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Nausea, no vomiting, stomach pain, occasional nosebleed. Done stomach emptying test. Visited counselor. Is it gastroparesis?

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Pediatrician, Infectious Diseases
Practicing since : 2005
Answered : 1528 Questions
for my granddaughter. Nausea most of time for at least 6 months -no vomiting, some pain in stomach most days, occasional bad nosebleeds in night (dry air?), nausea worse after swallowing blood. Eats lightly. Missed days and days of school. Had tests for anything possible inclu leukemia. Dr thinks it could be gastro paresis but hard to diagnose. Had"stomach emptying test" and food seemed to be going through. Has a counselor to help with the mental stress.
Posted Mon, 7 May 2012 in Digestion and Bowels
Answered by Dr. Hema Yadav 4 hours later
Thanks for posting your query.

I assume she has been thoroughly evaluated for any gastrointestinal cause of nausea.

I would agree that GERD could be one possibility. If stomach emptying is normal then gastroparesis seems unlikely.

Have you got her checked by an ear nose throat specialist for any throat irritation or adenoids, tonsillitis and confirmed the cause of nose bleeding? if not then please do consult and get these problems ruled out.

Another possibility is a premenstrual syndrome if she has started getting periods and symptoms are related to onset of periods. If she has not yet got her periods yet then please ignore this consideration.

I would also agree that stress can be a factor in causing such symptoms in this age especially for girls.

So kindly discuss these points with your physician to rule out the above stated possibilities and reach a diagnosis. It's difficult for me to pinpoint a single diagnosis as of now.

Hope I have answered your query.

I'll be available for any follow up queries.

Above answer was peer-reviewed by
Follow-up: Nausea, no vomiting, stomach pain, occasional nosebleed. Done stomach emptying test. Visited counselor. Is it gastroparesis? 2 hours later
I don't see how tonsils, adenoids etc could be the cause of nosebleeds. One dr told her that they are probably due to dry air so she uses vaseline in her nose and a room humidifier. She loves school this year, better than last year. Doesn't seem to be stress? Now she seldom goes for more than an hour a day because of feeling sick. Didn't go at all today because of blood in her stomach that made her feel extra sick. Fatty food, heavy foods make her feel worse the next day. No periods yet.
Could GERD cause all this nausea? Could it be mostly "in her head"? though her stomach hurts much of the time? Her counselor is trying to help her with it.
Answered by Dr. Hema Yadav 7 hours later

Thanks for the follow up query.

Tonsils, adenoids can cause throat irritation and nausea, the nose bleed could be due to dryness as her doctor suggested.

Hearing the details, I think GERD (Gastro Esophageal Reflux Disease) is the most likely diagnosis causing her problems, I would advise you to discuss with her doctor regarding starting daily antacids like pantoprazole or ranitidine.

It can be aggravated by stress if not caused by it. It's good to seek counseling if that helps.

Try to give her plenty of water, sleep and a balanced diet, eating one to two hours before bedtime.
Avoid XXXXXXX fried foods and coffee and minimize chocolate intake.

Hope I have answered your query. Please accept the reply if you have no further queries.

Above answer was peer-reviewed by
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