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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 45770
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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I'm 26 years old girl. 5 years ago I started to get sick

Customer Question

Hi, I'm 26 years old girl. 5 years ago I started to get sick every 5 months more or less.. I think it s because sometimes I starv myself. Now it s been one week I'm not really able to eat. I feel so hungry but if I eat something I end up vomiting and stomach pain. Is it any way I can start to eat again without pain and worries?
Assistant: How long have you been in pain? Are you experiencing any vomiting or nausea?
Customer: Few days now. I'm experiencing vomiting and nausea even at empty stomach
Assistant: Anything else in your medical history you think the Doctor should know?
Customer: Iv been suffered like this for the past 5 years.. If I'm stressed I stop eating untill I get sick and end up in hospital for 3 weeks more or less.. The longest period iv been in hospital was 3 years ago in eating
Submitted: 14 days ago.
Category: Medical
Expert:  Dr. Arun Phophalia replied 14 days ago.

You may try omeprazole and simethicone; both of which are available without a prescription. These are likely to help you as your symptoms are suggestive of;

1) Peptic ulcer/stomach sores.

2) Acid reflux.

If these measures are not effective; you may need prescription medications and evaluation by an upper GI endoscopy.

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Customer: replied 14 days ago.
I tried omeprazole.. And in the hospital the previous times they did all check up. I did gastroscopy aswell and they said all results are fine. I'm scared to eat I'm scared to feel pain and vomit
Expert:  Dr. Arun Phophalia replied 14 days ago.

This can be gastroparesis and a barium meal follow-through study or a CT scan with non-ionic oral contrast should clinch the diagnosis. Read about gastroparesis in this resource;

http://www.mayoclinic.com/health/gastroparesis/DS00612

Gastroparesis or slow emptying stomach needs a very comprehensive management regime. Judicious and persistent intervention by various measures should be able to control the symptoms quite nicely. Following is the management plan. If the initial conservative plan does not help, surgical intervention should be considered.

1) nutritional modifications,

a) multiple small meals,

b) favor liquids over solids,

c) avoiding indigestible solids,

d) consuming low-fat meals

2) medications to stimulate gastric emptying,

a) metoclopramide,

b) erythromycin,

c) domperidone,

d) phenothiazines (prochlorperazine, thiethylperazine),

e) Ginger

f) Acupressure

g) Nitrates, buspirone, sumatriptan

3) endoscopic and surgical approaches,

a) Injection of botulinum toxin

b) gastric electrical stimulator implantation

c) surgical pyloroplasty

4) psychological interventions

a) treatment of anxiety and depression

b) biofeedback and/or hypnosis

So a comprehensive approach is essential for controlling the symptoms and various specialists like a gastroenterologist, primary care physician, psychologist, etc would be needed to work in cohesiveness to get the optimal outcome.

Customer: replied 14 days ago.
Thanks for getting back to me. I did gastroparesis test but all results were fine.. Nothing abnormal.. I also take antidepressants since 5 years because the doctors thought it was an anxiety problem but it didn t help my pain in the stomach or to eat normally. I also been to psychologyst and they told me im not really depressed or anxious
Customer: replied 14 days ago.
I tried everything in 5 years but every 5 months more or less I still get sick and no able to eat or drink anything
Expert:  Dr. Arun Phophalia replied 14 days ago.

Nausea significantly affects the quality of life. The causes of nausea and vomiting are iatrogenic (doctor-induced like medicines), toxic, or infectious causes; gastrointestinal disorders; and central nervous system or psychiatric conditions. Following are the main causes;

A. Central nervous system

1) Migraine

2) Space occupying lesion in brain (Mass lesion)

3) Labyrinthitis

4) Ménière's disease

5) Pseudotumor cerebri

B. Gastrointestinal symptoms;

1) Gastroparesis

2) Irritable bowel syndrome

3) Non-ulcer dyspepsia

4) Peptic ulcer disease

5) Cholecystitis/cholangitis (gall bladder problems)

6) Hepatitis (liver inflammation)

C. Hormonal

1) Thyroid disorders

2) Diabetes

3) Adrenal disorders

D. Psychiatry disorders

1) Anxiety

2) Depression

3) Conversion disorders

E. Infections.

Chronic nausea is usually a pathologic response to any of a variety of conditions. Gastrointestinal etiologies include obstruction, functional disorders, and organic diseases. Central nervous system etiologies are primarily related to conditions that increase intracranial pressure and typically cause other neurologic signs.

Numerous metabolic abnormalities and psychiatric diagnoses also may cause nausea and vomiting. Evaluation should then turn to identify the underlying cause and providing specific therapies. When the cause cannot be determined, empiric therapy with an anti-vomiting (antiemetic) medication is appropriate. Initial diagnostic testing should generally be done by basic laboratory tests and plain radiography. Further testing, such as upper endoscopy or computed tomography of the abdomen, should be determined by clinical suspicion based on a complete history and physical examination.

Expert:  Dr. Arun Phophalia replied 13 days ago.

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