About B. Todd Troost, MD Expertise vertigo, benign positional vertigo, BPPV, and related ailments.
Experience
Past/Present clients More than 2000 patients with vertigo.
Chairman of Neurology Department for 18 years and examiner for American Board of Neurology for over 25 years. Extensive information is provided on my commericial free website at www.ivertigo.net
Expert: B. Todd Troost, MD Date: 9/5/2003 Subject: nausea
Question Dr. Troost:
Since around the late spring of 2001 my husband has suffered from debilitating nausea. It was definitely worse during the first four months of symptoms, but still persists. Pertinent info:
Symptoms:
Nausea, he describes it as constant motion sickness. Dry heaves when it is at its worst. The nausea is worse in the morning and is aggravated by moving and somewhat alleviated by eating (having a full stomach). For the first four months or so he was constantly experiencing the nausea, to the point where if he would of had anything but a desk job he wouldn't have been able to work. Now he still usually experiences it daily, but there have been a few days where it goes away completely.
Tests and Doctors:
We lived in Philadelphia when the nausea first presented, and the stomach doctors referred him to an ear doctor who performed some simple balance tests and said his balance was way off. He said he probably had some type of inner ear virus that was causing vertigo and perscribed valium. The valium did not help. He also got a cat scan which was normal. The doctor did not have any other recommendations other than to say it will go away on its own.
Since that time we moved to Minneapolis and the doctor's here are focusing on it being a stomach issue, however, none of the tests show anything wrong (upper gi, and the one where they stick a scope down his throat).
Everything I have read about ear disorders seem to focus on dizziness and imbalance, but Matt's main symptom is nausea. Do you have any idea what is going on? Any tests he should have done or talk to his doctor about? Any specific specialist he should see? I feel so bad for him---he is truly sick but no one can tell him why or offer any solutions.
Thank you.
Sara Bergen
sarabergen@hotmail.com
3427 Elliot Ave S
Mpls MN 55407
612.821.7987
Answer Dear Sara:
I just had a patient who primarily had nausea and whose work up was negative. We considered mostly, stomach ( g.i. problems ) as the most likekly cause although my patient had some lightheadedness as well.
Without clear cut balance problems described by your husband I don't care what the test suggests, it is unlikely he has a balance problem. On the other hand if he experience some rocking sensations with his nausea he could have MDD or even bppv ( Mal de Debarquement is MDD ) and bppv is Benign Positional Vertigo. I must say his symptoms do not sound like either of those conditions from what you write and I too would tend to focus on gi causes.
Both MDD and BPPV respond to exercise therapy and that may be something to consider. See: http://ivertigo.net/vertigo/vertherapy2.html and click also where it says "Brief Review for Patients".
