OpenHealth Q&A

Continuous Nausea for Nine Months and Frequent UTIs: Seeking Answers

I am a 22-year-old female, standing at 5'7" and weighing 113 pounds, living in the USA. For nearly nine months now, I have been experiencing persistent nausea that began in late July 2024. I refrain from any alcohol, smoking, or drug use, and my pregnancy tests are consistently negative. Until recently, I was quite active; however, the nausea has hindered my ability to maintain my usual lifestyle. Initially, the nausea was mild, but it escalated significantly, especially in August and September, rendering me almost incapacitated for days at a time and leading to a weight loss of over 15 pounds due to an inability to eat. I sought emergency medical attention at the end of September because of the nausea, only to discover it coincided with a panic attack. During this visit, a severe E. coli urinary tract infection (UTI) was diagnosed, which was treated with antibiotics. Both my Complete Blood Count (CBC) and Comprehensive Metabolic Panel (CMP) appeared normal, except for slightly elevated bilirubin levels, which my gastroenterologist attributes to Gilbert syndrome. I had initially believed the UTI was the root cause of my nausea, but post-antibiotic treatment, the nausea lingered despite some improvement, allowing me to function and regain some appetite. Further GI evaluations, including an esophagogastroduodenoscopy (EGD), revealed only mild inflammation, presumed to result from dehydration and insufficient food intake. Additional tests, including biliary ultrasound and a HIDA scan, yielded normal results, while a gastric emptying study showed slight delays but was not considered a significant issue due to the absence of vomiting or signs of gastroparesis. However, my nausea flared up again in November, leading me to an urgent care visit where I was diagnosed with another UTI caused by Enterococcus faecalis. After receiving more antibiotics, my condition showed slight improvement—though whether it was due to the medication or a placebo effect is uncertain. Subsequent imaging, including a CT scan of the abdomen, was performed to rule out any obstructions or abnormalities. The findings indicated small, non-obstructing kidney stones and noted chronic scarring in the upper pole of my duplex kidney—previously corrected at the age of ten months. Interestingly, a mild accumulation of fluid in the pelvic area was also noted, along with an 18mm cyst likely attributed to normal ovarian function. By late January, I started using home test strips for UTIs, which flagged leukocyte presence. A follow-up urinalysis revealed an infection characterized by red blood cells and protein, identifying Staphylococcus aureus in culture. Conditions remained manageable through February until an unexpected, intense wave of nausea struck me during a doctor's appointment, leading to significant anxiety reflected in my elevated heart rate of 180 bpm. This prompted a visit to the ER where another UTI was confirmed, leading to further antibiotic treatment. Monitoring of my heart activity revealed fluctuations in heart rates but no alarming abnormalities. Home UTI test strips remained negative until mid-March, when I sought additional care due to another infection presentation, again encapsulated by red blood cells and protein, yet the lab discarded my sample before culturing. Now on a new round of antibiotics, I have miraculously avoided vomiting despite enduring constant, debilitating nausea. Reflecting on my medical history, I've been plagued with chronic UTIs since early childhood, averaging around four occurrences a year until my late teens. Despite recurring UTI-like symptoms, cultures failed to confirm infection, leading to an unofficial diagnosis of interstitial cystitis. Notably, I had surgery as a child for complications from a duplex kidney and had initially been informed about vesicoureteral reflux, a detail I was not made aware of until recently when reviewing my medical record. Moreover, I have encountered periodic constipation, potentially linked to nausea medications, alongside intermittent abdominal discomfort unrelated to my menstrual cycle. Desperately seeking relief and feeling frustrated with treatment options that have yielded minimal results, I have tried various nausea medications (such as zofran, reglan, and phenergan) and home remedies, all proving ineffective. Securing timely appointments with specialists has been challenging, often stretching weeks or months into the future. I have an important internal medicine appointment upcoming on Tuesday, and I am determined to make every moment count because my current quality of life is untenable. What could be contributing to my persistent nausea? Is it normal to have bilateral kidney stones at my age? And why am I experiencing frequent UTIs despite my best hygiene efforts? I feel as though I need guidance on possible next steps. Any advice on how to proceed would be immensely appreciated.

Answers (1)

3/28/2025, 7:20:47 PM

OpenHealth AI

Your situation involves complex challenges, including persistent nausea, recurrent urinary tract infections (UTIs), and underlying kidney issues. It’s understandable that you feel frustrated and are seeking clarity and relief. Let's break down your concerns systematically.

Main Points:

1. Understanding Persistent Nausea: This may stem from multiple factors, including gastrointestinal issues, anxiety, or complications related to your UTIs and kidney concerns.
2. Kidney Stones and UTIs at Your Age: Kidney stones can occur at any age, and their presence alongside recurrent UTIs is significant.
3. Next Steps for Relief and Management: Focusing on holistic approaches and effective communication with your upcoming healthcare appointment can help.

Explanation:

• Nausea: Your nausea might be related to a combination of factors. Even mild complications from the gastrointestinal system, emotional stress (like anxiety), dehydration, and the chronic nature of your UTIs may exacerbate your symptoms. The connection between prolonged nausea and anxiety is often overlooked but is crucial in your case.

• Kidney Stones and Recurrent UTIs: Yes, developing kidney stones at your age is not uncommon, especially with a history of UTIs, which can affect your urinary tract health. Stones can irritate the bladder and urinary system, leading to infection susceptibility.

• Persistent UTIs: Despite good hygiene practices, structural issues (like your duplex kidney and vesicoureteral reflux) can contribute to frequent infections. Certain urinary tract structures can make it easier for bacteria to persist and cause infection, resulting in recurrent UTIs.

Next Steps:

1. Prepare for Your Appointment:

   • Create a clear list of your symptoms, their frequency, and intensity. Document any patterns you notice, particularly concerning your nausea and UTIs.
   • Prepare specific questions regarding your kidney function, potential interstitial cystitis, and long-term management strategies.

2. Hydration and Diet:

   • Maintain adequate hydration, focusing on water intake. Dehydration can aggravate both nausea and urinary issues.
   • Try consuming small, easily digestible meals to manage nausea better. Foods like toast, rice, bananas, and applesauce often help.

3. Nausea Management:

   • Since previous nausea medications have been ineffective, discuss alternatives with your doctor, such as addressing any potential anxiety through cognitive-behavioral strategies or considering medications specifically aimed at anxiety relief.
   • Simple techniques like breathing exercises or ginger supplements (after discussing with your doctor) may also aid in momentary relief from nausea.

4. Regular Monitoring:

   • Continue utilize home test strips and monitor UTI symptoms proactively. If symptoms worsen, seek medical attention sooner to prevent complications.
   • Follow up on the results of all imaging and testing to ensure effective management of any kidney stones or other findings.

5. Emotional Support:

   • Chronic illness can take a toll on mental health. Seek support from friends, family, or mental health professionals to help cope with the ongoing frustrations.

Your comprehensive understanding of your condition is essential in fostering effective partnerships with healthcare providers. Remember that you have the right to advocate for yourself in your upcoming appointment. Wishing you the best of luck, and I hope you find some relief soon!