I went to see a Hospital Doctor – he gave me an appointment for two weeks time - should I go back sooner ?

[Bill Poster]

For around 20 days I had been feeling constantly nauseous , just that feeling but never ever actually vomited I also noticed that on the day before I went to see the hospital doctor my feces ( stools ) were darker than normal .  

 

This is what I told the hospital doctor ....

 

1. Every day feeling nauseous ( no vomiting )
2. Blood pressure within the normal range ( taken with my home blood pressure machine ) .
3. Urine color looks normal ( No blood seen )
4. No stomach pains / stomach ache 
5. Stool looks darker than normal ( No blood seen )
6. I seem to be belching more that normal.
7. Since I had started to feel nauseous I had stopped drinking alcohol.
9 . Since I had started to feel nauseous I had stopped eating all spicy foods.
10. Since I had started to feel nauseous I had stopped drinking coffee .
10. I had not started to eat any different foods / fruits .
11. I have no headaches .
12. I am not taking any kind of drugs .
13. After eating a large meal my symptoms (  feeling nauseous ) temporally disappear.
14. 10 years ago I suffered from bad reflux acid and I underwent surgery  ( Nissen fundoplication ) to stop the reflux acid , which the surgery did.

 

 

The doctor said I had to undergo the following below - Results in brackets (  ) 

 

A. Physical examination of my stomach area. ( No issues found )
B. Blood test - 4 vials of blood were taken. ( Blood test results showed high cholesterol , every thing else was within the normal range) .
C. A stool sample .( stool sample results were negative ) .
D. An ECG test - electrocardiogram . ( results were normal ) .

 

When the doctor gave me the test results , I asked him why do you think my stool looked darker that normal , he said he did not know. I then asked him what do you think may be the ongoing cause that is making me feel nauseous every day . His answer was , at this point he was not certain .

 

The doctor then prescribed the following drugs .

 

1. Simethicone 80mg  ( Simeticone, is an anti-foaming agent used to reduce bloating, discomfort or pain caused by excessive gas. )

2. Domperidone 10mg ( Domperidone is an anti-sickness medicine. It helps you to stop feeling or being sick (nausea or vomiting).

3.Omeprazole 20mg ( a medication used in the treatment of gastroesophageal reflux disease, peptic ulcer disease ) .

 

Its now been 4 days since seeing the hospital doctor and I started to take the prescribed drugs . The feeling of nauseous has not gone away , but  my stool color has returned to normal.  

 

The thing worrying me relating to the prescribed drugs is this, only one of them ( Omeprazole ) is a drug that can possibly treat the issue that may be making me feel nauseous , the other two prescribed drugs ( Simethicone + Domperidone ) are just drugs that make you feel better. 

 

I’m now getting even more concerned there is still some thing that is causing me to feel nauseous on a daily basis , and I’m now wondering if its too soon after my first doctors appointment
to make a new appointment to go and see the same doctor right away , or just wait things out until my next all ready book appointment in two weeks time.  

 

Any thoughts / suggestions about the feeling nauseous symptoms / advice , would be welcome. 

 

 

Thanks .

[faraday]

Try taking Charcoal Tablets, you can buy them in 711 or pharmacies.

 

I would certainly go back & see the doc, & maybe have a Gastroscopy.

[Sheryl]

Certainly if you are not feeling any better you should return to the doctor or see a different one. Was the doctor you saw  a GI specialist?

 

Omeprazole would not address nausea. Dromperidone and simethecone possibly might but are obviously not working.

 

Do you know what blood tests were done? In particular was amylase included? Liver enzymes? Cretanine?

 

Are you on any regular medications? If so, what (besides those yo umention)

 

Dark stool is usually due either to presence of blood (which the stool test should have shown) or something you ate - many foods can do that.

 

Additional investigations that you may need would be:

    an abdominal ultrasound (check for gall stones/inflammed gall bladder)

    posisbly an endoscopic ultrasound (to check pancrease)

    possibly a gastroscopy

    if not already checked then amlyase levels, liver enzymes, creatnine and BUN. I would also suggest CA19-9.

