Nausea & GI Distress in Teens

Parent Q&A

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  • Seeking a recommendation for a gastroenterologist who can think outside the box. Our teen daughter has been experiencing long term chronic abdominal pain and nausea that seems to be triggered by food. We saw a traditional gastroenterologist who did a battery of tests and ruled out all the obvious major medical causes, and then told us they didn't have an answer for us.  I am open to suggestions at this point. Thanks, BPN!

    Have you considered a gluten intolerance? That is the most likely thing. If it is triggered by food, then an elimination diet may help you find out what food it is. Find two foods she rarely eats, such as amaranth and olives. See how she feels after a day or two on this diet. I know that can be hard to maintain. If that works, slowly add foods back in. If it doesn't try a different combination of two food that she rarely eats. You might want to try an allergist to get an idea of her allergy situation. 

    Has your daughter tried a low FODMAP diet? Although I agree with you that she should see another doctor, this might help while she is waiting to figure out the problem. I have been experiencing similar symptoms to your daughter and am waiting for a colonoscopy appointment. This diet has allowed me to get my life back. It is a very restrictive diet and if she tries it, I would recommend she also take a multi-vitamin and a probiotic. 

    I don’t have a good answer for a GI for you. I did have similar symptoms however and after months and months of looking for a diagnosis it turned out to be a pancreas problem. I am on rx pancreas enzyme replacement and the pain has mostly gone away. You can get not as regulated, but worth trying, pancreas enzymes from a health food store (proteasas, amylase, lipase). Take 10 minutes before a meal and you should know within 1 to 2 meals if it works. You can then take that information to your doctor. 

    You might look at the Abascal diet, it's an elimination diet to find what foods you are sensitive/allergic to. Sounds like cutting out gluten would be a good place to start. Good luck! I've been gluten free for 2 years and I feel so much better!

    My daughter had the same from 10 yrs old on (now she is 17). We discovered she has POTS (postural orthostatic tachycardia syndrome).  It is a problem with the autonomic nervous system and regulation of blood flow.  She is nauseous almost all the time, but worse with food.  Electrolytes and salt help.  No quick fix, but hopefully she will grow out of it. Kaiser has a POTS clinic but they just do symptom management through lifestyle changes and nothing seems to help with the nausea. Oh and anxiety makes everything worse.

    My college age daughter had similar symptoms over the last 1.5 years. My first attempt to help her was to send her to a GI doctor, who was not able to diagnose the problem. I later sent her to an internal medicine doctor who did food allergy testing (IGG?) and found out she had celiac disease, which also seems to cause something called "leaky gut syndrome". I then had her go to a functional medicine (naturopathic doctor), and she went on a special diet gluten free Ketogenic diet and supplement program for about 3 months to heal her intestines. Aside from all the abdominal pain and vomiting, I believe she was quite malnourished and that resulted in some mental health issues, partly because of the toll that being so sick took on her school work and self-esteem because of always feeling sick. It took about a year for her to fully recover and she is finally back to feeling pretty good. If Celiac disease is the culprit, check out the book "Jennifer's Way: My Journey with Celiac Disease--What Doctors Don't Tell You and How You Can Learn to Live Again". We both read it and it was motivational to help her overcome the problem. I probably helps that I am gluten free also because it causes severe eczema for me.

    Our daughters see GI Dr. Yvette Wild at UCSF, and we love her. Both of our girls have GI diagnoses, one with Eosinophilic Esophagitis (EoE) and the other with IBS, SIBO (at one time) and possible EoE. We've done lots of elimination diets and low FODMAP, very well directed by Dr. Wild and her team. She's extremely knowledgable and really listens to what the family needs/what works for the child. Our kids (17 & 19) have almost outgrown her but we're hanging on to her as long as possible! Feel free to contact me with any questions, we've been on this road for 12+ years. emily [at]

  • My teenage, almost young adult, daughter recently shared with me some anxiety and stress issues she's been having that manifests in GI issues.  We'll go see her doctor to investigate any potential IBS or other intestinal diseases that might be exacerbated by stress, but she'd also like to see a therapist to talk about the stress and anxiety she's been having.  Would love recommendations for therapists in Walnut Creek or Lamorinda area that have experience working with older teens. Thanks so much!

    Hi I’m a mom and I have suffered from IBS and though I have no therapist recommendation I do like this hypnotherapy app called Nerva which is really helpful on a daily level. I am not suggesting this in place of a good therapist but rather just something to do daily in conjunction with other help for your daughter. Warmly, Maureen 


    We just had 2 very successful tele visits with Dr F. Raph Berberich. He specializes in hypnotherapy for kids. My 12-year-old son with IBS felt better immediately after his first hypno session and did not have pain for 2 days. I think Dr Berberich is very observant and I like that he makes sure the kid feels in charge and "owning" the process. He takes insurance and seems to have plenty of open spots (a miracle, I know!!) Good luck!

