Doctors Lounge - Gastroenterology Answers
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Forum Name: Gastroenterology Topics
Question: Upset Stomach, Some Nausea, Too
|Jeezumacres - Tue Feb 28, 2006 11:53 am||
Errr, not sure how to do this.
For the last week-and-a-half, I wake up every morning feeling incredibly nauseous and my stomach churning. Recently--Last Friday, I think--things escalated to an upset stomach. So now every morning I wake up with a churning sensation in my stomach, nausea, and an upset stomach.
It's been hard to eat as a result. I can only eat one or twice a day and never a full meal, as I get nauseous and full very quickly.
Ever since January 2004 constipation has been on-and-off. I had a colonoscopy March 2004, but nothing was wrong. Two weeks before this all started, I hadn't been able to do #2 properly. I had some Benefiber, but it wasn't working. The times I did go it was hard, I even had to strain alittle, and really nothing still came out.
I'm an 18-year-old female, taking no medication. I don't eat very healthy and I drink no water lol (bad, I know).
|Dr. Tamer Fouad - Sun Mar 19, 2006 4:47 am||
Dyspepsia is upper abdominal pain or discomfort that is episodic or persistent and often associated with belching, bloating, heartburn, nausea or vomiting.
There are many causes for dyspepsia which include peptic ulcers and gastroesophageal reflux disease (GERD). Other causes include irritable bowel syndrome, biliary tract disease or medication induced.
Gastric or esophageal cancers are serious causes but account for fewer than 2 percent of cases.
In about 50 to 60 percent of patients, a specific etiology is not identified (ie, "functional" or nonulcer dyspepsia) which is the most common cause of dyspepsia.
After a thorough clinical evaluation and detailed history, conditions such as GERD, irritable bowel syndrome, biliary pain and medication-induced dyspepsia can most likely be confirmed or excluded.
Those at high risk for serious disease (cancer) should be identified. Those include patients above the age of 50 years, those with dysphagia, anorexia with weight loss or persistent vomiting; in addition to those with a palpable mass or those with evidence of GIT hemorrhage (melena, anemia or hypotension) and those presenting with a board-like abdomen. All patients at high risk should undergo immediate endoscopy.
The remaining patients probably have ulcer-like, dysmotility-like or functional (nonulcer) dyspepsia.
Once it is determined that the condition is safe the patient may be given a trial of empiric antisecretory drug therapy.
In all patients, management includes avoidance of ulcerogenic agents (including alcohol), patient reassurance, stress reduction and smoking cessation. All empiric drug trials should be stopped after 6 to 8 weeks, and endoscopy should be performed if symptoms return or continue.
1. Talley NJ, Silverstein MD, Agreus L, Nyren O, Sonnenberg A, Holtmann G. AGA technical review: evaluation of dyspepsia. Gastroenterology 1998; 114:582-95.
2. American Gastroenterological Association medical position statement: evaluation of dyspepsia. Gastroenterology 1998;114:579-81.
3. Talley NJ. The role of Helicobacter pylori in nonulcer dyspepsia. A debate--against. Gastroenterol Clin North Am 1993;22:153-67.
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