chronic vomiting; taking Baclofen for hiccups following partial gastrectomy

My brother (age 55) is recovering from surgery for cancer of the duadenum in August 2006. He had the whipple procedure, with about half of his stomach, and 2/3 of his pancreas removed, as well as his gall bladder and half of his bile duct. He had severe hiccups after the surgery and was prescribed Baclofen. He is still taking Baclofen (10 mg every 4 hours) and has been for about 7 months. His hiccups are under control, but he can keep almost no food down, and vomits many times a day. He has been vomiting daily since he got out of the hospital. He is so hoarse he can hardly talk. Do you think the Baclofen could be causing the vomiting? When he doesn't take it the hiccups come back. He has other meds but he says he is not taking them--he is too discouraged and overwhelmed.
We appreciate any advice you can give us. Thank you!

[Kevin Pho, MD]

This may be a reaction or complication from the surgery.  It is also possible that the Baclofen may be causing side effects.  There are other medications that can help hiccups, such as thorazine.  

I would look at the upper digestive tract with an endoscopy to rule out structural causes.  Motility testing, a 24-hr pH study or gastric emptying tests are more specialized tests can be considered if the endoscopy is negative.  

These options should be discussed with a gastroenterologist.

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.

Kevin, M.D.
kevinmd_

[logo53]

My husband also has stomach cancer and has had the same side effects as your brother.  The surgery was attempted but unable to proceed due to the cancer also involving the liver so a rouxen y bypass was done to avoid any future blocking issue with the tumor.  The hiccups you described I think are more a side effect of the surgeries as husband had them from the time he came home from the hospital, different meds have been tried including Baclofin but none have helped, now it has gone to a burping rather than hiccups and this has been going on for over four months now.  To say it drives them crazy is an understatement! The Dr feels "time" will maybe help but he really doesn't know the answer so we keep trying different med's, maybe to find something that will help this, also hard to keep foods down, again side effect of cancer and the treatments being given.
Let your brother know that he is not the only one with this awful side effect and I'm glad to see that the med's have helped him, I wish my husband could fine one that would put this side effect to bed as it doesn't help the fight when you feel so uncomfortable all the time .