One of the most common and vexing medical complaints I see in the office is nausea. Indeed, not a day goes by that a patient does not lament the presence of this uncomfortable and vague sense of distress. This symptom is among the most frustrating for both patients and providers. The reason for this is that in most cases, the complaint cannot be explained.
Of course, nausea can have an specific cause which we physicians will try to identify. In
these cases, the nausea is usually a secondary effect of another medical
condition. In other words, the nausea is
not typically caused by actual stomach disease.
Patients with viral infections, gallbladder issues, depression, appendicitis,
migraines, inner ear disease, pregnancy or marijuana abuse can all experience
nausea. And nearly every medicine will
have nausea listed among the long list of potential side effects. When I see a patient suffering from years of
nausea, how might I determine which of their 15 or so medicines might be
responsible? I'm open for suggestions!
Most of the nauseated patients I see have no clear
explanatory cause. They are just
nauseated for no obvious reason. The
nausea may be constant or intermittent.
It can vanish for weeks and may suddenly reappear without any clear
trigger. In contrast to concrete issues
that we gastroenterologists address, such as rectal bleeding, nausea is
vague. There is no ‘nausea blood test’
or ‘nausea scan’ to explain the symptom.
It’s similar to other challenging and common medical complaints such as
fatigue, weakness, dizziness and headaches.
Of course, these symptoms are all real, just like nausea, but they can
be difficult to explain. Such patients
often undergo a battery of negative diagnostic tests, which is reassuring but
still frustrating.
Even though physicians can’t explain your symptoms, doesn’t
mean that you can’t be helped. There are
many available medicines, counseling techniques, functional medicine approaches
and even complimentary medicines that can deliver hope and relief. Naturally, patients want to know what is
responsible for their complaints. But
when this is not possible, the mission should shift to searching out strategies
to feel better.
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