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What Causes Nausea And Gastritis Pain On Waking Up In The Morning?

Posted on Sat, 19 Jul 2014

Question: Female of 19, not pregnant, no STDs. I wake up with bad nausea and gastritis pain every morning for the past 7 months. I had gastritis for about 5 months but it pretty much went away. I've now started to have constant lower back pain (dull ache). Starting to have more constant pelvic pressure and pain. And I'm feeling the pelvic and stomach pain go through the inside of my legs. I recently had my period during this and the pain was ridiculous, I could barely get out of bed the first couple of days. I can barely eat anymore. When I have my pain in the am I have to lay in bed and half the time I fall asleep right after. I feel pain travel through my colon occasionally and when I ate enough for a bowel movement it would be pretty painful. Eating anything makes my stomach hurt (around belly button and under mostly) I'm so tired but I wake up early in the a.m due to bathroom urges, pain, or vomiting. I've had blood work done for CBC, liver function, pancreas amylase... And I've gone to the GI and had an endoscopy which found nothing causing the pains, a gyn who found no infections of any sort. And I also have not had blood in my stool or urine or vomit. The only other thing I noticed is that around the time all this started my nails started to become translucent on the white parts, started chipping and forming white dots on the tips. Also my CBC showed increase in platelets and my urine showed white blood cells twice on diff occasions.. Perhaps a week or two in between. Any ideas?

Answered by Dr. Deepak Kishore Kaltari (32 minutes later)

Brief Answer:
To rule out urinary tract infection

Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day

Dear Ms,

Presence of early morning pain , especially waking you up from sleep suggest the possibility of organic cause.
The analysis of your symptoms so far suggest the following possibilty
1. Pre-menstrual syndrome
2. Urinary tract infection:Especially in view of lower abdomen pain , back ache and presence of white blood cells in urine
3. Intestinal colic: To rule out possibility of malrotation of midgut. Ultrasound abdomen will be required
It would be more helpful if you could provide me additional information so that I am able to assist you better
1. Are your bowel movements regular? Do you have constipation The early morning bathroom urges: Do you pass stools in good quantity or you end up feeling to pass more but nothing comes(Tenesmus)
2. Do you have any urinary complaints: Like increased frequency of urination,burning urination, high colored urine?
3. Are you sexually active?
4. Are you cycles regular?
5. What is the color of vomiting? is it bilious?

Awaiting your response

Take Care

Best Regards
Dr Deepak Kishore
MBBS,MS,MCh

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Deepak Kishore Kaltari (33 minutes later)

Sorry, i thought my name would pop up for you. Its XXXXXXX I was just tested for a uti and it was negative. To answer your questions:
1) i have completely irregular bowel movements. Mostly diarhea... Actually tends to be green in color or occasionally yellow. ( gross ik) for a while when i was eating and the pain was at its peak it actually wud have some types that wud float and looked like it had mold on it... Like fuzzy stuff covering it. And i would say about a quarter of the time i feel like i could go more but cant.
2) i have had an increase in urination, but ive been drinking water and sometimes eating ice in place of a meal (the nausea gets that bad sometimes). When i wake in the a.m to use the bathroom the urine is a but darker than what i would think is okay but the next time i go its practically clear... But again i think sometimes it has a light green tint to it.
3) not sexually active
4)cycles are regular
5) when i do vomit it is clear sometimes a lil yellow, verry bubbly. When i throw up food thow it still has its color but its pretty much liquified. Also i have like throbbing and sometimes cramping pain in/around my vagina and anus. Sometimes its a shooting pain thst goes into my leg (dont remember if i mentioned that.)Bowel movements hurt more when they are normal (not diarhea). Sometimes my sides hurt (around my pelvis)

Answered by Dr. Deepak Kishore Kaltari (2 hours later)

Brief Answer:
Symptoms possibly due to Colitis

Detailed Answer:
Dear XXXXXXX

Let analyze your symptoms

1. Pain in lower abdomen , along with tenesmus( sense of incomplete evacuation) amd diarrhea suggest the possibility of Colitis. it is infectious inflammation of colon

2. Pain while passing stools suggest the possibility of painful anal condition like anal fissure.
Examination of anal region will be diagnostic. It would be helpful if you could provide clinical photograph for further assessment

3. Vomiting: It is likley to be due to gastritis: I assume there was no biopsy taken during endoscopy to rule out Helicobacter pylori infection

I would suggest you the following which will be helpful

1. Antibiotics: Combination Of ciprofloxacin and Tinidazole takentwice a day for 10 days

2. Anatcid like Pantoprozole and anti-emetic like Domperidone will be helpful

3. Hot Seitz bath: To a tub of lukewarm add a handful of common table salt. Sit in it for 15 - 20 minutes it will reduce the pelvic muscle spasm

4. Antispasmodic like Drotaverine will be helpful for abdominal cramps

5. Regular diet

6. Avoid caffeinated/carbonated/ alcoholic beverages

Do get back to me if you need any further assistance

Take Care

Regards
Dr Deepak

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar