Stomach Pain And Nausea

[Angelika_23]

Hello All,

The past week I've been waking up nauseated, staying mildly nauseated all day, and whenever I eat anything it gets worse. I feel like someone has punched me in the stomach. I am already on Protonix for acid reflux. This new nausea and stomach pain is different from the acid reflux.

Today, on top of the nausea and pain, my HR shot up to 140 with no warning while I was sitting and talking to a friend. Normally I have a little warning when this is going to happen. Not today though.

My PCP wants me to go have a gallbladder ultrasound on Friday. I hope this isn't gallbladder issues - I am terrified of the surgery.

I have been through so much lately with my hospitalization, then then my son's, that I thought MAYBE it was nerves, but now I don't think so anymore.

Any thoughts?

Angela

[juliegee]

Sounds a lot like delayed motility. If it's in the tum, it's called gastroparesis. If it's further downstream (in the small bowel), it's called small bowel dysmotility. Both have symptoms like you describe. Try to eat low fiber, low fat, and small amounts often. Your diet should be the opposite of a healthy diet lots of white stuff- bread, rice, pasta, etc. lean meat, mushy vegs, applesauce, etc. Many find relief with a non-dairy diet during bad flares. A motility agent may be needed like EryPed or domperidone and something for nausea like zofran or phenergan.

Your doc is right to rule out gallbladder issues. Your symptoms could fit that as well. I had oodles of ultrasounds over the years that showed no problem despite the fact that my gallbladder most likely gave out in my late 20's. A normal ultrasound means nothing if symptoms persist. A HIDA scan is the best test to check out how well your GB functions. If you've lost some weight with your and your son's hospitalizations, that could have pushed your GB over the edge. The laporascopic surgery really isn't too bad. It's typically same day and I was athletically walking a few days later.

Let us know what you find out.

Julie

[tinkerbella]

I feel for you sweets.....i have he same thing, only lost the gall bladder 4 years ago. that pain was unbearable, i couldn't breathe. today my bp is dropping low again and hr 140 just getting up. the heat, is really getting to me and i have a basin right beside me at all times. this florinef should be making my pressure go up. I think a lot of us are under a lot of stress and the heat is getting to us or at least me. I need someone to get my air coniditoner down here. You've had a lot going on sweetheart, but when in doubt check it out!

Oh thank GOD, it's raining now, that may cool things down here. I hope you are well! I'll say a prayer for you.....I go in the hospital tomorrow and they will check me and give me zofran while I get fluids. Julie, you break it all down so nicely.....

Take care.

Blessings~

Bellamia~

[Sophia3]

have you tried ginger root capsules from health food store or drug store? safe...even pregnant women take it. Good luck...I have that side effect a LOT.

But I know it's new for you.

[Angelika_23]

Yes, new to me... I am feeling full all the time and when I eat I feel like I have overeaten, even if I only eat half a cup of rice. I wish I knew what this was... It just came on about a week ago. Hopefully the mystery will be solved soon.

Also, the A/C in the house just went out. Sigh. Not a good time for that to happen.

Angela

[Sophia3]

Aack!! had the AC break here on Sat 90's and dewpoint in 70's. panic. They fixed by 8.30 Good luck.

You know the stress you have been under might be triggering your gastroperisis like symptoms.

I feel big knot in stomach sensation...I feel full all the time and yes, eat just a bite and feel full. Get gall bladder check and watch fat and fiber in diet as suggested

[sandymbme]

I have had my gallbladder removed (3 years ago) and still have symptoms just like yours! Have had all kinds of workups done and they can't find anything to fix. Had a gastric emptying study, have been scoped literally from one end to the other and have had soooo many abdominal CT's I glow in the dark! They will ocassionally find something (like I once had an intussuception of the bowel a few months ago), but for the most part the GI docs are all scratching their heads. I don't have any helpful hints, but can offer lots of empathy! BTW, how does one get diagnosed with small bowel motility issues? My pcp says it is clear this is where my problems are, but my gastric emptying study with the horrible atomic eggs came back fine...