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15 year old son with GI upset

Jan 2014

Hi there, My 15 year old son has been experiencing GI upset (nausea, heartburn) for quite some time now. He has a crap diet. If he could, he'd live on bagels and cream cheese, chicken nuggets, hamburgers and french fries. He will eat vegetables and fruit, and loves meat and milk, but there are some things he just cannot stomach (literally), like nuts, beans, and some greens. He tells me he's a ''supertaster,'' and while I find that hard to believe, if he is, then and I'd like to get some help from a dietician or nutritionist to help him come up with good food that he will eat, that will not have those unpleasant side effects mentioned above. We're going to see his pediatrician next week but in the meantime I'd love some recommendations or advice from parents who have dealt with this.

I recommend you take your son to a pediatric or adult gastroenterologist. Nausea can be a sign of reflux, plus your son is already having heartburn, also a sign. It's important to treat reflux as it not only causes short-term misery, but it can eventually damage the esophagus.

My daughter had reflux with only nausea as a symptom, which resulted in a 10-pound weight loss in about a month. Her pediatrician was totally stumped after multiple types of tests and blamed it on stress, which under our particular circumstances (summer, personality type) seemed ludicrous. It took a pediatric gastroenterologist at UCSF to diagnose her and put her on the right medication. This confirmed my feeling that pediatricians are great, but sometimes you just need a specialist.

On the diet issue, I'm a little confused. He sounds like he's eating a reasonably healthy diet that is typical of his age. You say he literally can't stomach nuts, beans and some greens--does that mean he throws up? Gets worse nausea/pain? Or that he just despises them? I can't tell from what you're saying. A diet without nuts, beans or some types of greens can still be a healthy diet.

I have found with my own very different kids that what you can control is what you put on the table. Offer a variety of healthy foods. Require (as much as you can) that your child eats some fruits/vegetables every day. Make sure that favored fruits/vegetables are readily available. And that's good enough. Like most of us, your son will probably eat poorly while at college and on his own, and then eventually improve his diet as he matures. In the meantime, his diet doesn't sound bad to me. If you really want it to change, I suggest researching more ways to serve the healthy things he eats or to make the other options more attractive. I do a lot of that myself.

mother of multiple picky eaters who are far worse

I would like to share in the advice, please post! Our insurance (PPO Blue Sheild) wouldn't cover the nutrition referral we got from my 15 year old son's Nephrologist and boy do I need advice! (Children's Hospital couldn't tell us what we would have to pay, and we just let it go.)

He always had tricky digestion and got ''intestinal flu'' so often that he was poop tested for Giardia twice. He was throwing up blood, hospitalized, and only then tested for Celiac. That was POSITIVE.

The near death comeback has been slow. He is adamantly vegan and I feel so unsure that I am giving him enough protein. He just does not have the stamina at nearly a year later. It is hard to have faith in prepared smoothie mixes... (We are very brown rice & beans heavy at present. I am worried about too much tofu?)

Anyway, you should ask for the Celiac blood test. For some reason, doctors don't test for it. Our's called it ''the flavor of the month'' and it is what saved his life.

Something about puberty really amplified the symptoms.

16 year old girl w/ morning nausea, not pregnant

Nov 2009

Over the last 6 weeks my 16 year old daughter has developed a worrisome problem. Every school day morning when she wakes at 6:15 AM she is hit with nausea. The nausea comes on strong and then diminishes throughout the morning. Often but not always she vomits (only saliva & maybe a small amount of bile). I have her using SeaBand (mixed questionable results) until the nausea passes. She is NOT pregnant. There is no fever or other glaring signs of illness. Her appetite is good (except in the morning). She is doing well in school, likes school, & looks forward to going....

The odd thing is that on the weekends when she is able to ''sleep in'' she almost never wakes with nausea.

Does anyone else have or experienced a similar situation? If so please elaborate. Have you been able to get any definitive answers as to what is going on? Very worried Mama

Hi, I had issues very similar to your daughters from the age of about 16-22. Some of it was stress related. A lot of it turned out to be hormone related. No one really thought to consider that. Sometimes I was on the pill and that certainly made it worse. But even when I wasn't on the pill, this was an issue for me and I missed lots of school in high school and college because of it. Tums or Rolaids in the morning helped. It might be worth talking to a hormone specialist (they did not have such people when I was young). It may just be the hormonal shift she is going through. Is she depressed or low-energy as well? I have had no issues with either since that time in my life, but they were bad then. Getting into exercise was huge for me. I'm not sure anyone could have talked me into it at that time, but it helped regulate my body quite a bit. Good luck! was a similar teen

