What exactly is nausea?

(very long question) chronic nausea. Doctors preferably?

• It started during mid-term exams, I ate KFC and studied before going home, eating fish and throwing up. I blew it off as stress even though I have never had any stress problems before and even when I was stressed, I never got nausea ever. In fact I almost never throw up, that was the first time in years. Everything seemed fine until the second week into school after the break. I was working out and felt nauseous and threw up. This happened several times when I worked out but only the nausea, I didn't throw up after. When problems really started happening was several weeks later, I was at a talent show and I felt nauseous and it slowly built throughout the show (but only between acts which was weird). I had to eventually excuse myself and I threw up in the bathroom at school. That night I got it again after eating but did not throw up. From then on every time I ate breakfast I would get nausea before finishing and would sometimes throw up; I had to stop on the way to school two separate times. I suspected stress again because the SAT was approaching, but when I finally went to the doctor she said it could be lactose intolerance and also gave me lansoprazole (prevacid) to take before meals. She also gave me ondansetron (zofran) to take while nauseated. After a week into taking these new meds nothing changed. I started drinking milk again after two weeks. On the day of the SAT I took the zofran but still threw up before the test and felt awful throughout the test (a little better closer to the end); and every time I have taken zofran (which to my understanding messes with neurotransmitters) there has been no effect . I thought it would go away after the test but it continued. I went to the doctor again and they took several blood tests (I cannot remember what they were, sorry) all of which were negative. Some patterns I noticed was that it was always particularly bad in the morning, I got better at holding the nausea in but occasionally I would still puke. At almost exactly 10:00 everyday (I usually eat at 7:00 and 10:00 is the start of second period) I get it, on the day of a test at 10:00 i threw up before the test. I usually get the feeling before I even start to eat lunch and generally do not finish. I have not once become nauseated after eating dinner; and it is before dinner that I would take the prevacid (however on days that I forgot to take it I would still not become nauseated). It subsided over then next few months to only feeling mild discomfort after and while eating breakfast. I stopped taking the prevacid (even though the doctor never told me) and there was no changes. I occasionally threw up but it was very rare. I found that whenever a big test or essay was due I would get especially sickly, but it was virtually always present (especially mornings like I said). During spring break it was almost non-existent (although I usually slept through breakfast). Since spring break it has progressively gotten worse. I feel virtually no stress and have nothing to be stressed about (school isn't that stressful to me). This morning was particularly bad and I did not go to school (but did not throw up). I am a male 17 year old junior. I am taking 4 AP classes in a pretty competitive school with 99-100% college acceptance rates. Prior to this illness I weighed 155 and am 5'9.'' Last I checked (been a while since I have stopped working out due to the discomfort) I weighed 146 (probably from eating less due to the illness and working out less); I don't give a **** about weight so there is no eating disorder or anything; if anything I want to gain weight. I have lived in Saudi Arabia almost my entire life, this is my second year in the US (north Texas area) but last year I hardly ever felt sick. I am Caucasian. I do not smoke or take any drugs. I usually go to sleep around 12:00 and wake up at 6:30. I am getting sick of this illness now. I used to eat all the time and a lot and now I can hardly eat two pieced of toast for breakfast. My doctor never came to any conclusion and my father who is also a doctor has changed his mind several times (now he just thinks its stress; which is what I used to think it was but no longer). One last thing, during the third month of symptoms, somebody else in my grade developed almost identical symptoms and missed class. His symptoms ended in less than a week though.

• Answer:

  Mabry, Yes, I am a doctor and I have been to Dhahran, Damman, Riyadh, and other locations in Saudi. After re-reading your posting, I did consider possible parasites or infections, but the long periods of reported wellness seem to rule out anything infectious. A congenital possibility would not have allowed periods of wellness. What appears left is a cause not always present since your "illness started." The most likely remainder is stress, perhaps a combination of academic stress and teenage hormone and other body physiologic changes. Please try working with a trusted high school counselor for a while.