dealing with angry guts
March 10, 2023 7:42 AM   Subscribe

My stomach hates me and I don’t know why. I’m looking for reassurance, possible theories, stories about how you had similar issues and got through it, all of the good AskMe soup for the soul of a miserable person in pain. TMI details under the cut.

I had this issue originally in February around the same time. The symptoms present in the following way:

- A day or so of early satiety and just generally going off food/lack of appetite which turns into..
- Feeling very bloated/uncomfortable/like I have a rock in my belly; it’s not so much pain as a constant awareness and discomfort; when this is bad my stomach feels tense and hard, like a beach ball
- Constant nausea and/or a gnawing empty feeling
- Vomiting/dry heaving from above
- Inability to tolerate food; everything I eat causes more pain/bloating/nausea

In February, this lasted a few days and resolved itself more or less overnight. This time it’s come back and the symptoms are exacerbated and include:

- Frequent cycles of nausea and dry heaving (3-4 a day)
- Burping a lot
- I had one day of diarrhoea but the rest of the time that side of things has been fairly normal, though clearly Not Great thanks to a very limited diet

I have been getting by on a yogurt and a banana a day, occasionally risking some crackers. I have to force myself to eat through the nausea, which I find very difficult. Sometimes if I do this, it goes away for a bit, but sometimes it doesn’t. It was almost normal on Wednesday and since then has become worse again, with today being the worst yet (actual vomiting instead of dry heaves, can’t stand the thought/sight/smell of food).

I went to see my GP on Tuesday and she suggested it might be h pylori and ordered a stool test (which I have to redo because the lab rejected it due to no name on the sample 😑). I’ve also spoken to the NHS telehealth service who didn’t express concern and just said to talk to the GP, which I will continue to do next week.

The GP also gave me some Buccastem (Prochlorperazine) which helped at first but doesn’t seem to be doing much right now.

Besides the stomach stuff I feel fine, but the stomach stuff is fairly incapacitating. I am a recovered emetophobe so just feeling sick stresses me out and I find it very very hard to force myself to eat even under good circumstances. I’m worried this is going to be a recurring, long term thing. I’ve made the mistake of reading accounts of people who have felt like this for years with no relief. I don’t know if I can do that. I can already feel myself becoming obsessive in a bad way about eating healthy/properly/using the Right Diet. Everything I read in the way of suggestions includes things like “try to eat little and often” (no, it hurts), and “try to force yourself to eat some carbs” (I just had 1 Ritz cracker and am already retching over my trusty bucket).

My theories at the moment range from a gluten intolerance to anxiety (likely) or gastritis caused by bacteria as suggested by the GP. The symptoms are all so general that it feels like it could be hundreds of things, but in the meantime I just need to get through this weekend.

I feel like I need someone to just pat me on the head and tell me it’s okay to be miserable and eat nothing but popsicles and yogurt until I can go beg for answers, or to hear some stories about going through similar Bad Stomach Times and coming out the other side. Please give me your thoughts, kind AskMe folks.
posted by fight or flight to Health & Fitness (25 answers total) 1 user marked this as a favorite
I have a Bad Stomach Times story, and some of your symptoms remind me of it. The short version is, I turned out to have gastroparesis, which is slow stomach emptying. They text for this by feeding you eggs or oatmeal with a radioactive marker, and scanning your stomach periodically to see how much is still there. At my test, I had moved only about 20% of food out of my stomach in the time that most people have moved over 90%.

That feeling of food just sitting there, the bloating, the fear of throwing up—-very familiar. I've managed it mostly by diet since my diagnosis, but before that i had a period of about 9 months when I could hardly eat—I lived on yogurt, occasionally broth, popsicles, and ginger ale. During this time I got very sick; in particular, my potassium got very low, and that put me in the hospital eventually. If you can, ask your doctors to help you keep track of that kind of thing before it gets too bad.

My saga started with isolated bouts of throwing up, kind of out of nowhere, which resolved in about a day. This happened every 2-3 months, and I did start modifying my diet to try to avoid it. Eventually, after about three years of this, I entered the nine-month period of constant illness.

