Cyclic Vomiting Syndrome Message Board
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Registered: 06/29/05
Posts: 2,643
Reply with quote  #1 
I'm having one of those stubborn moments about Amitriptyline.  The weight thing has really got me bummed.  It always happens when the seasons change and I have to try and get in last years clothes.  I'm still not as big as my all time record, but I'm getting close.  What has me bugged now is that I am  starting to get back pain and hip/knee pain when I am active.  The supplements have upped my stamina, as I hoped they would, but I am not able to get in enough exercise (without puking) to do much to counteract the weight gain.  So, I'm trying not to give in to the over eating.  Especially at night.  I'm always temped to eat anything that doesn't move about 45 minutes after taking my ami.

Here's the question:  Does anyone else notice more nausea when their stomach is empty as compared to when they have something in there?  That's the only way I can explain the nausea I'm having late in the day.  (I was told to cut out late night snacks, nothing after 7:30pm) It goes away with phenergan, but I'm taking it more often than I'd like.


Reply with quote  #2 
Hi Kate.
Hunger brings on an intense rather painful nausea. When this happens I have to eat, usually baby cookies, yogurt or a banana. Water with cornstarch is also good to keep the "empty" feeling away, this is usually before bed in an attempt to stay with me through the night.

Registered: 09/04/06
Posts: 286
Reply with quote  #3 

Oh yes, I cannot have an empty stomach!  If I go over 8 hours without eating I start getting sick.  Most of my attacks begin in the early a.m. when all of my food has processed and there is nothing in my belly.  It was the same before I got pregnant, and maybe even worse now.  I keep crackers and cheerios by the bed to snack on when I wake up queasy at 3a.m.  Good luck.


Registered: 07/26/03
Posts: 140
Reply with quote  #4 
Hello, It is the same with my son James. He will not feel well is he goes too long without eating. I think part of it is the excess bile that builds up from not eating. He has Gilbert's Disease too and those who do, should not fast at all or go long periods in between meals.

Sincerely, Deborah

Reply with quote  #5 

I also agree. Nausea comes more easily on an empty stomach. I will never get motionsickness unless i have an empty stomach


Registered: 05/27/07
Posts: 174
Reply with quote  #6 


          Before I answer your question of whether or not any of us here have similar symptoms to yours of “an empty stomach and nausea”, I have a few questions of my own if you don’t mind. 

You say,I'm having one of those stubborn moments about Amitriptyline”, in your post. Are you saying that the “stubborn moments” is due to the possible side effect of weight gain from the use of Amitriptyline? After 40 plus years with CVS myself, the experience of having been the CVSA Adult Coordinator for a few years, and a now young adult son (23) who has suffered with CVS since the age of approximately two years old, I’ve heard many reports of weight gain in relation to the use of Amitriptyline. Many of the older tricyclic anti-depressants list this as a possible side effect and we heard from many users that this was the case for them. It was (is) especially true for women. “(I was told to cut out late night snacks, nothing after 7:30pm)” Who is it that asked, or made this suggestion to you? Your physician? A dietician, or nutritionist? Was it suggested to help with weight control, as a benefit to the use of the Amitriptyline, or maybe the vomiting episodes? One adverse reaction with the use of Amitriptyline is “nausea”. (What drug doesn’t? ) Is it possible that the Amitriptyline is creating the nausea you are experiencing at this time? Another issue with the scenario you are reporting is that we have heard many users of Amitriptyline claim that it induces hunger. It seems you have some detective work that could possibly answer: “Does anyone else notice more nausea when their stomach is empty as compared to when they have something in there?” If you could solve the riddle of which came first, “the chicken or the egg”, you may be able to resolve the dilemma.

Is it possible to ask your physician/dietician/nutritionist about a late night snack that would not interfere with your diet or the Amitriptyline use?

Your post also mentions, “What has me bugged now is that I am starting to get back pain and hip/knee pain when I am active.” The supplements have upped my stamina, as I hoped they would, but I am not able to get in enough exercise (without puking) to do much to counteract the weight gain.” Has your prescribing doctor, or the doctor you see for pain, ever mentioned the benefits of using Amitriptyline as a form of pain control? This indication of drug use is also mentioned on many medication and pain control web sites. (I have included a definition for Tricyclic Antidepressants below, taken from the web site It may help to research this topic for more information. Other than my personal experience with Elavil (Amitriptyline) for CVS episodes, it was also prescribed in hopes of working two-fold for pain control. Sadly, Elavil has never worked for me regardless of intentions, which is another topic for the message board.

