Persistent Nausea Concerns
Age: 27 years old, Female. Current Medications: - Nurtec as needed - Latuda at a dosage of 20mg daily (initiated a month ago to address depression) - Meloxicam 7.5 as needed (I take this intermittently for a few days approximately every 3-4 weeks) Relevant Medical History: - My body mass index (BMI) approximates 20, and there is no possibility of pregnancy. I experience chronic migraines, having as many as 20 days of headaches each month. Initially, I attributed my constant nausea to these migraines even though it isn't typically a migraine symptom. However, the nausea persists even during migraine-free periods. I also endure widespread chronic pain without an identified origin. Since 2022, autoimmune tests have returned normal results; my rheumatologist concentrated on excluding spondyloarthropathies. While I tested positive for HLA-B27, it is important to note my ethnicity. Both my orthopedic surgeon and a sibling's surgeon suspect a possible genetic connective tissue disorder. Alternatively, it may be that all of us experience a mild form of hypermobility accompanied by chronic pain. Besides physical therapy, I haven’t pursued this avenue significantly. I tested negative for celiac disease via an antibody test at the age of 10. My diet mainly consists of whole foods, prominently featuring plant-based items and plenty of fiber. Typical foods include oatmeal, rice and various grains, a plethora of vegetables, eggs, avocados, and toast. Although I usually consume around 2800 calories daily, I find it challenging to reach even 1500 calories now. I have a history of reactive hypoglycemia, but it’s effectively managed by focusing on complex carbohydrates and pairing them with proteins and fats. **Symptom Description:** I have been experiencing pronounced nausea that has progressively worsened over the last couple of months. This sensation is now nearly constant, particularly intensifying after meals; however, my appetite has diminished significantly. There haven’t been any changes to my diet or medications during the initial weeks of this issue. This increasing nausea is affecting my ability to maintain my weight. I am experiencing early satiety, often feeling full after only a few bites of food. Occasional symptoms of acid reflux arise at night; I had a childhood history of reflux which I apparently outgrew. Now, it only becomes problematic if I eat right before sleeping. Though I currently use a wedge pillow for other reasons, it provides some relief. A past trial of a proton pump inhibitor (PPI) didn’t yield significant changes in my mild symptoms. I frequently hiccup, experiencing single hiccups multiple times an hour for the past year—this has been ongoing even before my nausea began. I attempted to use a PPI to determine if this was related to acid reflux, but the hiccups remained unchanged. Additionally, I hardly ever burp. I also contend with feelings of bloating and a consistent sense of fullness. There is general discomfort in my abdomen. The sensations are not sharp pains but resemble very mild lactose intolerance symptoms that are persistent. I plan to consult with my general practitioner soon, but I am eager to understand what additional avenues might be worth exploring. My current state leaves me feeling miserable and perpetually hungry, yet the idea of eating is no longer enjoyable. I do not have cravings for food, which is disheartening, especially given my constant nausea.
Answers (1)
3/25/2025, 2:50:43 AM
OpenHealth AI
I'm sorry to hear about the persistent nausea you're experiencing; it sounds quite challenging and frustrating. Your symptoms could arise from several interconnected issues, including medication side effects, gastrointestinal concerns, or even potential interactions between your health conditions.
Main Points:
- Nausea Characteristics: Your ongoing nausea, loss of appetite, early satiety, and bloating are important symptoms to track, especially since they are affecting your weight.
- Potential Causes: The nausea could stem from chronic migraines, medication side effects (especially from Latuda), gastrointestinal conditions like gastroparesis or acid reflux, or psychosomatic factors.
- Actionable Next Steps: Focus on symptom management, dietary adjustments, and keeping a diary to gather more data before your doctor visit.
Explanation:
- Medication Considerations: Latuda can cause gastrointestinal side effects, including nausea. Since you began this medication a month ago, this could be a contributing factor. While Nurtec might help with migraines, it may also add to gastrointestinal discomfort.
- Possible Gastrointestinal Issues: The feelings of early satiety and discomfort could indicate slowed gastric emptying (gastroparesis), which is common in individuals with chronic pain conditions or those with autonomic nervous system involvement.
- Dietary Links: Your diet emphasizes whole foods, which is great, but if you've reduced your intake significantly due to nausea, ensure that you are still getting adequate nutrition. It can also be difficult to manage reactive hypoglycemia under these conditions.
Actionable Guidance:
- Maintain a Symptom Diary: Record your nausea, food intake, and any accompanying symptoms. Include the timing of meals and how you feel afterward—this information can be invaluable for your doctor.
- Small, Frequent Meals: Try eating smaller portions more frequently throughout the day rather than three large meals. This might help reduce feelings of fullness and improve your calorie intake.
- Focus on Hydration: Drink plenty of fluids, especially clear, non-caffeinated options. Staying hydrated can help manage nausea.
- Consider Over-the-Counter Solutions: You could explore over-the-counter anti-nausea medications like meclizine or ginger supplements, but be sure to mention any new medications to your doctor.
- Limit Heavy Foods: Given the history of reflux, steer clear of heavy, fatty, or spicy meals that might exacerbate nausea or discomfort.
Follow-Up:
When you see your general practitioner, discuss the possibility of assessing for gastroparesis or any further gastrointestinal evaluation. An assessment of your medication might also be warranted to rule out side effects contributing to these symptoms. Please remember, you're not alone in this, and seeking out these solutions is a strong step towards feeling better.
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