Advice for management of nausea

[robyncausley]

Hi, my daughter (now 9) was diagnosed with Ulcerative Colitis about 18 months ago. Her symptoms have been quite tricky to get on top of and she spent much of the first 12 months on steroid therapy. She is now in remission but has had ongoing difficulty with nausea on a daily basis. The nausea started at the same time as her first flare and tends to be much more severe when she is having lots of bleeding/diarrhoea but even on a good day it is generally in the background. Her specialist says that there isn't a physical cause for it that he can find and wondered if it were anxiety related however assessment from a Psychologist has found that anxiety is not an issue for her. So basically it looks as though there isn't a medical option to help the nausea go away. My question is have any of you found nausea to be a part of your IBD symptoms, and if so, how do you manage it? At the moment my daughter's medications are 1.5 grams Mesalazine BD, 75 mg Azothyaprine daily, as well as an Iron supplement. She is officially in remission although she consistently has mild bleeding but they think that is just a part of this disease for her. Any advice would be hugely appreciated. Its horrible to see her battle with feeling yucky every single day.
Thanks in advance,
Robyn

 

[Clash]

My son has Crohn's Disease so I'm mot as familiar with UC but with CD if he was experiencing nausea and bleeding then he would not be considered in remission. He has had normal blood work but still been in an active flare, we generally use a fecal calprotectin stool test to keep a check on the inflammation levels in his bowels. Has your daughter had this? Has she had any imaging such as a CT, MRI or MRE or maybe motility testing to ensure that isnt the reason for her nausea?

Hopefully, someone with more experience with UC will be along. But if those symptoms are still present then maybe a second opinion is in order.

HUGS and I hope you find answers and relief for her soon.

 

[Clash]

Also, I'm going to tag some other parents that may be able to give you their experiences. So I'll tag Hope345, Dusty, my little penguin, sascot, jmrogers4.

 

[robyncausley]

Thank you! Her fecal tests have come back normal lately (apart from having C Diff a few weeks back). Our options with paediatric gastroenterologists are a little bit limited but the specialist she sees has an excellent reputation and I've been very impressed with his care of her and willingness to work hard for her. Despite the nausea and mild bleeding she is largely very well, which is very different to when she was flaring. She hasn't had motility testing but they did do imaging studies for her,which didn't bring up anything.

 

[Jmrogers4]

c-diff caused nausea in my son, has she been retested as it can be recurring? Hubby and son both get nausea especially if the eat fast, they both have to eat extremely slow but my son has crohn's located in duodenum and small intestine and it is apparent when he is flaring. We've also found prevacid helped with the nausea as there was gastric reflux as well going on. She is still bleeding? What was FC number? Was it completely in normal range or just slightly outside? The reason I ask is my son only shows a very mild raise in FC level even when in a pretty major flare. Iron supplements and azathioprine can cause nausea as well although I would think if it was the aza she would be over the nausea by now as it seems to only last a few months

 

[nogutsnoglory]

Nausea has always been a constant battle with my crohns and nothing I know of tiggers it so I cant do anything differently.

At worst I take Zofran which really helps with nausea, on milder days I do deep breathing, belly rubs, and tea with ginger and sips of ginger ale to ease the nausea.

 

[CrohnsNewbie2]

For nausea try chewing peppermint gum that tends to settle my stomach and not make me feel so nauseous. Also try crushing ice and sucking on it...surprisingly it does help.

 

[Johnnysmom]

My son usually has nausea as a result of being dehydrated. He has to drink a ton of water with his meds and brings a water bottle to school. We have him sip gatorade when he gets nauseated and sometimes will have him take zofran. He also can't get too hungry. He has small snacks between meals and we make sure he doesn't go too long without eating. He takes his meds at bedtime to sleep thru any nausea they may cause.

His was also psychological. For a while after diagnosis, especially at dinner, he would take a few bites and then just not be able to eat. This was especially true if we ate out at a restaurant and he felt pressure to eat all the food on his plate. It took time but we just had to make sure we made meal times pressure free and allowed him to take as long as he needed and eat only what he wanted. It did slowly get better. He has no issues now.

 

[Essieluv]

Prescription anti-nausea meds such as zofran or phenergan are usually the most helpful to treat nausea. However, there are a few over the counter options. Emetrol is nice and doesn't interfere with medications. Benedryl could also be used to treat nausea, but check with her docs first.

