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Vomiting when hungry
Jan 24, 2007

Dr H,

I am on Kaletra & Combivir with cd4 at 496 & vl undetectable. I have put on 35 pounds in year since on arv's so while I am bursting at the seams my friends all tell me how good & healthy I look.

I have been experiencing a very weird feeling in that I can not go hungry. The other day I was very busy at work and got very hungry. At a point I started retching and ended up vomiting fluids till I managed to eat something. Also this morning I woke up and just before I managed to have breakfast I started retching again.

How do I manage to control my weight and loose a few pounds when I have to eat all the time to prevent nausea from hitting me??

Response from Dr. Henry

Some patients have persistent nausea/stomach problems from the AZT in Combivir or from Kaletra so a discussion of whether a switch from Combivir to perhaps Truvada or Epzicom and/or from Kaletra to alternative 3rd drug (such as efavirenz or different boosted protease inhibitor) may be warranted. Looking for a non-HIV or treatment related stomach problem causing your stomach problems/nausea such as H pylori gastritis, et cetera may be worthwhile after a complete history and physicial evaluation. Also sometimes diet/exercise (life style) interventions can be helpful. Some patients who develop excessive intra-abdominal fat have persistent nausea from the pressure on the stomach. There are also some anti-nausea medications out there that can be used for symptom relief while undergoing evaluation for the problem. KH

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