Nausea More Often

[Radha]

hi, if anyone has any ideas, i would really appreciate hearing them! i used to get nauseaus once in a while but lately its happening more often and more severely, thank God my doctor agreed to let me try zofran, but i am just wondering why its getting worse when i havent taken any new meds or vitamins or done anything new or eaten anything new, does anyone know what could be causing the nausea and why it just comes on suddenly and then goes away after a while? and why its coming more often? thanks for any help

Radha

[Alizee]

Hi Radha,

I am so so so very sorry you are nauseous a lot of the time!! It's such a horrible feeling!! I had odd bouts of it this time last year. I'd get very sweaty all of a sudden and then feel very nauseous. It would come and go sometimes out of the blue but most of the time it would happen when I was trying to have a bowel movement (embarrassing info to tell but true). I am not sure if it was due to the hysterectomy I had in months earlier. I was also blessed to be able to use zofran that was prescribed to me after the surgery where I couldn't stop vomiting. Not good times! Luckily I hardly ever get those weird episodes anymore, only except when I get too hot.

What type of POTS do you have? Do you notice when these occurrences happen during weather related or temperature changes? Do you have IBS? Does anything else happen before or after the episodes that cue you that it's coming?

[Radha]

thanks for your reply, i dont have IBS and never actually vomit, i do sweat sometimes at the same time i get nauseaus and it just comes out of the blue and goes away after a while but nothing to do with weather or anything else, thats why its so strange! i have the hyperadrengic POTS

Radha

[Rachel]

Hi Radha,

There can be many explanations for nausea. Have you ever been tested for gastroparesis? I've had nausea off and on for years, but a few months ago it flared up badly. I was almost always nauseated (and feeling full). I had a gastric emptying test done, which confirmed gastroparesis. I've switched my diet now (cut out a lot of fiber, added more liquid foods like soup and Ensure), and am doing better. It hasn't taken the problems away, but it certainly does help. Also, when I'm nauseated a cup peppermint tea helps a lot.

I hope you can figure out what is going on.

Rachel

[Alizee]

Hey Radha,

Maybe it's just one of those crappy things that comes with hyperadrengic POTS? I have hyperadrengic POTS as well and get flushing a lot, real warm and then sometimes nauseous but not as much nauseous like last year. I actually never vomited either from my weird nauseous moments. I only experienced it after my surgery, it was due to not being able to eat for a day in prep for the surgery that triggered my non stop vomiting for a couple of hours. One of the nurses kept trying different anti-nauseous medicine to stop it but finally zofran did the trick and then I used that in later months to ease my nauseous attacks.

Rachel has excellent advice. The only other thing I can think of is, maybe you should get your gallbladder tested. I can only say I understand and I am so sorry you have these nauseous attacks.

[Radha]

does zofran make anyone drowsy or constipated? just curious if any of you had any side effects, thanks

Radha

[juliegee]

Hi Radha,

I have a few ideas you can try. In response to your last question: Yep, any antiemetic can slow things down a bit and cause constipation. And, zofran is one of the very few anti-nausea drugs that is marketed as NOT causing drowsiness. It doesn't for me or my son. However, we are all different.

I think Rachel is on to something with her idea of gastroparesis. Many people with dysautonomia have their GI tracts affected. It is one of many body systems that can be affected by our wacky autonomic nervous systems. My son was experiencing severe nausea. He was pretty much unable to eat anything. His gastric emptying study (GES) was normal. Long story- short. We ended up at Johns Hopkins where they did more extensive studying of the motility of his GI tract. he had an antroduodenal manometry which indicated severe problems with motility in the small bowel. Food actually moved in a retrograde fashion for long periods, up to 3 hours at a time. In other words, the nerves were pushing food UP, not down. Mack's manometry continued during his TTT, and his docs were able to prove a one-to-one correlation between his GI motility and BP/HR variability. He vomited right as he fainted during the TTT.

I share all of this to explain that your GI tract may very well be slowing down at some point: tum, small bowel, or even colon. Many with dysautonomia have GI tracts that are impaired, unusually too slow, sometimes too fast, and sometimes a combo of both. Particularly when things slow down, the end result is NAUSEA. Even if things ar damming up in the colon (constipation), the rest of the food may be backing up causing more nausea.

You may want to try a prokinetic. GI's love reglan. (Among those who suffer with gastroparesis, it is well known that this is a BAD drug that crosses the blood/brain barrier and may have many negative side effects.) Instead ask your GI for a tiny pediatric dose of eythromycin (200mg per mL) the sweet, pink liquid. When my GI tract is slow, a tiny dose, 1/4 to 1/2 tsp takes away the awful nausea and replaces it with blessed hunger!!!! Just that tiny dose can improve things so much. If morning nausea is a big issue for you, you may want to also take a dose before bed. This is the prokinetic of choice at Johns Hopkins. In this small dose, it is very benign and effective. Less is more as it works by slightly irritating the GI tract into emptying more quickly. Ask your doc for an empirical trial and avoid all of those expensive motility tests. If this works, voila, you've figured this out.

You must also treat any other GI things you have going on. If your GI tract is slow, you may also have GERD. Make sure you treat that, prilosec, nexium, etc. You mentioned constipation, very common with gastroparesis and small bowel dysmotility. Treat it. My GI has me take up to 4 doses of OTC Miralax daily. (2-3 usually do the trick. You must get everything moving to knock out the nausea.

I know from experience, there are few things worse than chronic nausea. Try to keep your body moving (when all you may want to do is curl up into a ball.) Walking and moving around really helps with GI motility. Be sure and let us know how you are doing, Radha.

Julie

[juliegee]

Sorry, Radha. I meant to add that you need to take your erythromycin about 20 mins. before meals.

Best of luck-

Julie