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    What causes nausea while on Omeprazole?

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Posted on Mon, 3 Jul 2017 in Digestion and Bowels
Question: Hello - I'm experiencing nausea. It may be related to a peptic ulcer (diagnosed) brought on by stress. I'm out of town looking at homes for my retirement. :{ ! I'm prescribed an antacid - omeprazole, but occasionally have nausea during high- stress situations, such as Christmas! (Maybe it's related to making big money decisions! I've read about supplements: vitamins A and E; and zinc (a-84). Any suggestions?
Thank you - XXXXXXX
doctor
Answered by Dr. Ramesh Kumar 1 hour later
Brief Answer:
Take stress relieving medicines.

Detailed Answer:
Hi,
Thanks for choosing HealthcareMagic for your query.
I have gone through your details and i appreciate your concern.

For explaining your treatment i have to initially give you a briefing about the cause of your problem.Our nervous sytem has got a Autonomous part termed medically as autonomous nervous system.This part of the nervous system is responsible for control of the bodily functions not consciously directed, such as breathing, the heartbeat, and digestive processes.
Acid is secreted in stomach by parietal cells and motion of the wall of stomach and intestines is controlled by autonomous nervous system.By autonomous its obvious that a person brain can't directly control it.When levels of anxiety increases autonomous nerves innervating gut get stimualted(Vagus nerve) leading to increased secretion of acid by parietal cells in stomach and increasing reflux of acid back in esophagus and causing stress ulcers.

The treatment you are on covers only one part of pathology i.e acid production(omeprazole is a proton pump inhibitor and stop parietal cells to secrete acid).

But even you can see that the main pathology or root cause is not covered by any of the medicines she is on.In lay mans language-"Take care of her anxiety and all symptoms wil settle down by themself as anxiety is the root cause of all her symptoms".
Unfortunately she is not on any anti anxiety medication(which soothens your autonomous nervous system).
Suggestions-

Increase dose of omeprazole to twice daily 40 mg can be increased to 80mg twice daily.
Very important-
Add a benzodiazepene to your regimen.They are anxiolytics and are very effective in calming down autonomous nervous system.Ask doctor to start her on 1mg lorazepam initially.This medicine would calm her autonomous nerves and hence would help her to cope with her symptoms.As anxiety levels settle down secondary symptoms wil also subside.

SSRIs ease anxiety by increasing levels of serotonin in the brain. Serotonin is one of the chemical messengers (neurotransmitters) that carry signals between brain cells. SSRIs block the reabsorption (reuptake) of serotonin in the brain, making more serotonin available. They should be added with benzodiazepenes. Initially we can start her on Paroxetine 12.5 mg once daily. doses will be increased to 25mg once daily as per the response of her body. It is a prescription medicine.

Discuss all with your Gastroenterologist.Question him/her that if she is diagnosed as having stress ulcers why anti anxiety medication was not started.
Follow what i suggested and tell me how she is feeling after 21 days.

Hope i was helpful.
Thanks.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ramesh Kumar 19 minutes later
That's obvious! Certainly not worth the membership fee!
What stress relieving meds do you recommend!!!
doctor
Answered by Dr. Ramesh Kumar 1 hour later
Brief Answer:
Follow up answer.

Detailed Answer:
Hello again,
Initially i would like to start you on lorazepam 1 mg .This is an anti anxiety medication and would lower down your levels of stress .
They are the drug of choice to relieve anxiety.
SeCondarily i would advice you to start sucralfate.15 ml once daily should be taken before going to bed it help to heal ulcers. Trials have shown that healing can be speeded up by (a) not smoking, (b) removing acid from the stomach, and (c) using non-antisecretory mucosal protective agents such as sucralfate and colloidal bismuth.

Natural derivative lacium can also be taken for anxiety and stress relief.It is an lactose-free milk peptide that helps regulate your body's cortisol levels during the day and promote better sleep at night hence reducing overall stres and anxiety.

Try them initially for 21 days if not relieved we would consider adding SSRI like paroxetine in lowe doses(12.5 mg) once daily.

In your case our aim is
1) Acid control-Omeprazole is given for that.
2)Stress and reflux control-The above suggested medication would cover it.
Control at both levels are required for complete benifit. It sounds normal and obvious but if followed properly would promote and hasten your healing.

Hope i was helpul.
Feel free to ask any other detail you want.

Thanks
Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
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Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2433 Questions

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