I really really need advice, I have been told different things by the hospitalists, my gi, and my surgeon.
I really can't tell you how much it will mean to get some input.
I apologize in advance for the length, of I left anything out, and also if it's poorly written as I am missing sleep currently, among other things.
Background: I have had chronic nausea for about 2 years or more, off and on in varying degrees. Sometimes this includes bloating and feeling full fast, sometimes after I eat it feels like food just slushes around. I've kept a diary of foods off and on and never found any specific foods that seem to cause it. I also have chronic constipation.
I am 29 years old, 215lbs and 5'9. I have fibromyalgia, bipolar, anxiety and possible pcos.
Was on some psych meds about 4 or 5 months ago but stopped suddenly (I know bad) and am currently on: omeprazole 40mg twice daily, linzess 145mcg, birth control, carafate and reglan, tramadol as needed (maybe twice a week as I try not to take it).
I also have a prescription for zofran, prochlorperazine, and phenegan as well but don't take them cause they don't help.
Initially I was told the nausea and issues were IBS, then a year ago I was told I had gastritis, diagnosed through egd, and treated with omeprazole 40my/twice a day since then. This mostly resolved my symptoms but the nausea persisted.
About 3 months ago I started getting churning and searing pain in my upper stomach with constant extreme hunger pains and increased nausea with loss of appetitie. At this point I was losing sleep from this and was started on carafate by my gi.
2 weeks onto carafate and I started throwing up every few days non stop, nausea was still bad and constant with the addition of waking up feeling full and like my stomach is full of hot liquid. I was also bloating and burping constantly.
Was admitted to hospital and they did some tests. Ct showed possible colitis, but was later ruled out. Also talk of an appendix stone but the surgeon said because my appendix is smaller than normal it's ok. The egd showed duodenitis, gastritis, and esophagitis, all 'mild'. Biopsies were negative.
Its been about 3 months after this started and symptoms still haven't resolved, though bloating and burping are a little better and the burning pain and actual pain in stomach a bit less frequent. The biggest issues is the nausea, I haven't thrown up in 2 weeks but my nausea is so bad constantly that I can barely move or function.
I lost about 35-40 lbs in 3 weeks of this starting and although my appetite is better than it was I still find it hard to eat. I ended up in the hospital twice for passing out, I guess from not eating enough.
When I nap, or sometimes sleep I wake up feeling like I swallowed lava, which doesn't feel like heartburn necessarily, and has happened before this 3 months but not as often. I also wake up around 4-5am with extreme nausea so much so that I can't sleep any longer.
I have been on a bland diet for 3 months, and gluten/egg/dairy free for 3.5 weeks. I eat oatmeal or cereal for breakfast with almond milk and then chicken breast with corn and mushrooms for dinner most days. I use some vegetable oil based dairy free spread for the mushrooms.
My gi insists this is all from gastritis. I had a follow up with the surgeon who did my egd in the hospital who thinks it doesn't explain my nausea as bad as it is. She ordered a HIDA and a Gastric Emptying Study (GI said I am too young to have either done).
Hida showed 47% functionality of gallbladder, GES showed I was 85% empty at 4 hrs (I think like 10% at 2hrs if that matters).
Results of ges said 'mild gastroparesis' but surgeon said it's not gastroparesis and couldn't be causing my symptoms.
She also said I could have my gallbladder removed for a 50% chance it could help my nausea and symptoms.
There was also reported 'small amount of bile' during my egd. Surgeon dismissed it, gi said it means bile reflux but then looked at the report himself and said I don't have it?? Hospitalists went back and forth as well.
SO, my questions I guess are: I was worried because she had me take my meds up to 12 hrs before my gastric emptying test (including ppi and tramadol), could this of affected my emptying study? She said it couldn't.
Could gastritis affect it? I'm understandably worried about the possibility of gastroparesis.
I was told that getting my gallbladder removed wouldn't have any risk of causing/more bile reflux, is this true?
Is it really more likely it's my gallbladder than the delayed emptying?
I was told I should go back on amitriptyline, but this time for stomach and not fibro. Can this cause more issues with delayed emptying?
Anything I am missing? Gallbladder out or no? Do I have gastroparesis?
If this is gastritis why is it worse now and why did the nausea never go away before?
Need advice on where to go from here. Please and thank you.