Question: Hello Neurologist person,

In October of 2012 I underwent a colon re-section due to diverticulitis. After the surgery I contracted C. Difficile and was treated with two rounds of Flagyl.
In February of 2013, 3.5 months later I began experiencing severe and chronic nausea. Basically, I feel like I'm going to throw up all day, every day. I don’t often actually throw up but the feeling is so horrible and so overwhelming that I am unable to work or do much at all.

I have seen many doctors since that time: 3 Gastroenterologists, a pancreatic specialist, an immunologist, an internal medicine physician and a psychiatrist. I’ve had numerous tests including a brain scan, heart stress test, stomach emptying test, and MRCP; the results of which have all been negative. I've tried a bunch of different diets including the FODMAP diet, along with restricting gluten, milk products and pretty much anything anyone credible has suggested, all to no avail. It seems at this point that there is no discernable “cause” for my ongoing nausea.
It has been suggested to me that there could have been some nerve damage either during the original surgery or caused by scar tissue forming in the months after. This hypothesis puts forward the idea that there is a signal being sent to my brain that says I’m about to throw up, regardless of the fact that my GI tract is functioning just fine.

So here are my questions:

1.     Is it possible that I have suffered some form of nerve damage that is erroneously indicating that I am about to throw up?

2.     Knowing that every other test has come back negative, is this a reasonable explanation for my illness?

3.     Is there any way to test the above premise?

4.     Assuming that the answer to #1 is yes. Is there any way to treat it? (If the concept is sound but there is no treatment available then there’s no point in pursuing this direction any further.)

5.     What would you do if you were me? Who would you want to consult with?

Thanks for considering my questions,

XXXX

Hello Dr. Panwar,

I've been undergoing weekly psychotherapy for the past 18 months with a psychiatrist. Mostly we've been dealing with my depression due to my loss of gainful employment and the general terribleness of my life since becoming ill.

We've certainly talked more than once about the possibility of my illness being psychiatric in nature but she doesn't believe this is the case. Her opinion in this matter is reinforced by the fact that I haven't experienced any trauma and in the months preceding my illness my life was actually going quite well both professionally and personally. Without any related trauma and the fact that my mood has significantly improved over the past few months, it would seem unlikely that I would still have the exact same symptoms that arose almost 3 years ago and that have continued unabated every single day since.

As this is her area of expertise I will defer to her opinion on this matter.

Any other theories?

XXXX

One more question...

A GP who answered my question suggested trying Gabapentin and Pregabalin. In your opinion is there any point in asking my GP about trying these medications?