My 16-year old daughter has a similar problem. We've determined (after many tests and trips to the gastroenterologist's office) that the nausea is a stress reaction, increase in epinephrine, drop in blood glucose, feeling nauseated and faint, even shakey at times. It's all stress. We have found three things that help: 1) Taking a Calcium Tums tablet or Prilosec at bedtime, 2) immediately upon rising (or even before getting out of bed) starting the morning with an ounce of protein -- chocolate SILK soy milk, 1 tsp of peanut butter, a little piece of meat, cheese, 1/2 cup of yogurt -- to give the stomach acids something to digest. Regular milk, though rich in protein, sometimes adds to my daughter's nausea. And 3) if nausea persists after taking above measures, we find that a fingertip of ginger paste used in oriental cooking does the trick beautifully! These need not progress in any particular order, though this is the sequence we have found most helpful. In my daughter's case, the stress of a private AP-level high school was too much, so we're homeschooling now, and she's loving it. Far less drama in the mornings! A dietitian and MOM

I remember that when I was a teenager I had an 8 am dance class and once or twice had to excuse myself so I could throw up. I was just not physically able to be up and active so early. I was always a kid who needed a lot of sleep -- still am.

There's lots of research on how much sleep teens need and how their circadian rhythms adjust in these years -- everyone knows that school should start later for this age group, but unfortunately no one is willing to modify the school day.

I'd have her checked out by a doctor just to make sure nothing else is going on, but I would consider the possibility that she just feels sick from lack of sleep and too early of a morning. Talk to her about the importance of sleep so that she can make the connection between how she feels in the morning and when she goes to bed. Then see if she can get to sleep earlier. Also make sure she's not using any screens (cell phone, computer, TV, gaming system) an hour before bed as research shows that these devices can also disrupt sleep patterns. Still need 9 hours when I can get it.

Hi, First of all if you haven't already done so I would like to suggest that you make an appointment for her to see her doctor for an exam.

You say that she looks forward to going to school and likes school but it's curious that on school days she is more prone to feeling nauseous. Might her symptoms be related to some underlying anxiety about school? Or a situation that is troubling her that she has not voiced to you?

If you feel that there may be some truth to what I am saying and her doctor doesn't pinpoint something physical you might want to seek the help of an alternative health practitioner who can work with your daughter to alleviate her symptoms and improve her well being. My daughter has an alternative MD who subscribes homeopathy and herbs to help her with her anxiety and she has responded very well to this approach. Unfortunately, her doctor is in Southern California but there are some fine practitioners in our area as well. If you are interested I think that the Berkeley Parents Network has some pretty good leads for alternative practitioners. Best of luck to you and your daughter. Hope this helps.

My 15-year-old daughter has had very similar morning stomach problems (nausea, indigestion, no appetite), that then go away later in the morning. She will have these symptoms for several weeks and then they will go away for awhile and later return. She also never has the problem on days when she is able to sleep in. I don't really have a solution, just some thoughts:

1. Last spring when my daughter was having her most severe morning stomach issues, she was shortly afterward diagnosed with an ovarian cyst. Ovarian cysts are very common and usually go away on their own after a couple of menstrual cycles. Stomach problems are one of the symptoms of ovarian cysts.

2. I also think there may be a stress component to my daughter's morning stomach problems. It seems to increase during exams.

3. Stomach problems are super common in kids, and not easy to identify the cause of. I know of many, many children and teens who have had mysterious stomach ailments that ebb and flow, and almost always are nothing serious (but still painful and real). teen parent

In my mid-20s I suffered from chronic reflux which manifested as nausea and not heartburn. Could night time acid reflux be part of the problem? Also when I was younger I hated to wake up early because, beside feeling really really groggy, I would feel sick as well although not as extreme as you describe. (I used to be a very heavy sleeper but now that I'm older and have been sleep trained by two babies, I can be instantly awake at any time.) I would look at diet, getting enough sleep, and stress (which makes any underlying condition worse). Good luck! Brenda

It's so long ago....but my boyfriend in high school had this problem. In his case, it turned out to be that his stomach digested food at a different pace than other stomachs, and he awoke nauseous every morning. He and his family experimented and found solutions based on when and what to eat. Another person I knew had similar issues and was helped by consulting with Nori Hudson, Berkeley nutrition expert, who helped figure out what was going on--it was a different problem but they found a solution. sympathetic

First, get to a doctor for a full workup. Items to check - cardiology workup, since children have different symptoms than adults, e.g. instead of classic angina kids often experience nausea (Lucile Packard at Stanford is quite familiar with this area). Other items include checking thyroid (hypothyroidism often manifests itself at this age) - the treatment in this case is a simple pill. There are other very less likely possibilities like tumors and such, but those are very rare. A thorough health exam will alleviate your worries and put you on quantitative ground.

