Chronic nausea and lack of appetite Chronic nausea and lack of appetite

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Thread: Chronic nausea and lack of appetite

  1. #1
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    Default Chronic nausea and lack of appetite

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    Hi Robert,

    I thought you might have some valuable insight into this. Since I was about 15 (28 now) I have had a general loss of appetite and chronic nausea. When I get hungry, I do not feel like eating, I just feel nauseated. At the same time the only thing that makes it feel better is eating. Sometimes just eating a little bit can be difficult, and I start burping/hicupping after just a few bites. I did an endoscopy in 2009. The Dr. noted I have what looks like the pre-stages of Barrett's Esophagus and mild inflammation. He prescribed me a PPI. I noticed no change, stopped taking them, and tried to just ignore the problems. I also started using marijuana daily at this point to help me get food down. It definitely helped a lot, and it helped me stay asleep at night and not wake up to the nausea. Over the years I've tried some other things too -- sleeping on a raised bed, taking a large dose of vit C before bed (as Rip has recommended for acid reflux), not eating before bed. Nothing had any impact. In late 2018 my GP thought I better go get another endoscopy to check things out. The ENT noted inflammation caused by acid producing cells in the throat, but said I was not dying, and he didn't recommend further action. He prescribed PPIs like the first doctor. I tried them, noticed no change, stopped taking them. The doctors once again didn't seem to be able to help me, so I decided that I better just keep using marijuana. Now, I am about to finish grad school and I'm thinking it may not be in my best interest to be stoned all the time. I also worry about my health from smoking/vaping weed. About 3 weeks ago I stopped completely. My throat feels better since I've stopped since it was also getting irritated from inhaling the smoke/vapor. However, the nausea has been terrible and I wake up multiple times a night to it. I'm hoping things might still improve over the course of the next few weeks/months.

    Anyway I just wanted to see if you had any thoughts on this. Despite these problems I'm still around 225lbs at 6'0, but I have to be extremely disciplined about eating and just force the food down. Usually, the later in the day it is the easier it is to eat. Still -- sometimes I have to eat dinner over the course of 2 hours just to get a big enough meal down. Any ideas or suggestions? Thanks.

  2. #2
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    Thanks for sharing. How strong are you? This is a rather complicated situation. Do you eat spicy or caffeinated foods? What does your actual diet look like?

  3. #3
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    Hi Robert -- thanks for responding. I'm pretty strong. You've taken a look at my deadlift before but I think that was on my old username. Anyway these are my best lifts (done before covid, but I'm just about back to the same strength level now, about to set new PRs):

    OHP: 86kgx5
    SQ: 234kgx5
    BP: I stopped doing these because of shoulder issues. I'll probably start closegrip soon though.
    DL: 262.5kgx5
    PC: I can hit something between 130-140 depending on my fatigue.

    As you might imagine, my diet has varied over the last 13 years and I've never noticed any change to how I feel. I did start drinking coffee recently -- just 1 cup in the morning. I do eat spicy foods, but again, I didn't before and I haven't noticed a difference. If anything spicy foods help me eat a little more. Here's a sample of what I might eat in a day:

    Breakfast: 6 soft boiled eggs and some simple carb like fruit or rice. (Can be tough to get these down, but eating the eggs soft boiled has made it easier).
    Lunch: Meat + vegetables + rice, or nothing.
    Dinner: Meat + vegetables + rice.

    The meat is usually one of the following: Ground beef, pork chops, steak, whole chicken. At least 350grams. I'll also have 1 - 2L of kefir throughout the day. Other snacks might be quark and berries or the occasional dessert. Mostly I'm just interested in getting calories in.

    I'd love to get up to 240lbs and keep getting stronger, but that's something I've been saying for a year now, and just haven't been able to get the eating done given the situation. I'm also at the point where I'm considering going back to marijuana, and exclusively vaporizing, as I simply cannot sleep enough. I must be averaging around 4 hours a night for the past 3 weeks because of the nausea, and I'm sure my lifting is suffering. Last night I slept 3 hours.

    I really appreciate you taking a look at this. I know it's a weird situation.

  4. #4
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    Quote Originally Posted by m s View Post
    The Dr. noted I have what looks like the pre-stages of Barrett's Esophagus and mild inflammation. He prescribed me a PPI. I noticed no change, stopped taking them, and tried to just ignore the problems.

    [...]

    In late 2018 my GP thought I better go get another endoscopy to check things out. The ENT noted inflammation caused by acid producing cells in the throat, but said I was not dying, and he didn't recommend further action. He prescribed PPIs like the first doctor. I tried them, noticed no change, stopped taking them.
    I donít know whatís causing your nausea, but the PPI might be useful to you even if you feel no different while taking it, if it reduces the inflammation in your esophagus. Barrettís esophagus, which it sounds like you donít have yet, is a risk factor for esophageal cancer, which is a cancer you definitely donít want, if you already have trouble eating. Odds are low youíll get it, but it is preventable and itís pretty awful if it happens.

    I would suggest GI eval, not ENT, and a full consultation, not just endoscopy. You may have gastroparesis or another underlying cause that gives you both the nausea and the reflux. But as long as the reflux exists, consider a PPI to protect your esophagus, even if it doesnít fix the nausea.

  5. #5
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    Thanks for the response jfsully.
    You may have gastroparesis
    I forgot to mention this, but 10 years ago I did get a stomach emptying test. It was normal.

    But as long as the reflux exists, consider a PPI to protect your esophagus, even if it doesnít fix the nausea.
    The last doctor offered the prescription "if I wanted it", so I assumed it was somehow unnecessary. I'll go and see my GP next week for a new prescription and ask for a referral to a gastro.

  6. #6
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    I agree with jfsully on the PPI and referral to a specialist.

    From my end the only way that we can narrow down dietary irritants is if we did an elimination/reintroduction diet similar to what I'd do for IBS. We'd start pulling out the obvious culprits first (highly acidic foods), then less obvious, then re-introduce them. If that doesn't work it may be a function of medical management. With regards to marijuana, have you tried edibles?

  7. #7
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    I suffered from really bad acid reflux and indigestion most of my life, to the point where I would get excruciating pain in my jaw, head, chest, along with the usual symptoms. Oddly enough, homemade water kefir fixed it, and it worked on multiple occasions. Might be something worth considering, unfortunately store bought probiotics donít do the same thing for me because it can be a bit of a pain keeping up with the kefir

  8. #8
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    Quote Originally Posted by m s View Post
    Thanks for the response jfsully.

    I forgot to mention this, but 10 years ago I did get a stomach emptying test. It was normal.


    The last doctor offered the prescription "if I wanted it", so I assumed it was somehow unnecessary. I'll go and see my GP next week for a new prescription and ask for a referral to a gastro.
    Sounds like you probably did get a decent GI eval last go-round. But if you are still having these issues after 10 years, it's time for another look. Something may declare itself more detectably now, and there may be other treatment options they can suggest at this point.

    Doing some diet testing as Coach Santana recommends is also a good idea, regardless of what the docs come up with.

  9. #9
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    Quote Originally Posted by Robert Santana View Post
    With regards to marijuana, have you tried edibles?
    Sure. But I find them to be too powerful and difficult to control. I.e. they take time to take effect, and take effect for much longer.

    Thank you everyone for your suggestions.

  10. #10
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    starting strength coach development program
    I'm not a fan either. I haven't heard of anyone who can effectively control them. Just a thought.

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