 

This all needs to be overseen by a GI specialist. Where in Thailand are you?

 

 

[stevenl]

"Omeprazole would not address nausea. Dromperidone and simethecone possibly might but are obviously not working."

It does for me.

[Bill Poster]

Thanks Sheryl for your reply , its appreciated .

 

The hospital where I saw the doctor underwent the tests is called the Suranaree University of Technology Hospital situated in Korat . The doctor I saw was not a GI specialist but a general doctor.

 

The doctor showed my the blood test results on his computer monitor , I remember the doctor saying that your liver is fine with no problems , but I can’t definitely say what was included in the blood test results. 

 

Thinking back to when I first started to feel nauseous I just assumed that I had contracted mild food poisoning and as I had done in the past , I bought some activated charcoal capsules from 7-11 , hence my dark stool appearance.

 

I am not taking any regular medications other than the one’s the doctor prescribed. 

 

During my conversation in English with the doctor , I think he mentioned some thing about undergoing an endoscope examination . 

 

The doctor gave me two future appointments , the first one in two weeks time where he asked me to provide a new stool sample , I now think that my dark stools were due to me taking some activated charcoal capsules . And at that next appointment in two weeks time depending on how I was feeling  at that time the doctor would then if my symptoms had not improved , would ask me to undergo further tests , which tests he was talking about I am not too sure . 

 

The second appoint the doctor made for me was to be in two months time , when I asked the doctor what that appointment would  be for , he said a new blood test. 

 

One thing that sticks out in my mind is the fact that if I eat a large meal ( my appetite has not diminished ) shortly after consuming the food my nausea symptoms seem to disappear for several hours .

 

As my feeling nauseous has not diminished , the best thing I can think of is to return to the same doctor before my next booked appointment in two weeks time and outline again my still feeling nauseous symptoms to the doctor , and then ask to be referred to a GI specialist .

 

One thought I just had , as its only 4 days since I saw the doctor and stated the medication , would it be prudent to wait a few more days to see if my symptoms may improve . I’m not sure . 

 

The  Suranaree University of Technology Hospital  I attended was well run and modern and I have no complaints relating to my visit there and the professional way I was treated .

 

Thanks .

 

[BritManToo]

3 hours ago, Sheryl said:

an abdominal ultrasound (check for gall stones/inflammed gall bladder)

 

I'd go with this, gallstones made me constantly feel sick (worse at bedtime) and changed the colour of my poop.

Cost me 200bht for the ultrasound in a government hospital.

General  doctors often miss gallstones, but the Ultrasound doctor/operator won't.

 

Edited February 18, 2021 by BritManToo

[Bill Poster]

58 minutes ago, BritManToo said:

I'd go with this, gallstones made me constantly feel sick (worse at bedtime) and changed the colour of my poop.

Cost me 200bht for the ultrasound in a government hospital.

General  doctors often miss gallstones, but the Ultrasound doctor/operator won't.

 

Thanks for your comment .????

 

I don’t experience any pain any where , so I researched …

 

can you have gallstones without pain.

 

And came up with this …

 

Gallstones themselves don't cause pain. Rather, pain occurs when the gallstones block the movement of bile from the gallbladder. According to the American College of Gastroenterology, 80 percent of people have “silent gallstones.” This means they don't experience pain or have symptoms.

 

 

So the gallstones theory may be correct , even though I do have the nauseous symptoms . 

 

 

 

[BritManToo]

Just now, Bill Poster said:

So the gallstones theory may be correct , even though I do have the nauseous symptoms . 

The nausea is caused from bile being blocked or restricted, i had this for 5-10 years.

You only get pain when a gallstone blocks the bile duct allowing bacteria from the gut to grow back and infect (10 years to get to this stage for me).

 

And the pain is unbelievable when it happens.

i changed my lifestyle, lost a lot of weight, exercised much more and over a 2 year period all the symptoms went.

Been problem free for 6 years now (although the quick fix is to get your gall bladder removed). 