I'm still a very iffy eater, and live on way too much yogurt as it's the most palatable and least likely to cause problems, though I can and do eat regular, if usually smallish meals of solid food as well, which is lovely. But I'm healthy-feeling and not suffering like I was. I've only thrown up one day since my hospitalization last June, after an ill-advised indulgence in some really delicious breakfast sausage that my stomach sat on for awhile and then rejected.

I'm sorry that your emetophobia exacerbates this. I hope that, like me, you find an answer, even if continuing to have a very restricted diet ends up being part of your life as well. It's much better than what I was suffering before, I can say that for sure.
posted by Well I never at 7:54 AM on March 10 [2 favorites]

Because you don't mention it in going to assume you don't have a uterus or ovaries but a friend of mine had ovarian cancer and feeling bloated and nauseated are symptoms.
posted by fiercekitten at 8:03 AM on March 10 [7 favorites]

This will be a reassuring data point for balance: I had an episode of feeling exactly like you describe that lasted a month or so (except for the vomiting, but I have a physical quirk that I do not vomit, having done so only once in the last 40 years). I went to my GP to find out if it might be h pylori and she put me on a prescription antacid for a couple of weeks and that fixed me completely, and it hasn't happened again (it was I think two years ago).
posted by Rhedyn at 8:10 AM on March 10 [1 favorite]

if you by any chance have access to the Learning Company (now "Wondrium",) they have a deep dive course on gut health that is all about treating tricky gut situations.

FWIW this doesn't sound like anxiety to me... not that I'm a doctor, just a person with an anxious belly. Guts are complicated and very poorly understood, and while stress can of course manifest in the gut, that's not always the answer.
posted by fingersandtoes at 8:11 AM on March 10

I have an ulcer that the NP says is not from h.pylori. It can be incapacitating; it fouls up your whole body. I'm on meds, they work okay.

I'm also lactose-intolerant, and generally gave up dairy, which dramatically improved my health by reducing inflammation. I recently went on a cheating binge because life without cheese has a giant hole in it. But my asthma, knee, and foot are flared up with various inflammatory troubles, and it will take a month or 2 to settle down. It takes at least a month of no dairy (milk, cheese, yogurt, sour cream, cream, butter) to tell if it makes a difference. As we get older, many of us lose the enzyme that allows us to digest dairy, not sure the inflammatory effects have a solid explanation, but it's not uncommon. Worth a try. If you do try it, make sure you get adequate calcium.
posted by theora55 at 8:15 AM on March 10 [1 favorite]

I've had several bouts of digestive issues similar to yours, though considerably less intense. In each case, the symptoms resolved in a few weeks (though one time they lasted about two months). I don't know if it had any effect, but I tried to treat the problem by eating a lot of fermented foods and taking probiotic supplements. Hard to say whether this strategy shortened the duration of my gastric distress. Also, for whatever it's worth, my spouse swears by drinking kombucha to combat any stomach issues.
posted by akk2014 at 8:17 AM on March 10

I had issues that overlap with some of yours, with the nausea, gnawing feeling, bloating, etc. At first my doctor was leaning toward an ulcer and treated with antacids, but it ended up being a failing gallbladder. I'm not sure that works with all of your symptoms, but it could be worth asking about.
posted by bizzyb at 8:23 AM on March 10 [1 favorite]

I had very similar symptoms and it turned out to be that I suddenly developed lactose intolerance. It took way, way too long to figure out and I had to suffer and do a ton of tests before discovering it on my own. Maybe switch out the yogurt for something else?

One other possibility is gallbladder problems, which can have a sudden onset as well, in which case you're reacting to fats. Again, a problem if yogurt is all you're eating.

The BRAT diet (bananas, rice, applesauce, toast - no butter!) is often recommended as a stopgap in this kind of situation. Rice, in particular, is more of a neutral food that's less likely to trigger issues than yogurt. People can survive a long time on just rice, with a bit of vitamin supplementation. To start out, try cooking it in tons of water as a kind of porridge/congee so you can almost drink it rather than eat it as a solid. The yogurt might be the only thing that's working because it's closer to being a liquid.

