Persistent Nausea and Neck Discomfort: Lymphatic Issues

Frequent nausea without vomiting may be related to lymphatic issues?

For the past three to four months, I have been feeling like there is something in my throat.
There have been several instances where I frequently feel nauseous and have the urge to vomit, but I can't.
This happens in the morning after waking up, while taking a shower, when I am almost full after eating, or when I turn my neck.
My stomach does not feel uncomfortable.
Could you please tell me what might be the issue? Three years ago, I had a gastrointestinal endoscopy which only revealed hemorrhoids, but there is also a lymph node in the left submandibular area that feels firm and is not painful, yet it often feels warm and swollen.
This has been going on for over six months, and the sensation in my throat feels different from the lump in my neck.
What kind of examinations should I undergo?

Hong, 20~29 year old female. Ask Date: 2023/06/04

Dr. Zheng Jueyi reply Otolaryngology

Hello, if there are lymph nodes in the neck, it is recommended to first visit an otolaryngologist for an examination, or consider undergoing a comprehensive health check-up at your own expense.
Based on the findings from the health check-up report, you can then seek further evaluation from the relevant specialists for any areas of concern.

Reply Date: 2023/06/04

More Info

Persistent nausea and neck discomfort can be distressing symptoms that may arise from various underlying issues, including lymphatic problems, gastrointestinal disturbances, or even anxiety-related conditions. Given your description, it is essential to explore these symptoms further to identify the root cause and determine appropriate management strategies.

Firstly, the sensation of having something stuck in your throat, often referred to as "globus sensation," can be associated with several factors. This feeling can stem from muscle tension in the neck and throat area, which may be exacerbated by anxiety or stress. Additionally, it can be related to gastroesophageal reflux disease (GERD), where stomach acid irritates the esophagus, leading to discomfort and nausea. Although you mentioned that your stomach does not feel uncomfortable, it is still worth considering that reflux can occur without significant abdominal symptoms.

The presence of a lymph node in the left submandibular area that feels swollen and warm could indicate a lymphatic response to an infection or inflammation. Lymph nodes often swell in response to infections, and while they can be benign, persistent swelling should be evaluated further. Since you have noted that this node has been present for over six months, it would be prudent to have it assessed by a healthcare professional. A fine needle aspiration biopsy may be warranted to rule out any malignancy or other pathological conditions.

Given your history of gastrointestinal issues, including a previous endoscopy that revealed hemorrhoids, it is also essential to consider the possibility of gastrointestinal reflux or other digestive disorders. Symptoms such as nausea and vomiting can be linked to various gastrointestinal conditions, including gastritis, peptic ulcers, or even functional dyspepsia. If you have not had a recent evaluation of your gastrointestinal tract, a follow-up with a gastroenterologist may be beneficial. They might recommend further imaging studies or endoscopic evaluations to assess for any abnormalities.

In addition to these physical evaluations, it is crucial to consider the psychological aspect of your symptoms. Anxiety and stress can manifest physically, leading to symptoms such as nausea, discomfort, and a sensation of tightness in the throat. If you find that your symptoms worsen during stressful times or if you have been experiencing increased anxiety, it may be helpful to speak with a mental health professional. Cognitive-behavioral therapy (CBT) or other therapeutic approaches can be effective in managing anxiety-related symptoms.

To summarize, your symptoms of persistent nausea and neck discomfort warrant a comprehensive evaluation. Here are some steps you might consider taking:
1. Consult an Ear, Nose, and Throat (ENT) Specialist: Given the lymph node swelling and throat discomfort, an ENT specialist can perform a thorough examination and potentially conduct imaging studies.

2. Follow Up with a Gastroenterologist: Since you have a history of gastrointestinal issues, it would be wise to have a gastroenterologist evaluate your symptoms further. They may recommend tests such as an upper endoscopy or pH monitoring to assess for reflux.

3. Consider Psychological Support: If anxiety is a contributing factor, seeking support from a mental health professional can help address the psychological aspects of your symptoms.

4. Monitor Symptoms: Keep a diary of your symptoms, noting when they occur, their severity, and any potential triggers. This information can be valuable for your healthcare providers in diagnosing and managing your condition.

5. Lifestyle Modifications: Implementing dietary changes, such as avoiding spicy or acidic foods, eating smaller meals, and not lying down immediately after eating, can help manage reflux symptoms if they are present.

In conclusion, while your symptoms may be multifactorial, a thorough evaluation by the appropriate specialists will help clarify the underlying issues and guide you toward effective treatment options. It is essential to address both the physical and psychological components of your symptoms to achieve the best possible outcome.

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