Definition of Tricyclic Antidepressant:

One of a class of medications used to treat depression. The tricyclic antidepressants are also used for some forms of fibromyalgia, and the control of chronic pain.

While you contemplate a bit of detective work/research on this, it would be helpful to have others here answer your question directly as to whether any of them experiences nausea with an empty stomach. I may not be the right person to get a direct answer from as I do not have a stomach, nor do I often have an appetite or feel hunger. Yes, I do become nauseous at times when I have an empty stomach, or technically, when I do not have food in my system. I have a very low tolerance to food since my stomach was completely removed in a second phase surgery almost six years ago. I have gastropersis, with less than two percent motility, making it very difficult to eat. With a Hickman for TPN/medication use, and a direct feeding tube into my small intestine, still, I’m allowed the luxury of eating whenever the urge strikes me. However, it is a very complicated process, but I do love to eat! There are certain times with this condition, (one created from the various effects of having CVS, which is another topic), when I do become nauseous if I do not have a small amount of food in my system. There a great variety of reasons for this and I will not express them now as they do not influence the focus of your post. I will say that there are times, whenever these conditions occur, that it is helpful for me to eat something either to combat minor nausea, or in helping to prevent it. The direct answer to your question is definitely, YES, I do experience nausea due to a lack of food in my system for a great variety of reasons.

I would like to ask you what supplements you are using that, “have upped my stamina”?  I certainly would be very interested in hearing what information you would be kind enough to share.

Having been a long time user of Phenerghan, out of personal interest, would you elaborate on your statement, “It goes away with phenergan, but I'm taking it more often than I'd like.” (During my use I suffered  the side effect of Restless Leg Syndrome and after long time use it became non-effective. I now use Zofran.)
         This may not have been the answer you were expecting, but your post was so much more interesting than that one question, I wanted to expand on it. I feel that sometimes when some of us do so it helps bring other valuable information out that may be of interest to others. I hope you don’t mind! I will be eagerly looking forward to hearing about your use of Phenerghan, your stamina supplement, and an update on your empty stomach/nausea mystery!

Take care,



Registered: 05/27/07
Posts: 174
Reply with quote  #7 
    "Water with cornstarch is also good to keep the "empty" feeling away, this is usually before bed in an attempt to stay with me through the night."
    I've never heard of anyone doing this before. Would you mind elaborating on this act being "good to keep the "empty" feeling away"? This has really piqued my interest... !


Registered: 05/02/05
Posts: 924
Reply with quote  #8 
I too am frustrated with the weight gain from Elavil, especially like you said Kate when trying on my summer clothes from last year.  But I have the opposide problem.  Food is my enemy right now.  I'm in pain and very nauseous at night.  And the past 2 weeks, I've been vomiting pretty much every night.  For some reason, I don't think my stomach is emptying so after dinner I'm full to the tippy top and it just comes right up. 

Julie, my doctor has spoken to me about using Ami for pain but it has not worked.  It has decreased my vomiting episodes ALOT.  I haven't had a full blown episode since Nov. 06 and before that May 05.  But I am in pain at least once a day.  It is very frustrating.  ~Joely

Registered: 11/18/04
Posts: 1,317
Reply with quote  #9 
Sorry to hear you're going through this...I'm thrilled with how much Ami has helped Riley overall (he's only had 17 episodes in 12 months), but the weight gain is out of control.  He has gained approx. 26 pounds just this last year, plus 40 the year before.  He's only 10 --- and so this is not good.  I'm hoping to find a "new solution" at tomorrow's appt.

My concern is, obviously, is taking him off something that has helped SO much... the big dilemma.

As for not eating...I know that eating later is not good if you're trying to control weight gain, but I have always understood that CVSers NEED to eat small amounts throughout the day...every 3-4 hours.  I'm going to try to find where I originally read that.

In the meantime...hope you feel better.

Here are a couple links where corn starch is addressed.
Notes from Conference
Pages 1 2

recipes for raw cornstarch
Pages 1 2


Registered: 06/29/05
Posts: 2,643
Reply with quote  #10 
I'll try and answer all your questions, but I didn't write them down so forgive me if I miss a few.  (I forgot that I can't go back to the thread without loosing what I have here.)

