7.0 Nausea and Vomiting with Bloating and IBS

These symptoms are more usually associated with the stomach which is obviously a long way from the lower bowel.

Nausea is one of those vague symptoms that often doesn’t help us to pin-point exactly what, or where, something is going-on. It can be due to almost anything that happens in our abdomen, which is why some people with IBS get it. The good thing is, treat the IBS and usually the Nausea will go away.

There is a particular type of IBS that gives us upper tummy troubles by themselves. To explain this, let’s take a step back.

"Dyspepsia" is the name for any pain or discomfort in the upper-centre of the tummy, between the ribs and the belly button.

Obviously, the first question that comes to mind is, “could it be an ulcer?” In the vast majority of people tests for the stomach are normal. For this reason, it is often referred to as “Non-Ulcer Dyspepsia”. There can be an element of “acid reflux” (heartburn etc.) present too.

7.1 Tests for Nausea with Bloating and IBS

The main test to do is a stool sample for the stomach infection Helicobacter pylori. This is a strange infection in that up to one-third of us have it. We pick it up as young children and in most cases, it just sits there doing nothing, but, out of the blue, it can start to trick the stomach into producing too much acid. It is treated with a course of acid-suppressants and two antibiotics for about 10-14 days.

The other tests worth considering are: General bloods including Kidney and Liver function tests and the inflammatory marker, C-Reactive protein. Also, consider having an Ultrasound of Abdomen to exclude gallstones, which one out of every six of us have.

7.2 Treatment of Nausea with Bloating and IBS
Our Diet can have an effect because foods such as oily/fatty foods (whether that is a burger with fries or finest virgin olive oil), chocolate, caffeine, alcohol (and smoking) slow down the rate at which foods move from the stomach itself. Having food and acid just sitting there in the stomach for lengthy periods of time will cause nausea and discomfort.

7.2.1 Medications for Nausea with Bloating and IBS

Because most things in the stomach get better if acid is reduced, sometimes an acid suppressant like famotidine, omeprazole, lansoprazole or pantoprazole is used to keep this top end of the bowel happy. Interestingly, there is never too much acid being made, it's just that with a bit less around, the tummy feels happier. By the way, these drugs still leave enough acid there to allow the stomach to function normally.

These acid reduction medicines are very safe and can be used for very long periods of time without the body getting used to them. Simpler antacids such as Gaviscon (that just neutralize acid rather than reduce its levels) can work immediately but the effect does not last long.

Another approach is to use an anti-nausea tablet such as metoclopramide ("Maxolon"- not used in UK) or domperidone ("Motillium") at a dose of 10mg three times daily. These drugs are best not used for very long periods of time. Ondansetron is an extremely effective and generally safe drug that can be used. None of these drugs should be used if you have a problem with heart rhythm.