[Bill Poster]

18 minutes ago, BritManToo said:

The nausea is caused from bile being blocked or restricted, i had this for 5-10 years.

You only get pain when a gallstone blocks the bile duct allowing bacteria from the gut to grow back and infect (10 years to get to this stage for me).

 

And the pain is unbelievable when it happens.

i changed my lifestyle, lost a lot of weight, exercised much more and over a 2 year period all the symptoms went.

Been problem free for 6 years now (although the quick fix is to get your gall bladder removed). 

 

Thanks 

 

I was just about to ask you this ..

 

Just out of curiosity , what treatment did you undergo to treat your gallstone problem .

 

So to treat your gallstone problem you never underwent any surgery or drug treatment ?

 

In my case I have the feeling of being nauseous all the time , it never really  goes away .

[Sheryl]

The charcoal would certainly explain the dark stool so no worries on that score.

 

Up to you if you want to wait or return to the doctor sooner. As it is already Thursday I'd probably wait till early next week. But I think if the meds were going to help they would have by now.

[BritManToo]

58 minutes ago, Bill Poster said:

In my case I have the feeling of being nauseous all the time , it never really  goes away .

Walk 5-10Km a day, particularly walk when you're feeling nauseous.

I always felt worse just before bed, so I''d go for a walk before bed.

 

Eat simple food, white rice, grilled chicken, avoid all bread, dairy, sauces, spices, fried, processed food, coffee, fizzy drinks.

Now I'm no longer overweight, and exercise every day, I've returned to eating anything I like, but the first 6-12months were hard.

Edited February 18, 2021 by BritManToo

[Bill Poster]

2 hours ago, Sheryl said:

The charcoal would certainly explain the dark stool so no worries on that score.

 

Up to you if you want to wait or return to the doctor sooner. As it is already Thursday I'd probably wait till early next week. But I think if the meds were going to help they would have by now.

 

Thanks .

 

I’m going to wait until some time next week to telephone the hospital and make a new sooner appointment with the same doctor .

 

To night for my evening meal I had grilled chicken and assorted steamed vegetables , as soon as I had finished that meal my ever present nausea symptoms magically disappeared and have not yet returned . And that situation happens every time I have a meal . I’m trying to understand why having a meal ( not a snack ) makes my constant  nausea symptoms temporarily disappear . So far I can’t seem to find an answer . 

[Bill Poster]

2 hours ago, BritManToo said:

Walk 5-10Km a day, particularly walk when you're feeling nauseous.

I always felt worse just before bed, so I''d go for a walk before bed.

 

Eat simple food, white rice, grilled chicken, avoid all bread, dairy, sauces, spices, fried, processed food, coffee, fizzy drinks.

Now I'm no longer overweight, and exercise every day, I've returned to eating anything I like, but the first 6-12months were hard.

Many Thanks 

 

Some sound advice I'm going to start following ????

[tonray]

9 hours ago, Bill Poster said:

 

Thanks .

 

I’m going to wait until some time next week to telephone the hospital and make a new sooner appointment with the same doctor .

 

To night for my evening meal I had grilled chicken and assorted steamed vegetables , as soon as I had finished that meal my ever present nausea symptoms magically disappeared and have not yet returned . And that situation happens every time I have a meal . I’m trying to understand why having a meal ( not a snack ) makes my constant  nausea symptoms temporarily disappear . So far I can’t seem to find an answer . 

Check the whites of your eyes....any yellowing ?

 

Also did the doctor check (ultrasound) gall bladder...very common to have nausea symptoms with gall bladder stone or obstruction

[Sheryl]

he has not had an ultrasound yet, that would be logical next step

[DogNo1]

Could be gallbladder or histamine intolerance.   Histamine intolerance is gaining recognition as the cause of many symptoms, including psychological symptoms.  Dr.Ede, a psychiatrist who is a Harvard graduate, has a website worth looking at for information regarding histamine intolerance.  It causes many problems that often are not diagnosed correctly.

