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Help on a really complex syndrome of excessive vomitting
This is a particularly complicated case for me, and it all started about 15 years ago (I am 22 now). It was the beginning of summer and I just had to vomit, all day. I would awake daily at 6 or 7 am due to the severe desire to vomit, and then have that feeling througout the day, occasionally actually vomitting. I would be in bed around midnight due to the horrible desire to vomit all the time, and then would have sleepless nights or frequent wakings due to the desire.
There was no dizziness, no headache, no cough, no fever, no GI discomfort, nothing else but the desire to throw up. The feeling strengthened and weakened randomly in the day, but never really went away. I had very little appetite and thirst those days as most of what i ate was regurgitated and the feeling to consume was weak. I lost a lot of weight and became very weak.
This persisted for weeks. I was at the hospital 4 or 5 times, never admitted. Each time the recommendation was observation and rehydration, no diagnosis ever. Blood work, urine, stool, all normal. No other symptoms made it difficult to assess as well.
We then decided to go to Germany (homeland, i live in asia) for a vacation and diagnosis. I was petrified with fear because i thought i would vomit and be sick for the 24 hour total journey. The moment I was in the cab to the airport I felt much better (this aspect will come into play later). The trip went smoothly. In germany, all was well so we didnt see the need to seek help. After 2-3 weeks however, it came back as strong as ever, exactly the same way as before. So we sought a pediatrician.
This new bloodwork revealed a deficiency in magnesium (however no other signs of magnesium shortage were present, by the way, I am starting third year med school in a month, and have actively researched my condition to no avail). I was prescribed supplements and within minutes of taking one, like magic I felt as strong as an ox. Maybe a placebo effect (then again i was 7 at the time) or the real cause but i felt great.
I continued to take Mg supplements for about a year, and no symptoms ever returned during this time. When we ran out of tablets, we just never restocked, and all was ok.
Over the next few years, it was mostly okay, every now and then, mostly random, sometimes Christmas, Summer, Term exams, regular school days, it would return, but much much weaker in feeling. A tablet got rid of it for that day immediately.
On the start of college though, it was back and fiercer than ever. After about one week of school, the following monday, I awoke to the most severe attack since I was a child. I began popping supplemements, but this time, there was no effect, may as well have been candy. This continued for about 1 month. I could not lose the feeling, and then I began taking many different supplements, but to no avail. Eventually, it tapered and vanished, but it was terrible. Could barely focus, read, study, anything.
It returned the next year, right after summer, again same duration and intensity, no help from supplements. Same symptoms, gone in a month.
That summer, i had a theory. Maybe it was the inaction. All summer I game, sleep long hours, eat heavy, etc., then all of a sudden back to buisness, figured it might be some metabolic shock. So that summer, i decided to walk, a lot. 7-9 hours a day in the city, every other day. When i returned for my third undergrad year, i felt great, no symptoms. Again, maybe a placebo, maybe a new cause.
I did this for two years. On the end of undergrad, i was so exhausted, i decided to spend my last free/good summer as a nobody student, that i gamed again, it had been 2 years since the last attack so i was confident. Returned to first year med, this time it lasted almost 3 months. I saw a doctor, and they said it was most likely anxiety. She had another patient who only had the desire to vomit during big life changes. Moving, new school, new job, death, etc. about two weeks each time. She said to relax, and stay hydrated.
At the end of 1st year, i got a full time job (been working part time till now, decided to extend hours into the summer), start of second year, perfect.
This summer, we went to Kuala Lumpur to watch the Sepang Malaysian GP, a gift for my bro who just finished med school. We left straight after my family exams, from the University. Whole trip was fine. On the last day, I had a severe vomit attack AND diarrhea.
It might be pertinent to mention now that every few weeks I get hypermotility diarrhea when im nervous or tense, usually just take a motilium (anti-cholinergic) and Im alright. I never vomit throughout the year (only start if school) and certainly never have both at the same time. The tension diarrhea only started in med school (yes, im quite the broken human arent I :) ).
It was horrible. For 12 hours on the travel home, i popped 3 motiliums and carried an array of bags to vomit into. After I got home, a good nights sleep, and it was gone. For the past 3 days, been laid back gaming. Now the 4th day, its back and stronger than ever.
Just for the record, during the flight home, today, and the attacks of the past 3 or so years, I walk arounf for 1-2 hours and feel much better, but not gone.
Any ideas?
It might be Mg, but why does it no longer work. Might be anxiety, but why only end of summer, why not final exams, funerals, Xmas and bad family reunions, hospital work (we are a PBL school, we go into the hospital from year 1). Why does walking help? Might be a placebo effect. Why only after dormancy...or rather mostly. Why the attack in malaysia, and the random strikes as a child.