[Sunfish]

first & foremost (((hugs))).

for the most part i ditto everything julie (mack's mom) wrote. it really does sound very much like Gi dysmotility of some variety.....not always easy to tell just based on symptoms whether stomach, small intestines, or large intestines...or some combination. as already said, the only gallbladder test likely to show anything would be a HIDA scan (vs regular ultrasound); the HIDA is essentially a test of dysmotility of the gallbladder (whereas ultrasounds show stones, etc, though with very severe longstanding dysmotility an ultrasound can sometimes show atrophy due to it essentially being "dead".) based on what you've described, however - in my non-medical (but ridiculously-well-traveled-in-the-GI-motility-world) opinion - the symptoms you describe don't sound as much like gallbladder trouble of any sort (motility-related or otherwise) but more so elsewhere along the GI tract; i obviously can't say for certain but if i had to make a guess i'd perhaps say stomach, aka gastroparesis.

for better or for worse, your hope/ guess/ thoughts re: it being stress related - as some others have mentioned - may not be entirely off base. while you're correct that it's unlikely that all you're dealing with GI-wise is ENTIRELY nerve/ stress-related, the timing of things (aka your GI troubles flaring up to such a degree so soon after all the added stressors you've been juggling) makes it possible - perhaps even likely - that there may be at least some relationship. not so much that it's solely a stress issue but that perhaps all the added stressors as of late - emotionally/ mentally &/or physically (i.e. not sleeping/ resting &/or eating as well as your norm) - acted as a sort of trigger for some not-yet-diagnosed GI issue that - when day-to-day things are at their "best" for you - may be very minimal, aka so mild that you hardly notice it (i.e. that it "normally" manifests as fairly mild things that you've learned to adapt to, perhaps without even thinking about or realizing it on a conscious level; some examples might be your getting full a tad bit sooner than the general population, your preferring - and feeling better - if you stay away from huge meals &/or certain foods, your having a slight spell of nausea every so often, etc.....and any/all of these things - and/or others - might be the sort of thing that only happen occasionally, aka they don't have to be "all the time").

anyway.....re: stress - of any variety - being a potential trigger of sorts for an exacerbation of symptoms, it's really a pretty common thing. different people are different & some seem to have symptoms that are more or less sensitive to stress - so to speak - than others; similarly some people notice that different types of stress affect them - and their physical symptoms - differently. i would say the exact same holds true for folks with dysautonomia - and for many (if not most) chronic/ long-term health issues - to the degree that observant people - over time - will generally come to realize that their physical symptoms are (or aren't) related to various types of stressors to varying degrees. in case i'm not making total sense, i'll offer a few examples; they're applicable for any type of dysautonomia is general, many GI issues...just about any chronic/ long-term health issue for that matter. as i'm sure you've noticed on the forum over time, some - perhaps many - people tend to have more trouble with their symptoms when they're stressed in some way. what you may not have noticed, however, is that different people tend to be more (or less) affected by different types of stressors.

i, for instance, have not once - in my more than a dozen years of dysautonomia diagnosis (& before), including but not limited to my issues of severe orthostatic intolerance, disabling fatigue, & extreme GI dysmotility (just short of total GI failure) - have i EVER noticed even the slightest relationship between emotional/ mental/ spiritual stressors and my physical symptoms; no matter the degree of this type of "stress" in my life - and trust me, there have been times that it's been extreme! - i'm one of the "lucky" ones (relatively speaking ) whose physical symptoms don't seem to get aggravated by stressors of the emotional/ mental variety. as you have likely heard/ read here on the forum (and/or elsewhere), this is very much not the case for some others as it is not at all uncommon for some people's physical symptoms to be "triggered"/ exacerbated by acute &/or ongoing elevations of emotional/ mental stress in their lives; this holds true for some with gastroparesis &/or other GI issues as well, for other health issues, etc. as we all know - whether they are generally defined as "stressors" or not - there are certainly other types of stressors as well that may also affect all of us to differing degrees. the other primary type of stressor, for instance, can be defined as a physical stressor; common - and universally applicable - physical stressors include lack of sleep/ rest, less-than-ideal nutrition &/or hydration, infection/ injury & exposure to extreme environmental temperatures and of course many with dysautonomia could add "being horizontal" to the list. and while it is true that such physical stressors will affect everyone - including the most healthy among us - at some point, just as some individuals find their physical symptoms to be triggered/ exacerbated by mental/ emotional stressors to a greater degree, others - myself included - find the same to be true when it comes to physical stressors.

