Constant Nausea and Weight Loss

Dear Ask The Doctor: I will start out with my various symptoms. In the mornings im very nauseated and have the constant feeling of throwing up when i bend over it gets worse and i actually do start throwing up. Major loss of appetite i can hardly eat without throwing up and gagging. I have lost about 23 pounds in about a 2 month span. I have upper right side pains a little under my rib cage its a sharp pain and is radiating. My stomach even throbs when i drink water. I have had my gallbladder removed due to an infection and golf stones. I know im not pregnant because i have had two tubular pregnancies and can no longer get pregnant. I feel like i have constant morning sickness. I have also had constant diarehea for the last year.My fingers also swell up constantly. My stomach is constantly feeling bubbly and its loud and growling. Do you have any ideas what this could be??? Any advise would help i am very scared.

Dear Andrea: Some of the symptoms you describe are consistent with gastro-oesophageal reflux disease, including the upper abdominal pain, nausea, vomiting especially on bending over. However not all your symptoms can be explained by this diagnosis. The prolonged diarrhea and intermittent swelling of the fingers could suggest a more widespread inflammatory problem such as inflammation of the pancreas or inflammatory bowel disease. In view of these symptoms and the associated weight loss, I advise that you attend your family doctor for a full history and clinical examination. He may perform blood tests, and refer you for further investigations such as endoscopy and an abdominal ultrasound.