  By stubborn moments I mean that I am frustrated that the ami has been so beneficial in stopping cycles while at the same time causing enormous weight gain.  Both my CVS doc and my PCP tell me not to worry, my blood work is all good, but neither of them have to try and zip my jeans every morning.  I'm up 45 pounds since I got the ami to a therapeutic dose.  I KNOW it's the ami.  We cut it back and the weight fell off.  Of course I was puking all the time and that had to contribute to the weight loss as well.
     It was a dietitian who suggested I not eat at night.  I am a type 2 diabetic (sort of, my HgB A1C has hovered around 4 since my diagnosis, I insist on keeping it under tight control.  It only goes haywire during an
attack) so she has me eating small meals throughout the day.  After reading my food logs she had no explanation for the weight gain and said to cut out food at least 2 hours before bed.  I don't think it's the ami that is making me nauseous before bed because I have taken it for over 5 years now and have never had the nausea before.  Like I said, the phenergan works, but I'm taking it 2 or 3 nights a week, and that's much more than I had to take it before we put the breaks on my fruit and nuts at bedtime.  My morning fasting blood glucose levels are the same with or without the snack so I don't need the cornstarch for diabetic reasons.
     The back pain and leg pain is directly related to how much weight I'm carrying around.  I'm 5'4" and weigh almost 240lbs.  That's alot for my size 4 shoes to handle.  I'm taking the carrnitor and Co Q 10, started them in February.  I do have more energy, which is good since exhaustion is my #1 trigger.  I guess I just want to scream from time to time. 
     I've got a friend who is constantly working out so she can stay a size 4.  She spent an hour yesterday lecturing me on how I must be cheating because a fast food diet is the only way I could put on so much weight in 2 years.  By last night I had about all I could take.  I had two options; 1. kill her, 2. come here and vent where people know just how rotten I feel.  Not puke rotten.  Just bummed.


Registered: 05/20/05
Posts: 555
Reply with quote  #11 
Hi Kate,  I'm glad we did not have the newspaper headline... "Murder in Kansas, CVS???... perhaps the pharmacy??? involved??? details to follow"  LOL.  You know you can always come here for understanding.  We love you.  Anne


Registered: 06/29/05
Posts: 2,643
Reply with quote  #12 
Thanks Anne

I'm no longer feeling homicidal, though I would like to force feed some spaghetti down her throat.   Thank goodness this is the last class we have together.  One more semester and I couldn't be held responsible for my actions.   You would think I would know better.  This is the same girl who, after coloring in the circulatory system in anatomy last semester, asked "So, If you take blood from my right arm it's blue but in my left arm it's red?"  I'm hoping she isn't planning on becoming a phlebologist!  How'd you like to have her start your IV?

Weight is just one of my touchy subjects.  I just hate when people judge without all the facts.  Do they really think I have put on all this weight by choice?  Kinda like those people who say I can stop puking if I want to bad enough.  Gee,  I wish I had thought of that!

Registered: 04/16/05
Posts: 3,033
Reply with quote  #13 
I've been on anti D's for some time, and I know the problem well that your facing, when first on them I went from a size 9/10 to and 18-20 in just a matter of months.

What I have been doing at night... Is eating pretzel rods.  As a type II diabetic.. pretzles we can have.  The rods make me think I'm getting more than I am, in addition if I start to get nauseated, it controlls that too.

I used to do popcorn in the evening, but with the Iley.. I cannot have much of that these days.

Dieticians I have discovered are great, if you only have one.. maybe 2 common conditions.  But toss them several that dont have canned diets and you might do better to save your money.  When its something they cannot pull a one size fits all diet off the computer.. well it just appears at least the ones here, their brains have said goodbye, and left the building.

Registered: 05/02/05
Posts: 924
Reply with quote  #14 

I do popcorn at night too.  I've discovered the 100 calorie microwaveable bags and I can't get enough.  Great way to snack and not over do it.  ~Joely


Registered: 06/29/05
Posts: 2,643
Reply with quote  #15 
I went ahead with my snack with my ami tonight and am not nauseated.  So much for the no food before bed rule.   I'd much rather have a handfull of almonds now than a phenergan later.  I did lose some weight last week, but who knows why.  It wasn't from puking and that's what counts, right?
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