all of these superfluous ramblings to say the following: whether you're one whose physical symptoms tend to be particularly triggered/ exacerbated by mental/ emotional stressors, by physical stressors, or by both, the notion that whatever "new"/ extra is going on with you GI-wise is in some way related to all you've been dealing with is not ALL far-fetched. your last several weeks have undoubtedly been full of both mental/ emotional stressors (goes without saying, no? child very ill & in the hospital & thus dealing with all hospitals involve to name only a slice...) AND physical stressors (the hospital stay/ visits as well as your continued role as full-time nurse - PICC/ IVs & else wise - now that you're home, all of which i'd hazard to guess have had & are continuing to have at least some less-than-ideal effect of your sleep/ rest, eating habits/ nutrition, etc. any one of these stressors - mental/ emotional OR physical - would very truthfully be reason enough - for susceptible individuals - to have some measure of flare-up in their underlying symptoms - GI or otherwise - so while this may be your first or perhaps most troublesome/ severe flare-up/ exacerbation to date, you have had more than sufficient "reason" to provide an answer (or rather MANY of them!) to the oft-asked "what cause things to get worse all of a sudden?"

all of that said i realize that it unfortunately doesn't give you a solution. the good thing is that your recent/ current level of stress on every level is unlikely to continue at the same threshold; as such it would not surprise me if your GI troubles settle down significantly on their own. that said, sometimes flare-ups don't subside as much as desired even when the initiating/ triggering stressor fades.....a case of something getting "jump started" so to speak but then carrying out the tried & true physics principle of "a thing in motion will remain in motion...." does this mean that you're doomed to contend with your current degree of GI discomfort? NO. (aka very VERY unlikely). what it DOES mean, however - or perhaps more accurately, what it might mean, is that some intervention will be needed to quell/ calm whatever your current state of unrest is GI-wise; this could include dietary &/or other lifestyle modification(s), medication, &/or some combination of things, and very well may be only a temporary measure - at least in part - to help return you to baseline rather than a permanent change &/or it may become something you end up having to employ periodically.

so...while it is of course possible that things could return to normal for you GI-wise without any measure of testing/ investigation &/or treatment/ intervention, to a degree that's reasonable i think you would be wise to make some efforts to pin down what it is that's behind what's going on (i.e. unless i'm missing a significant amount of additional information i certainly wouldn't vote for anything invasive at this point, aka if a doc pulls a scalpel on you, definitely run!) as you well know not all doctors are created equal; the same holds true for GI docs and if anything - not unlike the (quite related) world of dysautonomia - some (perhaps many) GI doctors are NOT well-versed in motility issues and to varying degrees can even be fraught with misinformation & at times dismissive attitudes to problems which are very real and - in proper hands - diagnosable and manageable (though, unfortunately, not often curable; sound familiar?) treatments/ interventions vary in their success but for many can be very helpful so do NOT let yourself become unduly concerned if online investigation leads you to some more extreme cases (such as myself ) b/c - as w/ my overall autonomic failure/ dysautonomia - i am very much the exception rather than the rule.