Any ideas, drugs, anything?
Just on a dramatic side not, it is so severe and the feeling so bad, i actually hope for death. Wake up, throw up, want to throw up all day, wanes only. Cant read, eat, sleep, watch TV or anything. This for on average one month. It is terrible
There was no dizziness, no headache, no cough, no fever, no GI discomfort, nothing else but the desire to throw up. The feeling strengthened and weakened randomly in the day, but never really went away. I had very little appetite and thirst those days as most of what i ate was regurgitated and the feeling to consume was weak. I lost a lot of weight and became very weak.
This persisted for weeks. I was at the hospital 4 or 5 times, never admitted. Each time the recommendation was observation and rehydration, no diagnosis ever. Blood work, urine, stool, all normal. No other symptoms made it difficult to assess as well.
We then decided to go to Germany (homeland, i live in asia) for a vacation and diagnosis. I was petrified with fear because i thought i would vomit and be sick for the 24 hour total journey. The moment I was in the cab to the airport I felt much better (this aspect will come into play later). The trip went smoothly. In germany, all was well so we didnt see the need to seek help. After 2-3 weeks however, it came back as strong as ever, exactly the same way as before. So we sought a pediatrician.
This new bloodwork revealed a deficiency in magnesium (however no other signs of magnesium shortage were present, by the way, I am starting third year med school in a month, and have actively researched my condition to no avail). I was prescribed supplements and within minutes of taking one, like magic I felt as strong as an ox. Maybe a placebo effect (then again i was 7 at the time) or the real cause but i felt great.
I continued to take Mg supplements for about a year, and no symptoms ever returned during this time. When we ran out of tablets, we just never restocked, and all was ok.
Over the next few years, it was mostly okay, every now and then, mostly random, sometimes Christmas, Summer, Term exams, regular school days, it would return, but much much weaker in feeling. A tablet got rid of it for that day immediately.
On the start of college though, it was back and fiercer than ever. After about one week of school, the following monday, I awoke to the most severe attack since I was a child. I began popping supplemements, but this time, there was no effect, may as well have been candy. This continued for about 1 month. I could not lose the feeling, and then I began taking many different supplements, but to no avail. Eventually, it tapered and vanished, but it was terrible. Could barely focus, read, study, anything.
It returned the next year, right after summer, again same duration and intensity, no help from supplements. Same symptoms, gone in a month.
That summer, i had a theory. Maybe it was the inaction. All summer I game, sleep long hours, eat heavy, etc., then all of a sudden back to buisness, figured it might be some metabolic shock. So that summer, i decided to walk, a lot. 7-9 hours a day in the city, every other day. When i returned for my third undergrad year, i felt great, no symptoms. Again, maybe a placebo, maybe a new cause.
I did this for two years. On the end of undergrad, i was so exhausted, i decided to spend my last free/good summer as a nobody student, that i gamed again, it had been 2 years since the last attack so i was confident. Returned to first year med, this time it lasted almost 3 months. I saw a doctor, and they said it was most likely anxiety. She had another patient who only had the desire to vomit during big life changes. Moving, new school, new job, death, etc. about two weeks each time. She said to relax, and stay hydrated.
At the end of 1st year, i got a full time job (been working part time till now, decided to extend hours into the summer), start of second year, perfect.
This summer, we went to Kuala Lumpur to watch the Sepang Malaysian GP, a gift for my bro who just finished med school. We left straight after my family exams, from the University. Whole trip was fine. On the last day, I had a severe vomit attack AND diarrhea.
It might be pertinent to mention now that every few weeks I get hypermotility diarrhea when im nervous or tense, usually just take a motilium (anti-cholinergic) and Im alright. I never vomit throughout the year (only start if school) and certainly never have both at the same time. The tension diarrhea only started in med school (yes, im quite the broken human arent I :) ).
It was horrible. For 12 hours on the travel home, i popped 3 motiliums and carried an array of bags to vomit into. After I got home, a good nights sleep, and it was gone. For the past 3 days, been laid back gaming. Now the 4th day, its back and stronger than ever.
Just for the record, during the flight home, today, and the attacks of the past 3 or so years, I walk arounf for 1-2 hours and feel much better, but not gone.
Any ideas?
It might be Mg, but why does it no longer work. Might be anxiety, but why only end of summer, why not final exams, funerals, Xmas and bad family reunions, hospital work (we are a PBL school, we go into the hospital from year 1). Why does walking help? Might be a placebo effect. Why only after dormancy...or rather mostly. Why the attack in malaysia, and the random strikes as a child.
Any ideas, drugs, anything?