BTW, I'm hypothyroid and I've often found it extremely difficult to get up rapidly (note, not ''early'' - ''rapidly''). I get dizzy and nauseated and can't eat. Too little sleep also is difficult when your thyroid levels are off, and they are at the lowest in the early morning - that's why you're supposed to take your thyroid pill first thing in the morning without fail.

One thing to consider if she has some physical limitations at this time - why not start school later? My daughter had a 2nd-7th period schedule for junior year. It can be done if you push for it.

Finally, make sure you do a pregnancy test. Now I know and you know and she knows that she's not pregnant, but do it anyway, because the doctor's office will insist on it. Assure them you have done one yourself, but they are free to do one as well. This gets this issue off the table fast and allows you to get talking about other medical issues.

Good luck. Lynne

Your post does not mention if your daughter has been to a doctor. Also it may take more than one pregnancy test to know if someone is pregnant. Nausea can indicate many things:

Since she needs to sleep in on weekends and then the symtoms go away could mean she is really stressed at school. I don't think any adults today have a reasonable idea of the stresses in school today - even carefully chosen school environments are a mixed bag. If this is the case please seek counseling. Being stressed can lead to many long term physical changes in the brain and organ systems that are real, debilitating, and potentially life threatening. Not sure why society is not supportive as a whole to this option in this day and age, but change is often ''a long time coming''.

I would really support your making a doctor's appt, or if your medical office has a nurse practioner or a physician's assistant if this gets her in sooner. Rule out medical causes, and at the same time check out counseling. Counseling (IMHO) should be seen more as as something that keeps us well, or makes us better, than as a last ditch unwelcome resort. Hope things improve

Hypoglycemia can cause nausea in the morning--I have had this. She should try eating a small meal w/ protein & no sugar just before bed, and see if she feels better. Hope this helps. por

Is she taking birth control pills (maybe without telling you)? They can cause symptoms of pregnancy, including ''morning sickness'' and nausea.

Lack of sleep could also be the culprit. My daughter, who has a sensitive system, feels nauseous when she doesn't get enough sleep or if she has to get up drastically early in the morning. That would fit why your daughter is OK on the weekends.

Good luck figuring it out!

I know this is a long shot, but I know my teen was getting morning nausea when we switched our brand of daily vitamins. I didn't figure it out until I started taking them and had the same experience. Now I am sure we take them on a really full stomach and there's no problem. mom of teen

There are many causes for morning nausea. Have your daughter checked for food allergies, seasonl allergies, lactose intolerance, sinus infection. The sinus infection can go undetected for a long period of time. The infection is toxic to your body and causes nausea. Hope your daughter feels better soon, Cecilia CC

I wonder if this could be an inner ear problem from rising early or from interrupting a sleep cycle. Or an acid stomach/reflux issue, from anxiety, diet, eating disorder. etc. In any case, I hope she goes to her doctor to check out all possible physical causes. Without any disrespect, it is possible to get a false negative on a home pregnancy test. I'd be worried too

I've always felt a bit nauseous upon awakening early. As a girl, I remember horrid egg breakfasts before church on Sundays. Now, when I'm readying for work at 7:00 a.m., the smell of eggs or onions cooking is too much! I can handle a bit of toast and tea. My appetite comes into full force at about 11:00 a.m. Weekends I wake up later, and have no problem! I think my body is telling me it's just not quite awake yet. I usually bring a mid-morning snack with me if I have to leave early. I don't see this as a problem -- I've always been amazed at anyone who can actually eat so early! Fit & Healthy Mom

Are you sure she is (1) getting enough sleep and (2) not stressed by school? I've known of kids who got nausea when faced with a situation that stressed them - including a day at a summer camp that ''should'' have been fun. At 16 she could be trying really hard to fit in, to assure herself and you that she's not being a baby, and just having stress. High school is full of really good reasons for anxiety.

Try waking her up at the school time on the weekend and see if that makes her nauseated. If she is sick on the weekend you should take her to the doctor. Good luck, it sounds stressful to YOU! sympathetic mom

I have the same concern with my 15 year old daughter. She is out of school today for the same problem, wakes up at 7, often feels nausea and has a light amount of vomiting and then states she does not feel well enough to go to school. She usually likes school and is doing ok but I fear that missing so much school is affecting her grades. I think that part of the problem is fatigue, not getting enough sleep and it affects her physically. My advice is to make sure she eats and drinks well in the evening and then goes to sleep early enough to get at least 9 hours of sleep. I am trying this and have suggested counseling but my daughter is resistant. She seems to have more of this problem when she returns from staying with her Dad, we have joint custody. RN Mother

It could be stress, dehydration, food sensitivities.... Probably a good idea to have a doctor rule out pinworms, ulcer, or worse. Good luck