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Oncology (General Cancer)/nausea and other GI issues...

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Question
Hello Doctor,

I am 32 and have 3 children. Since having my youngest 3 months ago, I have had horrible GI symptoms. My main complaints are peristent nausea, a feeling like there is something heavy in my stomach, and a tender spot on my lower abdomen. I have had several tests over the years for unrelated problems... A sigmoidoscopy in April was normal except I had hemmroids, an upper GI series in August 2011 showed a small sliding hatial hernia and marked reflux, abdominal ultrasound last month showed mild fatty liver (I gained a lot of weight during pregnancy) and mildly enlarged spleen (which I have had for at least 4 years). Abdominal MRI one year ago was normal. Tons of blood tests all normal except for elevated liver enzymes which went back to normal in subsequent tests. I also had a colonoscopy 3 years ago plus biopsy. All normal (no polyps). Oh yes...I also had a pelvic ultrasound 2 months ago and a pap test. No call backs, so I'm assuming that was all fine.
I am troubled by the constant nausea and worry that it might be stomach cancer or something. The docs have basically said I'm fine and its probably a post partum thing. Do u think I should push for a stomach scope?  This nausea is awful to live with...and I'm starting to think something is seriously wrong. I have an apetite but have lost weight...however this might be because of my recent pregnancy.
Any input, thoughts or suggestions would be very helpful.
Thank you.

Answer
If you have marked reflux, and you've put on a lot of weight during your pregnancy, I would wonder if that's the main problem.  Surely the symptoms you are describing are consistent with severe acid reflux, and many with this problem don't have "heartburn".  Before worrying too much, I'd try a couple of weeks of an over the counter preparation like pepsid, tagemet, or zantac.  Take as directed to reduce acid and see if there is an improvement.  If this fails to relieve your nausea, I would consider an upper endoscopy.  Nausea can be due to things wrong with the stomach, like acid reflux; or to some imbalance in the blood like renal failure; or to something involving the nervous system; there are people who experience severe nausea for psychologic reasons as well.  .  So if you have an exam of your stomach and it's negative, you need other things looked at.  Hope this helps.  

Oncology (General Cancer)

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Donald Higby, M.D.

Expertise

I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.

Experience

I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

Organizations
American Society of Clinical Oncology

Publications
New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

Education/Credentials
MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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