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Dr. Sohaib
Dr. Sohaib, Doctor
Category: Medical
Satisfied Customers: 5225
Experience:  MBBS, FCPS Experienced in all Medical Specialities
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Hi there. I have an appointment with my GP scheduled for Monday

Customer Question

Hi there. I have an appointment with my GP scheduled for Monday but I really need to describe my situation just now.

Ever since an an argument with a colleague at work 9 days ago, I have been feeling unbearable, intense anxiety. I have been unable to stop obsessing about this and other things even though they are very minor issues.

I have been feeling incredibly nervous and stressed during the day and at night. I have found it very difficult to sleep and even when I do I have been waking up very early, around 5.30 am and have just lay there unable to fall asleep again. Again I am nervous but also gagging, wrenching and I have had to run to the bathroom to vomit saliva because there is no food in my stomach.

In the mornings after I have vomited fluids, I have only been able to take a few bites of cereal. During the day I have not had much appetite and even the food I do swallow like soup or sandwiches I have wanted to vomit back up. Again I get the gagging, wrenching feeling in my throat.

This is increasing my anxiety problems as I know I have to eat to avoid more serious health problems but just can't seem to do it. My energy levels are very low and I know I could become susceptible to things like coughs and chest infections, etc.

I have had periods like this in my life before when I am dealing with stressful situations, sometimes for weeks; in 2005 it was for several months. I know by not eating and sleeping right and constantly vomiting my health will suffer greatly. I have already lost about half a stone in weight.

On a psychological level I am angry and upset with myself for feeling like this because I know in general I am very fortunate to have a good quality of life. I have relatives suffering from MS and Breast Cancer who still eat fine and look a picture of health compared to me.

I am worried too that this will affect my relationship with my girlfriend as I have had to avoid seeing her this weekend, due to my feelings of anxiety and the thought that I will shake or throw up when I am with her.

I have spoken with my team leader at work who is sympathetic but I want to be able to do my job without feeling intense anxiety or go on sick leave.

I am really struggling here and any help or advice would be much appreciated.

My name is XXXXX XXXXX I am 27 years old.
Submitted: 4 years ago.
Category: Medical
Expert:  Dr. Sohaib replied 4 years ago.

Dr. Sohaib :

Hello and Welcome to Just Answer.
Thank you for the question. Answers given are for informational purposes only and are not meant to replace an exam by an in-person.
I am Dr. Sohaib, a Medical Internist (who deals with diseases of all the organ systems of body) and I will do my best to find an answer for you.
You need to answer a few questions first which will help me assist you in a better way.

Dr. Sohaib :

Have you taken any kind of treatment until now?

Dr. Sohaib :

What kind of doctors did you see?

Dr. Sohaib :

There is no problem with the stools right?

JACUSTOMER-75xv9lep- : I have been taking omeprazole. I spoke to a nurse on the phone who prescribed me this last Monday. I had hoped this would stop me vomiting but It has remained just as bad all week.
Dr. Sohaib :

Okay. And how much dose of omeprazole have you been taking?

Dr. Sohaib :

And no treatment for anxiety?

JACUSTOMER-75xv9lep- : I have not been going to the toilet as much. When I have defacated the output has been quite liquidy and sloppy rather than solid. I believe the anxiety is causing this also.
JACUSTOMER-75xv9lep- : I have been taking 1 tablet of omeprazole before bed
JACUSTOMER-75xv9lep- : Sorry forgot to say I have not been prescribed anything for anxiety either
Dr. Sohaib :

Thank you very much for the useful information. There are two important problems you have. First, severe anxiety, which has disturbed your sleep as well, and secondly, recurrent episodes of vomiting (especially during periods of stress). This vomiting is most likely a result of ulcers in the stomach, or gastroesophageal reflux, or a combination of both. Interestingly, both these conditions get worse or become symptomatic during the periods of stress and anxiety.

Dr. Sohaib :

I will address your question in 2 ways. What you can do for yourself at home? Secondly, what your doctor can do for you.

Dr. Sohaib :

For Anxiety, you have to take rest.

Dr. Sohaib :

Daily exercise.

Dr. Sohaib :

Go out with friends or relatives (change of environment).

Dr. Sohaib :

And avoid alcohol, cigarettes or any other drug (if you use any).

Dr. Sohaib :

For the vomiting, you should avoid all kind of spicy and fatty meals.

Dr. Sohaib :

Switch to small frequent meals intead of three large ones.

Dr. Sohaib :

Raise head end of your bed to 6 inches.

Dr. Sohaib :

And avoid tight clothings/belts around the abdomen.

Dr. Sohaib :

As far as medical help is concerned, you should see a Psychiatrist, and get yourself interviewed in detail to get the treatment initiated for Anxiety, which can be in the form of drugs, psychotherapy, cognitive nehavioural therapy etc.

Dr. Sohaib :

As your anxiety issues will calm down the stomach issues will also settle gradually, but its better to get a consultation with a Gastroenterologist discussing the possibilities i have mentioned to chalk out further management plan that suits best to your needs.

Dr. Sohaib :

This may eventually require an endoscopy for an appropriate diagnosis.

Dr. Sohaib :

Usually the dose of omeprazole in severe reflux is initially up to 40-80mg per day, thereafter the dose is gradually reduced.

Dr. Sohaib :

Other drugs like alginates, and prokinetic agents (like metoclopramide) can also be beneficial.

Dr. Sohaib :

So where do we start from here? The answer to that is, try to modify your life style (i have mentioned few important steps). And get a consultation with a Psychiatrist as well as a Gastroenterologist soon.

Dr. Sohaib :

I would have been worried too if I were at your place, but let me reassure you that this is a treatable condition and carries a good prognosis with appropriate management.

Dr. Sohaib :

Does this help you dear Gerard?

Dr. Sohaib :

My goal is to provide you with Excellent Service - if satisfied with the response, Please do not forget to RATE my service. If you feel you have gotten anything less, please reply back, I am happy to address follow-up questions.

Kindest Regards.

Expert:  Dr. Sohaib replied 4 years ago.
Dear Gerard,
I am just following up regarding your health issues.
How do you feel now?
I will be glad to assist you on any queries.
Customer: replied 4 years ago.

Thank you for the follow up query.

I saw my GP on Monday and was prescribed Proparanol Hydrochloride. I have
to take this once a day. At the moment I am still feeling great anxiety and
sometimes want to throw up and gag and wretch. However since Monday I have
been able to keep food down and not throw up.

All in all I am feeling slightly better but I am still not able to control
my anxiety.

Expert:  Dr. Sohaib replied 4 years ago.

Thank you.

Propanolol is a good drug, but not the best one to control the anxiety.

There are other drugs like citalopram, paroxetine, sertraline --- which provide extremely good results.

And these can also be used long term for a more sustained and durable control of anxiety.

Why not have this discussed with your doctor and ask for a prescription.


My goal is to provide you with Excellent Service - if satisfied with the response, Please do not forget to Rate my service. If you feel you have gotten anything less, please reply back, I am happy to address follow-up questions.
Kindest Regards.