The following dreary dissertation concerns a chronic gastrointestinal
disorder which has plagued me for approximately seven years. I have written
this in one form or another for every doctor I have consulted. None have
been able to diagnose the condition, much less treat it.
I am seeking advice from the sci.med readership. If you have experience
with this sort of thing and think you might be able to help, please read on;
I'd greatly appreciate it. If not, hit 'n' now.
My illness began in late summer of 1984, at age 20. After a fairly
heavy szechuan Chinese lunch at a local restaurant I had frequented for over
two years, I was stricken with severe nausea. No vomiting occurred. The
nausea lasted the entire afternoon and into the evening, and recurred
several times a day up until the present time.
The attacks sometimes disappear after an hour or two, but most often
persist for days or weeks without letup; the symptoms are there when I go to
sleep and instantly appear when I wake, sometimes forcing me awake before I
get sufficient rest. They are never accompanied by pain or vomiting. Aside
from two vicious intestinal virus attacks in January of 1990 and 1991, and
as a side effect of a recent esophageal motility study, I have not
regurgitated anything significant in over ten years. Periods of nearly
complete absence of symptoms range in length from hours to several weeks.
Other symptoms include fatigue (ranging from slight lassitude to a need
for over twelve of sleep a day) disorientation (inability to focus attention
for long minutes or even hours) and a constant feeling of febricity, often
accompanied by actual low-grade fever. I also experienced several months of
severe depression about three years ago, but this was apparently due to use
of Reglan (see below.)
I have been completely unable to determine the cause of the nausea. It
persists even in the apparent complete absence of stress and disease
factors. Stress will aggravate it, as will any claustrophobic situation,
but neither will produce it if it is not already present. Vigorous exercise
usually causes some discomfort.
History Of Treatment
In an attempt to diagnose the problem, I have had three GI series, three
gastroscopies, two motility studies with acid perfusion, an ultrasound
examination, an intradermal allergy workup, and have been on various
elimination diets. These have brought to light
a) a partial hiatal hernia
b) unusual esophageal sensitivity to acid, and the sporadic
presence of ulcer-like irritation in the distal esophagus
c) a strong histaminic reaction to molds
d) slight reaction to high-fat / high-sugar foods, which I now avoid
in any case simply on principle
e) extreme nausea response from allium vegetables such as onions
and garlic
According to all concerned physicians, none of these accounts for the
constant nausea I experience. The medications I have used include Carafate,
Compazine, Tagamet, Probanthine, Donnatal, Reglan, Imipramine, Desipramine,
Nardil, and countless antacids. The only noticeable effects have been
negative (severe constipation from Imipramine, severe depression from
Reglan.) I am currently on Prilosec and Bethanechol, which are having
minimal effect at best, and at worst bring on a constant feeling of raw
soreness throughout my stomach area.
I have consulted several internists and gastroenterologists, a
psychotherapist, a psychopharmacologist, four hypnotherapists, a holistic
therapist, and a chiropractor. Naturally, the body-oriented physicians tell
me the problem is in my head. (I suppose this gives them a convenient
excuse when they can't diagnose it.) The mental types tell me the same
thing, which, given the nature of psychiatry, is an equally applicable
excuse.
The only positive result came from hypnotherapy: a three-week symptom-
free period almost immediately following one session. Given the
historically nondeterministic nature of the illness, and the fact that a
repeat of the session's treatment produced no results, I attribute this to
coincidence.
Medical History Prior To Illness
Aside from being some ten to forty pounds underweight, I have always
been in fairly good health. The common cold has usually bored me; I would
catch it about once a year, ignore it, and it would go away. I contracted
tonsilitis twice while in my early {*filter*}s, chicken pox at age 17, two or
three cases of the flu, and one strange but fleeting eye infection. I can
recall only four cases of serious (i.e., viral) stomach illness from age
eight or so up to the present time; these lasted a few days at most. I
would invariably be the only one in the house who remained well while
everyone else was ill, and vice versa.
I have two other unusual conditions, neither of which causes any
problems: mitral valve prolapse, and the complete loss of hearing in my
right ear from a concussion suffered at age 9.
My mental health was also excellent until the onset of the nausea. I
never experienced unusual hyperactivity, aggressiveness, or depression.
Diet
I am currently a vegan by choice, choosing to abstain from consumption
of animal products due to the heinous practices of the American meat and
dairy industries with respect to antibiotics, hormones, pesticides, and
feedlot conditions. I eat exclusively whole grains, fresh vegetables, dried
and fresh fruits and fruit juices, seeds and nuts, soy products and other
legumes, and purchase organically grown foods whenever possible. Beverages
are limited to herbal teas, fruit juices, and water. I scrupulously avoid
foods with artifical additives. I don't smoke, take {*filter*}, or drink {*filter*}
or colas in any amounts.
I have followed this diet for two years with no apparent ill effects.
Current Condition
I have nothing remotely resembling a normal lifestyle. I am generally
unable to do anything when beset by severe nausea; I have to go home and
sleep (or sit in the bathroom.) My entire daily schedule revolves around
when I have to eat and how much I can expect to get done before eating. I
plan for most of my shopping, important work, and other business to be done
before lunch, and preferably even before breakfast. For the year and a half
that I had the problem while still in college, I missed about a third of my
classes. My social life during the entire seven years has been nearly
nonexistent.
I am, at present, having significantly greater trouble eating than at
any time in the past. My weight has dropped below 100 pounds (I am 5'10"
tall.) I suffer from fatigue, shortness of breath, and poor concentration.
Inability to work a full work-week is costing me about 1/4 of my salary.
==========
Shortly before sitting down to post this, I ate a small meal of
whole-grain toast and fruit/vegetable salad (typical of my diet.) Save for
salary problems, I am under no external stress that I can perceive -- not
from work obligations, relationships, whatever. Nevertheless, I am on the
verge of vomiting, and have a 99.5 fever. This state characterizes most of
my waking hours.
I am not seeking pity, prayers, or flames -- merely sound medical
advice. If you have any insights, please send e-mail.
Thank you for your time.
- chris ross
Please help me diagnose my condition