“My ultrasound/endoscopy/HIDA scan all came back completely normal. What else could it be?”
I'm a female, age 19, 110 pounds, 5'3", based in the United States, Caucasian. I started waking up with really bad nausea in the middle of the night back in February 2021. It continued to get more frequent and by April 2021 I was waking up with nausea/indigestion every single night. Then I started to get fatty food intolerances and some upper right side pain that feels like a mild to sort of bad ache (but this is so infrequent).
Doc ordered an ultrasound, came back completely normal. Then an endoscopy with biopsies, all of which came back completely normal, not even any evidence of acid reflux. Then I had a HIDA scan, which came back completely normal. I will say though that the technician did mention that it took a very long time for my gallbladder to show up on the scan.
I have been on 5 mg of lexapro for anxiety, 40 mg of Famotadine, and have been perscribed Zofran as needed for nausea. I have tried everything from raising my bed to sleeping in a recliner. My symptoms are the worst in the middle of the night, and are also bad after eating fatty foods/ "heavier meals".
I am seriously going crazy. It is so discouraging to have all of my tests come back normal. I just want answers, peace of mind, and to feel better. Have any ideas?
Doc ordered an ultrasound, came back completely normal. Then an endoscopy with biopsies, all of which came back completely normal, not even any evidence of acid reflux. Then I had a HIDA scan, which came back completely normal. I will say though that the technician did mention that it took a very long time for my gallbladder to show up on the scan.
I have been on 5 mg of lexapro for anxiety, 40 mg of Famotadine, and have been perscribed Zofran as needed for nausea. I have tried everything from raising my bed to sleeping in a recliner. My symptoms are the worst in the middle of the night, and are also bad after eating fatty foods/ "heavier meals".
I am seriously going crazy. It is so discouraging to have all of my tests come back normal. I just want answers, peace of mind, and to feel better. Have any ideas?
Female | 19 years old
Complaint duration: 9 months
5 Answers
Even though your scope was negative, you could still have acid reflux causing almost all of these symptoms. You should try a diet without spicy food, greasy food, fatty food, fried food or caffeine. Also, try a course of over-the-counter acid reflux medicine like Nexium or Prilosec. Make sure you drink plenty of water and get daily exercise.
The next step would be esophageal motility with impedance measurement and 24-hour pH monitoring. Before seeking the motility, I would try taking 2 Gaviscon with a glass of water at bedtime. If that worked it would confirm nocturnal reflux. An endoscopy with biopsy does not exclude the possibility of reflux.
Ask your GI doctor if you might have delayed stomach emptying. That is also called gastroparesis. Sometimes, even though the HIDA scan is normal, it might still be the gallbladder. You may want your doctor to repeat in 3-4 months. Each study is just a snapshot and sometimes has to be repeated to get to the answer.
Hope that helps!
Hope that helps!
The differential diagnosis must include GERD, biliary dyskinesia, gastroparesis, pancreatic insufficiency, fructose malabsorption, etc.
You need to see a doctor who will go beyond the simple measures that you have had, namely, endoscopy and imaging. These tests often do not find the problem, and if your GI doctor doesn't know what to do next, then you need to find a new doctor, because there are many, many causes of nausea that have nothing to do with your stomach or gallbladder. Nausea can be caused, for example, by endocrine disorders like Addison's disease. You need a thorough history taken and a proper work-up vs. empirical treatment.
