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Exhaustion, nausea, vomiting, low grade fever, sweating, no abdominal pain, colonoscopy and EGD normal. What is the cause?

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Internal Medicine Specialist
Practicing since : 2003
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My 42 yr old daughter has experienced crippping exhaustion with frequent episodes of nausea ,vomiting, low grade temp, sweating for past two years. Colonoscopy and EGD normal. No abd pain. Recouperates about a week or two, then it happens again. over and over. Goes from diarrhea to constipation . Headaches. diagnosed with migraine and new med helps but these too often bouts of sickness and exhaustion are ruining her life. Thyroid, other tests normal. Never had the test for gallbladder disease without stones. Where ejection factor tested. Is this possible cause or would she keep gettin better, then it happening again? She has a ventral hernia, but dr does not think this causing problem
XXXXXXX takes med for blood pressure, sleeping aid, prescription, celexa and topiramate for involuntary movements at night, and the migraine medicine. Past history of alcohol abuse but alcohol free for many months now. Lost child four yrs ago , still in treatment for ptsd.
Posted Mon, 9 Jul 2012 in General Health
Answered by Dr. Rudramani Swami 17 hours later

Thanks for posting your query.

I understand your concern for XXXXXXX and I empathize too.

Her symptoms are quite general and it is not pointing towards one particular system.

Though her Colocscopy and EGD studies are normal, we need to clinically rule out Inflammatory bowel disease (IBD) here. Consider celiac sprue too.

Let her continue the current medications that she is taking.

In this clinical scenario, I would like XXXXXXX to get certain blood investigations done like blood sugar levels (to rule out diabetes mellitus), liver function test since she has a history of alcohol abuse in the past to rule out deranged liver function. One can get mild grade fever if there is underlying liver dysfunction. Serum XXXXXXX level may be considered to rule out autoimmune disorder.

It is advisable to XXXXXXX an expert Gastroenterologist for this.

I am sorry that XXXXXXX is also facing other issues like Migraine and involuntary movements. Definitely, continued treatment will help in increasing the quality of her life.

I hope I have answered your query; Please feel free to ask any further queries that you may have.

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