Simethicone (brand name Gas-X in the US) helps with the bloating — if the pills trigger vomiting, you can get drops, they're intended for infants but you can just take more of them. Lots of ginger tea (grated fresh ginger if possible) helps with the nausea. You may be dehydrated as well, some watered-down gatorade might help get a few calories in you and hopefully not trigger your stomach.
posted by 100kb at 8:28 AM on March 10 [3 favorites]

One thing that might help your symptoms in the short term: strictly avoid anything that contains onions or garlic.

Onions/garlic cause stomach misery if you are sensitive to FODMAPS.
posted by chariot pulled by cassowaries at 9:30 AM on March 10

Sorry to hear you're going through this. I have had similar issues in the past, especially the bloating and nausea, and I had to take a lot of tests to rule out intolerances (lactose, gluten) or inflammatory bowel diseases. I didn't have any of that. The interesting thing is that while I didn't test for SIBO, at one point I did respond very well to rifaximin, the main antibiotic that's given to treat it. On the advice of my doctor, I took it for a week once a month for a few months, following it up each time with probiotics. It did help at the time. So that (SIBO - small intestine bacterial overgrowth) may be something else to look into.

NB: SIBO can have different manifestations, with or without diarrhea, in some cases (like mine) even with constipation, it basically makes food ferment in your guts, hence the likelihood of bloating and nausea and vomiting.

Again you have all my sympathy, best of luck, really hope you find out soon what it is and how to treat it
posted by bitteschoen at 10:03 AM on March 10

As a hopefully reassuring data point - I had very similar symptoms with an ulcer that caused swelling right at the spot where my stomach empties out. I never had H. Pylori, just the ulcer (lucky me!) and it was easily treated with a course of sucralfate and Prilosec, over the course of 6 weeks. That's how long the treatment lasted - I felt better after about 3 weeks I'd say. I hope yours is something just as easy!
posted by invincible summer at 10:16 AM on March 10

Sorry just wanted to add: one reason I didn't test for SIBO is that the testing (a kind of breath test) is kind of annoying and not very reliable, my doctor said it was just easier and quicker to take the rifaximin (a specific antibiotic for the gut which clears out "bad" bacteria but doesnt destroy your whole gut flora) and see how you respond.

I'm simplifying a lot but I read up a ton about this at the time, browsing the clinical studies, and one thing that I remember I found very interesting is that SIBO is often an undiagnosed component of IBS, which is itself a big umbrella definition for anything the doctors don't always find a specific cause for. So you may have "just" a case of IBS, with or without SIBO, but that can be pretty horrible in itself and it can be a case of trial and error in finding what helps. Sending lots of hugs.
posted by bitteschoen at 10:16 AM on March 10

Response by poster: Thank you all for your kind comments and sharing your experiences.

For the record, I do have my uterus/ovaries still and ovarian cancer has been on my mind, so I will mention it as well to the doctor.

Since writing the post I've barfed again a couple of times and it's (TMI warning) mostly white foam (a surprising amount given how little I've eaten), which Google suggests is indicative of a few things. I think I'll be on clear liquids only for a bit, weirdly enough I'm now craving chicken broth, though idk how good of an idea it is to have something oily at this stage?
posted by fight or flight at 10:17 AM on March 10 [1 favorite]

Ask for a referral to a gastroenterologist to rule out twisted bowel or celiac, or whatever else you might be reading about.
If you aren't able to eat, the sudden weight loss and malnutrition is a cause for concern.
posted by Enid Lareg at 10:56 AM on March 10

In my case similar symptoms cleared immediately after a course of antibiotics (after 2 months of GP insisting I was probably pregnant despite it being impossible). I did have to get a remineralising treatment for my teeth, throwing up a lot is really bad for tooth enamel.
posted by I claim sanctuary at 11:37 AM on March 10 [1 favorite]

Nthing have your doctor check for gallstones. The way you describe your symptoms is exactly how mine manifested - right down to the burping - except my nausea, while constant, never worsened enough to lead to vomiting (though it came close a few times). But in my case it was several months of my GP essentially shrugging his shoulders when every other test came up normal - h. pylori, ulcer, celiac, multiple endoscopies (ugh), etc. I believe it was my lack of any pain at all (pain is very typical of gallstones) which let him to originally claim that's not what it was. After venting my frustration he finally sent me to a specialist, who after a CT scan and an ultrasound, said "yep, you've got gallstones!" A couple weeks later I had laparoscopic surgery to remove that little suspect sack of stones, and I was right as rain almost immediately after.

