vomitting stomach acid

For almost 5 years I have been dealing with a problem of when I wake in the morning, and only in the morning, I vomit pure stomach acid. There is no food in the vomit, just acid. And quite a bit of it too. Once the vomit is out, I feel much better and can carry on a normal day.  I will do this for months and then suddenly it will stop for a couple of days to a couple of weeks and then come back with a vengenance. I have tried all kinds of medications and undergone sooooo many tests. Upper GI which they discovered a hiatul hernia, endoscopy and biopsy of my stomach which my esophagus was the only problem in that all the acid had damage it some. I have had sonograms and MRI's. I have taken, Prevacid, phenergan, zantac, tagament, maalox. But nothing helps. If my stomach is acting up the only relief I get is by vomiting up the acid. It does not occur during the day time or night either. This only occurs in the early morning right when I wake up. Can you tell me what is going on??

Christy

[Kevin Pho, MD]

Hello - thanks for asking your question.

You note vomiting stomach acid.  Upper GI shows a hiatal hernia, endoscopy shows damage from chronic acid reflux.  You also note ultrasounds and MRI's.

You have tried prevacid, zantac, tagamet etc.  If medical therapies are not controlling your reflux, you may want to consider an evaluation by a surgeon to see whether surgery is an option.

I would suggest a 24-hr pH study to document the severity of the reflux and an opinion by a surgeon.  

You may also want to consider tests for gastric tumors that can cause excess acid (known as Zollinger-Ellison syndrome).  This can be tested via blood tests and you may want to discuss this with your personal physician.

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.

[surgeon]

It sounds as if you already know what's going on: you have a hiatal hernia and reflux. Medications can reduce the amount of acid, and relieve pain, but won't stop the reflux. If it is troublesome enough that you want more relief, surgery is probably the answer. A laparoscopic fundoplication (using scopes poked into the abdomen to wrap the top of the stomach around the esophagus to make a valve) is very effective; and has a pretty rapid recovery with the new techniques.

[GI.PA]

If it hasnt been tried, a dose of Reglan (Metaclopramide) right before bed has proven helpful for some of my patients who present with this.  This is a pro-motility agent that can help the stomach empty acid during the night.  I would suggest elevating the head of the bed or buying a reflux wedge pillow to allow gravity to work its magic as well.

Erin

[tessa0825]

The wedge pillow that Dr. GI speaks of are available at most medical supply companies for about 24.00-28.00, they are also available online....It will keep the acid from refluxing into your esophagus while you sleep.....Please read up on untreated acid-reflux. There are many complications that can develop, its important to get it under control......Take care
Tessa