Chronic vomitting after surgery

[ktor240]

I am writing this on behalf of my girl friend and hopeing she is better by the time my concern reaches your eyes.
She is 19 years old and this whole mess started about 2 months ago with a spinal fusion surgery -for scholiosis. after the surgery she was fine but wasnt eating like she should have been because of the pain medications she was on. when she returned to the hospital for a checkup, they readmited her because shed lost so much weight and did an upper GI (with the barium). they concluded that she had a minor obstruction they called SMA syndrome and they put her on a feeding tube. she was in the hospital for about a week and went home with the feeding tube doing better. about 4 days after going home she started getting natious and vomitting all the time. she went to another hospital, closer to our home town than the original one. they did an xray and saw that the tube had come out and was coiled in her stomach, so they admited her and took it out. a few days after they took it out, her nausea was going away, and she was starting to eat some solids. they did another upper GI test and they said there was still a "minor obstruction" so they performed a surgery, it was like a bypass surgery called a jujunostomy if i remember correctly...ever since the surgery she has been vomiting almost whenever she eats. she usually vomits 2 to 4 hours after she eats, though, there isnt and obstruction anymore because they did another GI after the surgery. after two weeks at the hospital they kicked her out saying they no longer thought she needed to be there. I am very concerned about her and would like to know what might have caused this. sometimes it seems like shes not even digesting the food, just today she ate some rice and threw it up five hours later and it basically looked like chewed up rice. please reply with any ideas of what might be wrong with her....she is currently on TPN (total parental nutrition) through a pic line IV. although, tonight she is going without it on the hunch that it might be causeing some of the nausea. she went without it ounce a couple of days ago and she acctually ate quite a bit and kept it all down no problem. she even had a bowel movement which appeared normal today, and she thinks it was the food she kept down a couple days ago. please post anything you can....
thank you Kamron

you can also eamil me at ***@****

[Kevin Pho, MD]

There are some studies that show an improvement of chronic vomiting from gastroparesis is improved by major gastric surgery (i.e. gastric resection).  In this case, the vomiting has worsened.

Multiple upper GI series has been performed.  I would consider seeing another gastroenterology opinion for possible upper endoscopy.  That would be a more comprehensive test to evaluate the upper GI system for any anatomical abnormality that may be causing the vomiting.

Another consideration would be cyclic vomiting syndrome, which is uncommon in adults.  This is a disorder that is associated with migraines and if this is suspected, perhaps a referral to a neurologist can be considered for further evaluation.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[ktor240]

She was seen at valley childrens hospital, the second time, for her surgery -despite her being 18.  I beleave its the largest pediatric hospital in California.  Her first surgery, the spinal fusion, was at Shriners -another notable pediatric hospital- in Sacramento, we are from Fresno.

[ozark]

if i were she, i would be seen by a gi/surgeon md at a large medical center to figure out whats wrong....it sounds strange that theyd do a bypass surgery for a minor obstruction.......good luck

[ktor240]

I forgot to mention she has taken a few anti nausea medications that havent really done anything, reglen, zofran, and Hydroxizine i think