In the meantime, see if your doc will prescribe Ondanestron (aka Zofran) for the nausea. Worked very well for me.
posted by SquidLips at 11:51 AM on March 10 [1 favorite]

Best answer: Most storebought chicken broth has almost all the fat removed — I just looked at a couple of brands and they both have 0% fat, so that should be fine. If it's homemade, you can put it in the fridge until the fat congeals and then skim that off the top. But in general, chicken broth is a really, really great thing to have, very stomach-friendly and hydrating. I also used to eat like, overcooked ramen noodles or rice noodles in broth, basically cooked until they were falling apart. Regular pasta might be too much, but something very small like orzo might work. Just again, cook it way too much in some broth or plain salted water. It can sometimes be a while until you figure it out, and you just need to keep your strength up until then.
posted by 100kb at 11:54 AM on March 10 [1 favorite]

Best answer: For a month, perhaps off and on, you've had bloating and nausea so bad that you're vomiting. This is despite eating only about 300 calories a day. You can barely keep one cracker down. Do I have this right? Please ask your GP for a referral (if that's the way it works where you are) to a gastroenterologist, who is better situated to diagnose. If I were in your shoes I'd be curious about what imaging (e.g., CT) or scoping (e.g., endoscopy) might show. I'd also make an appointment with my gynecologist to check for ovarian cysts or other gyn issues.

I'm sorry you're going through this. Hope you feel better soon.
posted by ImproviseOrDie at 12:08 PM on March 10 [4 favorites]

I don't think my stomach issues are similar enough to yours to advise, but when going through phases of difficulty eating, I auditioned a lot of nutrition/calorie booster drinks. The chocolate Ensure is probably the most palatable I tried (with vanilla Boost being the grossest), and might be worth trying to see if you can keep it down (if you haven't already) to help keep yourself going while you try to get answers.

There's also some plant protein based ones you can get (generally online) if milk turns out to be a contributing issue, though Ensure claims to be suitable for lactose intolerance.
posted by space snail at 6:18 AM on March 11

Response by poster: An update: things didn’t improve and yesterday I went to the local A&E department because I was starting to feel woozy/tingling in my hands. They gave me IV fluids & Zofran, did an EKG (fine), blood tests (fine) and urine sample (high ketones but consistent with dehydration), then sent me home with metocloprimide (Reglan).

When I got home I felt better and had a slice of toast and went to bed. This morning I had a banana and took a dose of metocloprimide 10mg, but all it did was make me sleepy and I passed out for three hours. I woke up, tried to eat a bit more, but felt pretty bad and now I’m back to square one of nausea/dry heaving/unable to stomach eating anything.

I feel pretty miserable. The doctor in A&E was kind but clearly exhausted, he suggested a future ultrasound to check for gallstones but didn’t think it was worth ordering one. In hindsight I should have pushed for it. When I contact the NHS telehealth service (111), I’m told to go to my local supermarket pharmacy(!) or that someone will call me back, but they never do.

I’m going to try and get an emergency appointment with my GP again tomorrow morning. The problem is this week there is mass industrial action across the whole NHS so it’s likely everything will be fucked up. Really not liking my body’s timing right now.

Sorry to vent, I just feel crappy and scared that this is some major issue that’s going to get worse before I can ever see someone.
posted by fight or flight at 8:59 AM on March 12 [2 favorites]

Best answer: Thank you for the update and I don't think you need worry about the venting. I'm hating this situation a lot and I'm so sorry it's happening to you: it sounds scary and very unpleasant. Pretty sure everybody in the thread is rooting for you and very much hoping you'll get some help and some relief from this as soon as possible.
posted by Don Pepino at 3:26 PM on March 12 [2 favorites]

Response by poster: So here's where I'm at:

Generally feeling a bit better every day, but I'm not sure how much of this is down to healing from whatever this is or the fact that I'm still eating very little/meds I've been prescribed.