[Bill Poster]

14 hours ago, tonray said:

Check the whites of your eyes....any yellowing ?

 

Also did the doctor check (ultrasound) gall bladder...very common to have nausea symptoms with gall bladder stone or obstruction

Thanks for your comment , the Ultrasound is on my list of things to talk to the doctor about .

[Bill Poster]

4 hours ago, DogNo1 said:

Could be gallbladder or histamine intolerance.   Histamine intolerance is gaining recognition as the cause of many symptoms, including psychological symptoms.  Dr.Ede, a psychiatrist who is a Harvard graduate, has a website worth looking at for information regarding histamine intolerance.  It causes many problems that often are not diagnosed correctly.

Thanks ???? I had never heard of histamine intolerance , so I'm now going to check it out.

[Bill Poster]

Ever since I started to feel constantly nauseous , although my apatite had not diminish I cut back on eating my normal three meals a day routine just to see if doing that food reduction improved my symptoms in any way. Cutting back on the amount of daily meals I ate did not seem to have any obvious effect and my being constantly nauseous symptom never changed or reduced. 

 

However I did start to notice that after one of my home cooked evening meals , within 10 minuets my feeling  nauseous symptom slowly went away and I felt better . So I wanted to see how I would feel when feeling nauseous , If I ate a small amount of food instead of a large home cooked meal, so today I ate  a small sandwich and a packet of crisps .  ‘’ Lo and behold  ‘’ after eating only those two small food items my constantly nauseous feeling started to become less and less .

 

I’m trying to find out what the possible relationship is between eating food and then my nauseous symptoms diminishing . 

 

Any one have an idea ? 
 

[Bill Poster]

8 hours ago, Sheryl said:

he has not had an ultrasound yet, that would be logical next step

Thanks Sheryl

 

Other tests Ive now read about are ....

 

1. Liver function
2. Ultrasound ( already mentioned ) 
3. Colonoscopy
4. HIDA Scan
5. Endoscopy
6. Chest X-ray
7. Urine Test
8. CAT Scan
 

[tonray]

9 minutes ago, Bill Poster said:

Ever since I started to feel constantly nauseous , although my apatite had not diminish I cut back on eating my normal three meals a day routine just to see if doing that food reduction improved my symptoms in any way. Cutting back on the amount of daily meals I ate did not seem to have any obvious effect and my being constantly nauseous symptom never changed or reduced. 

 

However I did start to notice that after one of my home cooked evening meals , within 10 minuets my feeling  nauseous symptom slowly went away and I felt better . So I wanted to see how I would feel when feeling nauseous , If I ate a small amount of food instead of a large home cooked meal, so today I ate  a small sandwich and a packet of crisps .  ‘’ Lo and behold  ‘’ after eating only those two small food items my constantly nauseous feeling started to become less and less .

 

I’m trying to find out what the possible relationship is between eating food and then my nauseous symptoms diminishing . 

 

Any one have an idea ? 
 

With gall bladder issues the most common symptoms would be nausea after eating foods with a high fat content. Gallstones can present a variety of symptoms or almost none at all so not outside the realm of possibility for your so far anecdotal observations under loosely controlled conditions. Please let us know by following up after the tests. Good luck

[Bill Poster]

30 minutes ago, tonray said:

With gall bladder issues the most common symptoms would be nausea after eating foods with a high fat content. Gallstones can present a variety of symptoms or almost none at all so not outside the realm of possibility for your so far anecdotal observations under loosely controlled conditions. Please let us know by following up after the tests. Good luck

Hi and many thanks for your comment ????

 

In my case the constantly nauseous symptoms are reduces / go away ‘’ after eating ‘’ which seems to be the other way around rather than the normal ‘’ nausea after eating foods with a high fat content ‘’  situation. When I eat my nauseous goes away . I’m going to see the doctor in a few days to tell him about my situation where it seems that my feeling constantly nauseous is reduced / goes away after I eat some thing .

 

I have my fingers crossed that I don’t need to have my gallbladder removed. ????.

 

I will of course post back on how things go .