Non medication options are ginger tea, crystalized ginger to eat, or ginger ale (best when flat so that the carbonation doesn't cause rebound nausea). There are also bracelets that use biofeedback and accupressure to help with nausea, called Sea Bands.

You may also find it helpful to eliminate certain foods/drinks such as caffeine or fried, fatty foods. Eating smaller, more frequent meals helps with slow digestion, a trigger of nausea. Of course, this is so individualized with IBD patients so it may not help too much.

 

[Sascot]

Sorry I don't have any great advice. Our GI is always reluctant to give anti nausea needs for some reason, so I don't know what there is. Hope you can find something that works. Just as a maybe - could she try travel bands? My kids feel sick when driving far so they use acupressure bands on their wrists. Might be worth a shot.

 

[Ali29]

Thanks Essieluv - I have CD and have to take nausea meds every day - I just bought the Sea Band online - I had never heard of this but I am willing to try anything - especially non medicine!!

 

[Tuff]

Hi Robyn,
I got severely nauseated at one time, not sure what it was caused by, but I think it was my iron pill. I also get very dehydrated. I found that Dimenhydrinate worked very well. It's an over the counter drug, Gravol. There is also Ginger Gravol and Children's Gravol. You didn't say where you are from, I think this is a Canadian brand name. It's for travel sickness, vomiting and nausea.

 

[Daisy123]

I take domperidone for nausea. I used to take cyclizine but am not sure it ever helped. I also eat ginger biscuits when feeling sick if I can stomach it. The thing that helps the most though is an ice lolly, not sure why, but it is worth a go.

 

[my little penguin]

DS was 7 at dx. He is 10 now.
He also constantly battles nausea even chronic vomiting when flaring ( his disease is from stomach to rectum basically.
Have you gotten a second opinOn ? Even if its just a records review ?
We have traveled a ways for DS to have a second opinion .
Since it's only a one time thing - we treat it as a vacation.

Bleeding is not a good thing even mild bleeding.

DS takes zofran for bad nausea .
Mild stuff he makes sure to eat before he drinks anything.
Warm baths/swimming
Hot packs on the tummy ( we use adult back microwaveable heating packs - perfect size).

At one point the Gi tried
Periactin
Levsin
Elavil
Maybe a few others ...
None helped too much .
His numbers have always been normal except fecal caloprotectin was raised once.
But his biopsies tell a different story .

Good luck

 

[wondering]

Nausea is my most frustrating symptom. I have a huge fear of needing to vomit and not being home, even though it's never happened! Even though I'm in remission (at least by colo), still will have 2-3 day periods of nausea every month or so. I don't have any brilliant solutions, but just wanted to say that I sympathize!

 

[SarahD]

I suffer from really bad nausea since being on Azathioprine, I really feel for your daughter as it's an awful awful symptom. There are lots of anti-nausea medications available. I tried Domperidone, which worked fairly well, but I ended up switching to Prochlorperazine which works better for me. I tried some others, including cyclizine, which did nothing for my nausea. It was a lot of trial and error until I found something that worked. I do still get nausea, but it's generally mild instead of severe. I find that getting some fresh, cool air also help, as I tend to get very hot with my nausea.

I would also be concerned about the bleeding - that shouldn't happen if someone is in remission, unless it's unrelated to her UC and is coming from a fissure or hemorrhoid? I wonder if it's worth getting a second opinion from a different GI?

 

[Wendles]

My son gets nausea on azathioprine we split his dose half morning half night and this has seemed to stop his " morning sickness" as we referred to it worth a try good luck

 

[Meech]

For me my nausea is mainly triggered by smells, or when eating and my mouth feels 'too full' even when it isn't. If possible keep you daughter out of the way when cooking strong smelling foods, that puts me right off for the entire day, even if it is just burnt toast. Lightly cooked food like scrambled eggs instead of fried as an example.

My nausea is also connected to blockages in my colon which mean I constantly feel full even when I am hungry, which only came to light after colonoscopy and CT scan.

So unless it has already been checked I would suggest asking for a CT scan.

 

[robyncausley]

Thank you so much for all the suggestions. There is lots for us to follow up on and investigate. Thank you!

 

[Hope345]

Our daughter just went through several days of not eating because of nausea, and fortunately it passed, but so did the pain she was experiencing at the time. could be tied together. The other thing that stands out is the iron. There are several ways to get iron and maybe try something different. We recently have started with a natural path and she has an iron that is easier on the digestive system. It is rough trying to figure it all out. ginger tea was a good idea too.