I was back in A&E yesterday because I vomited so hard there was a quantity of bright red blood. Blood tests were okay besides some slightly raised infection markers. I had a chest x-ray to check for oesophageal tears and that was clear. The doctor I saw noted that I seemed quite dehydrated (one look at my pale tongue and he said "okay, you haven't been drinking anything", though I had been sipping on water throughout the day), but I didn't get IV fluids because my veins are so terrible that the lines blew in each arm, resulting in saline leaking into the tissues, and I almost passed out (I have some interesting coloured bruises today). Overall the doctors didn't seem concerned, said it was probably an ulcer or a stubborn stomach bug, and I was given omeprazole and more painkillers and sent home.

So right now I'm taking famotidine 40mg + omeprazole 40mg + cyclizine when needed. Today's the first day of that combo.

Today I woke up feeling fine, had some bread and honey, felt okay and even hungry around noon (when previously I'd been starting to feel nauseous about this time). I risked a cup of miso soup and started feeling slightly worse, took a cyclizine and tried to power through. Just now the nausea got the better of me and I vomited again, which seemed like mostly the water I'd been drinking. I have a sort of burning ache in my stomach which is typical of these episodes. I know if I don't eat anything and lie down I'll probably feel fine again in a few hours and may be able to eat something.

Still haven't had the test results from the h pylori test. Every time I speak to a GP, they say it's probably a stomach bug/infection and to wait and see how it goes, and only to go to A&E again if it gets much worse.

I've chatted with some folks on the gastritis subreddit and the gastroparesis subreddit and they pointed out that the sudden onset doesn't sound like either of those conditions and it may be food poisoning that's sticking around. I honestly have no idea. I'm already tired of trying to convince healthcare professionals to do something besides throw medication at me, I can't imagine doing this for much longer, but I don't know what else to do.
posted by fight or flight at 9:46 AM on March 16

Response by poster: To add: I've been tracking my weight and I've lost 3lbs in a week. 😕
posted by fight or flight at 10:16 AM on March 16

only to go to A&E again if it gets much worse.

Well [string of expletives deleted], that seems a tad unrealistic to me! What if it doesn't get worse but it also doesn't get better? How long are you expected to kick it at home steadily losing three pounds a week?!?

I tell you what, health care standards on Planet Earth... They are not high.

In the past month here in Florida, USA, I've had two friends whose elderly parents arrived in the ER by ambulance and then sat in the waiting room for a day unseen and unassisted being wheeled by their children into and out of the crowded dirty bathroom to vomit. Everybody in my age cohort is looking at this and shuddering. How are things going to look for us when we're their age and beginning our inevitable decline...?

But anyway, I mention this mostly to complain but also to add a tiny data point, namely, my one friend's mother was vomiting in the bathroom of the ER at age 87 because she has a hernia. They are afraid to get surgery for the hernia because they're afraid of anesthesia at her age causing cognitive decline. Her hernia was acting up and causing her to be unable to eat or keep anything down. I don't think I saw hernia mentioned above; it seems like a long shot, but did docs check for that?
posted by Don Pepino at 11:37 AM on March 17

Response by poster: Update time:

It's been a fucker of a week. I was in A&E again on Sunday and this time got all the way to Majors because I was pretty tachycardic (140+ bpm) and needed a potassium drip. I spoke to an absolutely lovely consultant there who both believed me and was totally sympathetic. She gave me an urgent referral to a same day emergency clinic (basically halfway between being admitted and being seen in ED) on Tuesday where I was seen by the gastroenterology team (finally!).

I now have an appointment for a small bowel MRI on the 5th of April (surprisingly soon!) and an endoscopy TBD.

In the meantime, one of the tests I took with the GP came back for high calprotectin (215µg/g) which suggests it might be IBD of some kind, which would.. explain a lot, actually. My family has a history of autoimmune-type issues and we're of Ashkenazi descent, so. I would not be shocked.

In the meantime, I'm on famotidine twice a day + domperidone before meals and feeling fairly normal again, which is such a relief. Famotidine is giving me a slight rash but I noticed as soon as I stopped taking it I started to feel that nasty/acidy/barfy feeling again, so I'm cautiously staying on it. I'd rather not take a PPI right now as I've heard they can cause more problems than they solve.

So, fingers crossed for more answers soon!
posted by fight or flight at 5:31 AM on March 24 [3 favorites]

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