I'm occasionally, inexplicably nauseous. :-|
February 7, 2017 5:05 PM   Subscribe

For as long as I can remember, I've had occasional nausea and a generally sensitive stomach. My annual exam is coming up soon, and I'd like to put together a list of questions to ask my doctor and labwork/other diagnostics to inquire about.

I'm a 26yo cis female. Generally healthy, except for migraines (which I prevent with daily amitriptyline) and anxiety (which I manage with fluoxetine and very occasional alprazolam). I have had the Mirena IUD for a little under a year and am very happy with it. My nausea symptoms predate all of this stuff.

Basically, I will go months with no nausea, and then will wake up one day feeling queasy. The change does not seem to correspond with my menstrual cycle or migraines, or a change in my diet, stress levels, or activity levels. Once I am in a queasy phase, it will usually last at least a few weeks. It's mild - I can eat fine, although I do tend to find some foods especially unpalatable during this time - but noticeable throughout the day. Things like ginger, mint, Alka Seltzer, and Pepto Bismol all provide temporary relief but aren't perfect solutions.

When I say that I have a sensitive stomach, I mean it. A single beer or glass of too-sweet non-alcoholic apple cider can easily make me vomit. Rich/heavy meals usually make me feel sick until I've slept it off.

So: If you were me, what you you ask your doctor?
posted by schroedingersgirl to Health & Fitness (16 answers total) 2 users marked this as a favorite
Test for celiac.
posted by fshgrl at 5:08 PM on February 7, 2017 [2 favorites]

Check for h. pylori too.
posted by lydhre at 5:14 PM on February 7, 2017 [1 favorite]

I second the above, my friend was symptomless apart from being unable to put weight on. It can manifest in strange ways. Turned out they were wheat intolerant.

Or try lactose.
posted by TheGarden at 5:15 PM on February 7, 2017 [1 favorite]

Oh, I have this. It's the worst. I have pernicious anemia (I can't absorb B12; this used to be fatal, but no worries, now they just give you B12 shots) and it makes me nauseated when I need my shot. Have your doc check your vitamin levels even if your iron levels are okay. (B12 deficiency also contributes to migraines, FYI. Ask me how I know!)
posted by Countess Sandwich at 5:22 PM on February 7, 2017 [1 favorite]

posted by soakimbo at 5:47 PM on February 7, 2017

I had migraine related nausea before my migraines got bad. The nausea started in my 20's and the migraines came in my 30's. My migraine specialist gave me some anti-nausea pills that worked miracles.
posted by Jacen at 5:52 PM on February 7, 2017 [1 favorite]

I'm tend to have nausea in the morning. I recently saw a gastroenterologist who said it was reflux. I started taking a medication with dinner and it has resolved.
posted by Ftsqg at 5:59 PM on February 7, 2017 [2 favorites]

Definitely ask the doctor if you should try a small dose of rx meds for the nausea. If OTC remedies aren't a complete solution, meds taken occasionally could really improve your quality of life. I've tried many options and my favorite is ondansetron (works well for my occasional severe nausea and doesn't seem to have a dizzying/tiring effect like other options do).
posted by kalapierson at 6:17 PM on February 7, 2017 [2 favorites]

Since I got treated for very low iron, my nausea has decreased a lot. I don't absorb it well, so my doc ended up prescribing an iron transfusion and a day or so after I felt markedly better.
posted by fairlynearlyready at 6:53 PM on February 7, 2017 [1 favorite]

Just as an aside, wheat intolerance isn't celiac. Celiac is an autoimmune disease where your body reacts to gluten and the antibodies produced attack the villi of the small intestine. It's pretty common to have "silent" celiac where you can eat wheat and have no immediate reaction at all. The effects of inflammation and malabsorption are what do you in over time.

Similarly pernicious anemia is the end stage of autoimmune gastritis (the true disease, the term gets thrown around a lot for anyone who has malabsorption issues). Basically your body attacks and destroys the acid secreting cells in your stomach and you need acid cells to absorb it. So you have on and off gastritis then you just stop absorbing B12. And probably protein too. The point from when you stop absorbing it to when you run out enough to have symptoms varies but is typically no more than a few years. A serum B12 test isn't a great test for PA, especially if you take multi vitamins etc. because it'll throw it off. And because of the way the body cycles B12 celiac can cause you to lose it faster than you can replace it, mimicking pernicious anemia so it's important to get the right tests. Ask me how I know. I recommend the NHS (UK) guidelines on PA for patient friendly reading materials so make sure you get the right tests. Most docs wil do a serum and it's next to useless without a lot more info you won't have.
posted by fshgrl at 8:42 PM on February 7, 2017 [3 favorites]

I'm also anemic most times without supplements, just for full disclosure.

When I had these symptoms from 19 to about 22 when I was FINALLY diagnosed and had a laparoscopy - endometriosis was the cause.

posted by jbenben at 10:25 PM on February 7, 2017 [1 favorite]

If you've got at least a couple of weeks before your appointment, I would start keeping a nausea diary. Write down every day what you eat, if you feel nauseous and how badly. Also write down any irregular bowel movements.

I say this because I found--as a woman with formerly-undiagnosed stomach issues--that doctors take young women a lot more seriously if you can go and tell them, "I was feeling nauseous for 8 of the last 20 days," instead of, "I've been feeling nauseous a lot."
posted by colfax at 1:26 AM on February 8, 2017 [2 favorites]

This could also be post nasal drip. Both me and one of my kids get this and it's because we both have a terrible birch allergy that basically causes our stomachs to be flooded with mucus. Have you ever tried correlating the queasiness with allergen levels?
posted by yes I said yes I will Yes at 2:47 AM on February 8, 2017 [3 favorites]

Get your gallbladder checked out. I had unexplained nausea and it turned out that I had a polyp in my gallbladder. This was discovered during an abdominal ultrasound. Gallbladder polyps can become cancerous if untreated, and gallbladder cancer is quite lethal.

I still have nausea issues after having my gallbladder removed, but they are an improvement over the pre-surgery situation.
posted by delight at 10:55 AM on February 8, 2017 [1 favorite]

Thanks for helping me brainstorm this, everyone!
posted by schroedingersgirl at 12:22 PM on February 8, 2017

Came in to suggest testing for celiac as well. I used to have this all the time. Doctors didn't take it seriously because it's such a vague set of symptoms, but it lasted for years and I couldn't figure it out until someone suggested probiotics/prebiotics. It went away in a few days after my gut bacteria got back on track, and never returned.
posted by onecircleaday at 5:18 PM on February 8, 2017 [1 favorite]

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