less blood supply for stomach.

The ligament can also due to its location press onto the coeliac plexus and ganglion, which causes all sorts of nerve related issues (dizziness, breathing, tachycardia, and nausea).

How to find:

I urge you to go onto fb forums for MALS and look into the files or ask, which doc to see in your location, who knows about MALS (and something else I will mention in a second) to not waste any time and money.

Easiest is a doppler ultrasound (really non invasive, not painful, not expensive -yet still costly for you if you had to pay privately- compared to other imaging)

and you need a good technician/doc to do that: you MUST lie absolutely flat (supine) and deeply exhale and hold compared to an inhaled imaging. Maybe compared with upright imaging, but the most important is: supine.

This will show if your coeliac artery has a problem and is restricted causing symptoms.

Those symptoms usually do get better when standing or sitting, but not always.

It can also be seen in CTA, MRA, but again, it needs exhaling pictures, not in a routine CAT scan.

Now the problem: if only the coeliac nerve plexus was compressed, it will not show in those imaging, only via diagnostic invasive coeliac plexus block. This comes last hence! 

There is also something called SMAS/Wilkie. When your duodenum (often also left renal vein as it sits there too) get's compressed between abdominal aorta and superior mesenteric artery angle.

One does not have to have a complete obstruction with blown up stomach and 3rd part of duodenum (yet most docs and imaging only concentrate on this worst szenario!),

to be effected by a squeeze of duodenum. If it was a bit open (like my girl has 3-4mm space), smoothies and the likes do go through much easier than solid chewed food.

If it was a bit open, only weight gain can help a bit further before considering anything else.

We are juicing, smoothie and feeding the whole day to keep the weight up....

no special diet helped anything, yet she has gastroparesis (gastric emptying study would prove that, BUT it is not telling as to why it is delayed in emptying), so we have to keep the oh so good fibre down and give loads of mushy liquid food. no grain diet, FODMAP, GAPS, no milk,  no egg, nothing helped, because it is not a digestion problem in my girl's case. We had to do all these lactose and fructose testing and it was all perfectly fine as we knew by experience anyway. It's a physical problem of compressions if one suffers MALS and/or SMAS (often going together unfortunately). So my girl actually survives on cottage cheese and apple sauce, when it is bad.

MALS will never go away with weight gain in contrary to SMAS. But MALS can be helped a bit with certain stretching exercises to get the ligament up higher. Which will not influence SMAS.

So there are two conservative approaches: try to gain weight (duh, a boomerang if you feel nauseous) and try to google the exercises (they are there).

(for nutcracker of left renal vein we tried Aspirin as the only conservative option, but didn't help)

This AA/SMA angle could be seen in your CAT scan, IF it was scanned up there (just under stomach, not at appendix) and preferably if you have a sagittal image (often can be reconstructed from other planes). I hope you have a copy of your imaging and can scroll through yourself or post it as mentioned onto the forum pages, there is a wealth of knowledge there for free.

Or you go back to the doc and ask specifically if the scan could please please be reviewed under the light of SMAS and nutcracker and if you were exhaling: for MALS.

Reviewing existing imaging is the best no harm and cheapest approach. It should not be embarrassing for radiologist as his/her job was not to find those issues in the first place, but looking for acute volvulus or appendicitis.

Please join those MALS and SMAS or even nutcracker fb groups to get info,

where to go, to get checked for it.

I only got my child diagnosed thanks to those groups, as every test came back 'negative' and I could see something odd on the MRE imaging and was proven to be right.

Very very often teenaged girls get this, as our anatomy changes with wider hips and pulling onto the diaphram differently. My girl is also hypermobile, so everything collapses more easily and has lumbar lordosis, which again effects the AA/SMA angle.

Yet it is 'rare', because....it is also underdiagnosed, not looked at.

She will have a massive invasive surgery as she can't live any normal life anymore.

Not everyone get's MALS or SMAS or nutcracker of LRV (which causes pelvic congestion in her) that severe.

It depends if one can function still a bit or not at all anymore.

So it really depends on your individual situation, if something was found and how to tackle it.

But please don't let it go unlooked at as unfortunately the ignorance about MALS and SMAS is exorbitant high.

It seems only to be taught shortly to vascular surgeons.....which is a bit late in the process of diagnosis.

There are MALS exercises to lift the ligament away. My child can't tolerate them.

please google around a bit and please join those forums or maybe you find a doc for these certain constellations to not loose more time and money. Exclusion is peace of mind too. But we females are far too often too early dismissed as IBS or 'in your head' with real physical issues, that can be tackled, be it conservatively (with diet, weight, excercises, Aspirin) or surgically.

All the best!

Was just a thought as I try to get the knowledge of those issues out there as they seem highly unheard of.

13

I have had the same thing for about a year now. I have cut gluten & dairy & sugars out. I’m not feeling 100% better but a little. I recently had blood work, ct scan, ultrasound, stool sample & all came back normal! If I don’t feel better soon we will do an endoscopy which I think you should get! That will show your upper gi & esophagus & give answers, they biopsy as well! I have two kiddos & feeling nauseous all the time is miserable! You are not alone! Don’t give up, there is an answer & it will get better even though it seems like it won’t! Good luck to you