Mid night waking up

[NAPPE]

I am 55 years old male, 5'10", 158 lb, Indian Vegetarian (no eggs, no sea food, no meat, Milk and its products are o.k.). I do not eat lot of hot, oily and spicy food. I eat home cooked meals only. I eat dinner between 6.30 and 7.30 p.m. and go to bed ~10.00 p.m. I eat apple and a banana everyday. My bowl movements are very normal. I drink instant coffee (with milk and little sugar-minimum use of coffee powder)) at work one time only. Abdominal ultrasound is normal, CT scan is normal, Endoscopy is normal except very little inflammation on very upper part of the stomach and upward. Blood test shows Salivary Isoenzyme 135 (normal per report is 12 to 90).
Since 1 and 1/2 years I wake up between 1.30 a.m. and 3.30 a.m. with emptiness in my stomach. I do not have problem falling sleep at 10 p.m. After I wake up at midnight  cannot fall sleep unless I drink warm milk and few cookies. I have tried zantac and pirosac with no help. During day and night time I do not have any burning, aching or vomiting sensation. Sometimes I have to pass gas after dinner. I exercise. My job is not sedentary.
In mid seventies I had acidity which was cured by Ayurvedic medicine (ancient Indian herbal medicine). In early nineties I was tested for H. Pylori and took antibiotics and was cured. During that time(90-93) only under stress (my mother was sick during that time and she was in India) I was feeling pain in my stomach during day time only when I used to think about her. Sleep was normal throughout my life. My parents have very good sleep.
My gastroiternist at the last resort wants to see something in pancreas which may be blocking duct to gall bladder. There are risks involved and I can live with this condition. I am not fresh in the morning due to this condition. I am drinking enough water also.
My job or life is not stressful.

[Kevin Pho, MD]

The test that your GI is suggesting is likely an ERCP - which certainly has its inherent risks.  You can consider an MRCP, which is the more non-invasive study.  

Another consideration would be more specialized testing, such as a 24-hr pH study or gastric emptying scan.  The former test is the definitive test for GERD, while the latter test can evaluate for gastroparesis.

You can also re-test for H Pylori, which can recur after treatment.  Stool tests looking for the H Pylori antigen can be considered to test for recurrence.

These options can be discussed 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.

Kevin, M.D.
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