it's long past when i should have wrapped things up so i will do just that but don't hesitate to touch base w/ me re: any/ all questions you might have moving forward, particularly in the GI dept. in addition to my own experiences over the years i am in fact particularly up-to-date in the world of GI motility issues as i was blessed with the opportunity to attend (portions of) a week-long professional GI conference - the largest in the world - early this summer as a representative of a GI motility-focused NPO (Gastroparesis Association for Cures & Treatments, or G-PACT) with which i am involved (which - in addition to our intended outreach/ education of the many GI docs, etc. who are not up-to-speed re: motility disorders - also included amazing opportunities to network & engage in a good number of one-on-one &/or small group conversations with almost all of the top motility specialists from across the country!) but anyhoo....through not only the conference but also my work w/ that organization in general i have lots (or little...your choice!) of info - online &/or in "hard copy" - that i would be happy to send you if you do find yourself in the world of some variety of GI dysmotility (&/or for anyone else who is reading).

okay....FINALLY shutting up now.

hopefully there's at least something of some use in the above tome!

hang in there the best you can & don't hesitate to be in touch if i might be able to help in any way,

melissa

[firewatcher]

I'm sorry that you are suffering with this now, you have enough on your plate!

I'll just throw in another possibility: electrolytes. They could be off, causing or amplifying your nausea. Are you making sure that you are drinking enough/too much? I have minor motility issues, but I know the constant low level nausea feeling and the fullness after a few bites. My worst nausea was when my sodium was too low.

On the flip side, gallbladder surgery is fairly easy. I had mine removed with three teeny tiny incisions and recovery was quick. There are many other procedures that I fear much worse and would gladly have gallbladder surgery instead!

Please, take care of yourself too! Your stress level will make everything worse if you don't.

[juliegee]

Angela,

My son's gastric emptying study (GES) came back NORMAL too. He was so nauseous at the time that it took all of his will power to have one bite of his radioactive muffin and not vomit. He was vomiting so much, his weight had dropped down to 100lbs when he was 5'8". Based on the GES, his GI said it wasn't a motility problem. I wanted to scream I had done my research via the internet and I knew it was.

I got him to a motility specialist (a specialized GI- very few in the country) who performed a test called an antroduodenal manometry. That's how you get DXed with small bowel dysmotility. They placed a probe (under anesthesia) into Mack's nose, down his throat, into the tum, and then small bowel. The probe has sensors on it that measure pressures. Your GI tract works like a squeeze pop, moving food rhythmically downwards. If some areas aren't squeezing properly or pushing food in the wrong direction- you can end up with the symptoms you describe EVEN IF THE STOMACH IS WORKING PROPERLY (as measured by the GES.) Johns Hopkins is the only hospital (that I know of) that actually performs the antroduodenal manometry in conjunction with a tilt table test. This enables them to prove that an autonomic dysfunctiion and dysmotility are strongly correlated. Mack barfed (with the probe in his nose and GI tract) at the same time he fainted.

I do NOT recommend all of that testing for you. Very difficult to find specialists, etc. It makes much more sense to work with a progressive GI who is willing to let you begin trying GI prokinetics (if dietary changes aren't helping.) Mack is currently having good results with a liquid erythromycin called EryPed. Try very tiny doses at first, like 1/4 to 1/2 tsp before meals. Less is more as the "E" irritates the tum into emptying more quickly. Another one to try is domperidone, not available in the US, but obtainable overseas. Do not try reglan- bad drug/side effects. Keep up your GERD meds and try adding nausea meds as you need them- zofran during the day and phenergan at night.

I have GI motility issues too. Mine come and go. I'm working through a mildly bad patch now. i just use ranitidine for GERD, 40 grams of miralax daily (keeping everything moving is the key for me) and phenergan at night. I'm allergic to "E" and am resisting the domperidone- don't want to add another drug. I know you'll find a regimen that works for you. You can do it without lots of expensive testing as long as you have a helpful, progressive doc working with you.

Melissa (Sunfish) is living with major dysmotility issues as well as lots of other folks here. You're in good company

Hugs-

Julie

[Angelika_23]

I guess I just wonder WHY NOW??? I have never had this problem before - unless all these "intestinal flus" that I get have been this all along... Hmmm?

I thought I was going to be one of the "lucky" ones without the GI stuff.

Thanks everyone, your comments give me a lot to think about.

Angela