At age 61 my wife was treated with CMF for br ca. Previously she was reflux and abdominal pain free. Ca treatment abandoned early due to sores in mouth and other adverse symptoms. For 5.5 years we sought relief from multiple Specialists, multiple gastroendoscopes, refractory to medication. Then relief was offered by fundoplcation (loose partial). This was successful although heartburn returned but now controlled by PPI's. Abdominal pain was totally relieved.  At the same time, in addition to chemo nausea, she developed refractory episodic nausea. Anti emetics from the cheapest to the most expensive, did not help. We saw a site on PubMed stating prophylaxis of tricyclic and reliever of sumatriptan (we added cyclizine-marzine) and for the past 6 years this treatment has been successful when episodes are experienced. Neurologist (3) said it is not migraine. (we think perhaps abdominal migriane but again this is contentious??). 24-hr pH monitoring showed acid and DeMeester score double normal, manometry showed LES and motility dysfunction. Also slow gut clearing (non-diab) now treated motilium. Cognitive deficits are present as well and so was severe photophobia. By what mechanism did a previously health person develop all these gut abnormalities all at once?.

Tom Cawood Auckland NZ.