Chronic Nausea: A Comprehensive Overview
Greetings! I'm a 20-year-old individual, standing at 5'9" and weighing 320 lbs. My medical history is quite extensive, including diagnoses of bipolar disorder, panic disorder, level 1 autism, binge eating disorder, polycystic ovary syndrome (PCOS), metabolic syndrome, and non-alcoholic fatty liver disease (which my gastroenterologist is monitoring, although it’s not currently critical). I also deal with gastritis, acid reflux, irritable bowel syndrome (IBS), sleep apnea, and insomnia. Unfortunately, my gastroenterologist doesn’t seem very accommodating; I feel the need to engage in my own research and self-advocacy because she often dismisses my concerns. She attributes my nausea and discomfort to my medicinal cannabis use. However, I've only been using cannabis for three years, while my symptoms have persisted for about six years, showing no improvement during periods without it. In fact, cannabis actually helps me manage my food intake and alleviates some of the discomfort. If you require any further details, feel free to ask! **My Symptoms Include:** **Nausea and Vomiting** - Frequency: Nausea occurs 4–7 days per week. - Episodes of vomiting happen approximately 3–5 times weekly. - Primarily occurs in the mornings upon waking. - **Triggers:** - Eating breakfast - Chewing food - Gagging, coughing, or dry heaving - Relief: Vomiting typically offers fleeting relief, but may include regurgitated food that hasn't digested from previous meals consumed 9–12 hours prior. - **Associated Symptoms:** - Feeling overheated just before vomiting - Weakness and shakiness - During episodes of nausea, I experience significant drowsiness, sometimes severe enough that it's hard to stay awake, even while driving. **Swallowing Difficulties and Reflux** - I have suffered from acid reflux since childhood, which has progressively worsened over time. - **Current Symptoms:** - Severe burning sensation in the chest and throat - Chest pain - Nighttime and morning reflux incidents - Antacids only offer brief respite - **Dysphagia (difficulty swallowing):** - Intermittent issues, particularly with pills or tablets, often feeling as though they get lodged in my throat and not alleviated by drinking water. - Occasionally, swallowing liquids and saliva can also be difficult. - Symptoms sometimes exacerbate when lying flat. - I frequently wake with a sour or bitter taste, accompanied by coughing or a burning sensation in the throat. **Abdominal Pain and Bowel Patterns** - I experience cramping similar to menstrual cramps, usually localized in the lower abdomen, lower back, and pelvic region. - These cramps can be intermittent, particularly prevalent at night, causing occasional but severe discomfort. - My bowel movements are irregular, alternating between constipation (with hard, dry stools) and diarrhea (with loose, watery stools). - Cramping sometimes alleviates post-bowel movement. **Autonomic and Systemic Symptoms** - There is a constant feeling of fatigue. - After eating, I often feel excessively sleepy. - During flare-ups, sleep may extend for lengthy periods, sometimes lasting entire days. - During nausea episodes, I experience: - Significant weakness - Shakiness - Near-fainting sensations - Episodes of heart racing or pounding. - There are instances of urinary incontinence when sneezing or coughing, along with frequent urges to urinate with minimal output. **Gastrointestinal Reflex Symptoms** - Vomiting can sometimes be instigated by bowel movements. - I have occasional involuntary bowel movements concurrent with vomiting episodes, typically associated with intense nausea and systemic symptoms.
Answers (1)
2/16/2026, 2:20:59 PM
OpenHealth AI
Thank you for sharing such detailed information about your symptoms and medical history. It sounds like you are experiencing a complex combination of gastrointestinal issues, and I understand how challenging this can be for you. Let’s break down your main symptoms and provide some guidance on how to manage them effectively.
Summary of Key Points
You are dealing with chronic nausea, vomiting, acid reflux, swallowing difficulties, abdominal pain, and fatigue, all of which significantly impact your daily life. Your symptoms, particularly the nausea and vomiting, can be distressing and frustrating, especially since you've noticed no improvement with past treatments.
Explanation of Your Symptoms
Your symptoms could stem from multiple interconnected issues, including:
- Gastritis and acid reflux: Inflammation of your stomach lining and acid reflux can lead to persistent nausea and discomfort.
- Irritable bowel syndrome (IBS): This can cause fluctuating bowel habits and may be contributing to your abdominal pain and secondary nausea.
- Dysphagia: Difficulty swallowing can be exacerbated by acid reflux and may require specific attention.
- Autonomic symptoms: Feelings of fatigue and weakness, especially after eating, may relate to your gastrointestinal issues or could indicate a possible metabolic aspect due to your weight and underlying health conditions.
Practical Steps to Manage Symptoms
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Dietary Adjustments:
- Small, frequent meals: Eating smaller amounts more frequently can reduce the amount of acid your stomach produces and may help alleviate some nausea.
- Avoid trigger foods: Identify and avoid foods that worsen your nausea or reflux (common triggers include spicy, fatty, or fried foods, as well as carbonated beverages).
- Stay upright after eating: Try to remain seated for at least 30 minutes after eating to help minimize reflux.
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Hydration:
- Ensure you stay well-hydrated, especially if vomiting occurs. Sipping clear fluids like water, herbal teas, or electrolyte solutions can help keep you hydrated.
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Medication Review:
- Discuss your current medications with your doctor, focusing on the effects of any medications that might contribute to nausea or reflux. Be sure to communicate your symptoms thoroughly to advocate for possible alternatives or adjunct treatments.
- Consider discussing over-the-counter medications like proton pump inhibitors (e.g., omeprazole) or H2 blockers (e.g., ranitidine) that may provide longer-lasting relief from acid reflux.
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Mindful Eating:
- Try to eat at a slower pace, chew food thoroughly, and practice stress-reducing techniques before meals, such as deep breathing, to help reduce anxiety-related symptoms.
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Monitor Symptoms:
- Keep a symptom diary, noting what you eat, your symptoms, and any medications taken. This can help identify patterns or triggers, which is valuable information for future healthcare appointments.
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Physical Positioning:
- Elevate your head while sleeping and use extra pillows to help reduce nighttime reflux.
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Stress Management:
- Techniques such as mindfulness meditation, gentle yoga, and regular physical activity (as tolerated) can help reduce stress, which in turn can alleviate gastrointestinal symptoms.
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Regular Follow-ups:
- If your symptoms persist or worsen, continue seeking medical opinions and advocate for comprehensive evaluations, potentially considering a multidisciplinary team approach with both gastroenterology and mental health support.
Next Steps
- Implement dietary adjustments and hydration strategies as immediate actions.
- Review your medication with a healthcare provider focused on managing gastrointestinal symptoms.
- Start keeping a symptom diary to track your experiences over time.
- Consider stress management techniques in your daily routine.
Remember, it’s essential to advocate for yourself in your healthcare journey. If your current gastroenterologist isn’t accommodating, seeking a second opinion may provide additional support and treatment options. You're not alone in this, and it's commendable that you're actively seeking ways to improve your quality of life. Please let me know if you have further questions or need clarification on any steps!
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