Just on a dramatic side not, it is so severe and the feeling so bad, i actually hope for death. Wake up, throw up, want to throw up all day, wanes only. Cant read, eat, sleep, watch TV or anything. This for on average one month. It is terrible
Yes I have been to a gastroenterologist (2 in fact), a pediatrician (from long ago), and 2 Internists. The others were nurses or medtechs. Like both posters said I was given a wide assortment of GI diseases like IBD, GERD, etc. Ive also tried a good deal of the faculty and other students, but they have the same suggestions. Ive also done my own extensive research into anything related.
The main problem is, I have no other symptoms. I have no fever, no bowel discomfort, no bowel pain, no LBM, no nutritional disorder (at least until the under-nutrition sets in from prolonged periods). My CBC, electrolytes, scans, etc are always normal.
It really just is, excessive urge to vomit, not even dizzy or fatigued or anything. Like the first said, I was also diagnosed with a psychological anxiety condition. This doesnt really fit the whole picture though for reasons in the above story (happens some stressful events not in others, magnesium worked in the beginning, walking lowers the desire, etc)
Right now I am trying to live healthy. I now walk 3 hours a day, eat only twice a day, one meal is a sandwich, the other a salad. I sleep at least 8 hours, etc.
The desire is still there, but now much supressed, I can read/watch TV/etc. Its not gone but reduced. Which points away from psychology. The thing is, it usually wanes anyway, so Im not sure if this healthy living week is doing it, or if its doing its natural course.
Anyway thank you very much for your time Cindee56 and doctornee medical. I greatly appreciate all who answer questions and put forth helpful suggestions. I will ride this out and one day hope to find an absolute definitive answer. Thanks :)
The main problem is, I have no other symptoms. I have no fever, no bowel discomfort, no bowel pain, no LBM, no nutritional disorder (at least until the under-nutrition sets in from prolonged periods). My CBC, electrolytes, scans, etc are always normal.
It really just is, excessive urge to vomit, not even dizzy or fatigued or anything. Like the first said, I was also diagnosed with a psychological anxiety condition. This doesnt really fit the whole picture though for reasons in the above story (happens some stressful events not in others, magnesium worked in the beginning, walking lowers the desire, etc)
Right now I am trying to live healthy. I now walk 3 hours a day, eat only twice a day, one meal is a sandwich, the other a salad. I sleep at least 8 hours, etc.
The desire is still there, but now much supressed, I can read/watch TV/etc. Its not gone but reduced. Which points away from psychology. The thing is, it usually wanes anyway, so Im not sure if this healthy living week is doing it, or if its doing its natural course.
Anyway thank you very much for your time Cindee56 and doctornee medical. I greatly appreciate all who answer questions and put forth helpful suggestions. I will ride this out and one day hope to find an absolute definitive answer. Thanks :)
MEDICAL PROFESSIONAL
Hi
Thanks for writing to the forum!
Well, you have really been suffering for too long. It could be a simple case of GERD or reflux disease. If it is GERD or severe acidity then Omeprazole is a good drug to combat this. Along with it you can try over the counter antacids. However I would recommend you see a doctor and take medication under a doctor’s supervision. Avoid heavy meals. Avoid too much of caffeine, tea, fried food and drinks both alcoholic and non alcoholic fuzzy ones. Avoid heavy exercises within 4 hours of a heavy meal. Raise the head end of the bed by pillows to 30 degrees. Go to bed at least 2 hours after food.
Another possibility is irritable bowel syndrome. Related problems like Celiac Disease/Ulcerative Colitis should also be looked into. It could be a food allergy like gluten allergy. Maintain a weekly diary of what you eat and list in detail the food items you had the day you were very sick.
Hope these tips help. If symptoms persist consult a gastroenterologist. Please let me know if there is any thing else and do keep me posted. Take care!
Thanks for writing to the forum!
Well, you have really been suffering for too long. It could be a simple case of GERD or reflux disease. If it is GERD or severe acidity then Omeprazole is a good drug to combat this. Along with it you can try over the counter antacids. However I would recommend you see a doctor and take medication under a doctor’s supervision. Avoid heavy meals. Avoid too much of caffeine, tea, fried food and drinks both alcoholic and non alcoholic fuzzy ones. Avoid heavy exercises within 4 hours of a heavy meal. Raise the head end of the bed by pillows to 30 degrees. Go to bed at least 2 hours after food.
Another possibility is irritable bowel syndrome. Related problems like Celiac Disease/Ulcerative Colitis should also be looked into. It could be a food allergy like gluten allergy. Maintain a weekly diary of what you eat and list in detail the food items you had the day you were very sick.
Hope these tips help. If symptoms persist consult a gastroenterologist. Please let me know if there is any thing else and do keep me posted. Take care!
I am so sorry. This sounds terrible. It's amazing that you're a med student yet you can't find anyone to help you. Have you seen a gastro specialist? How about an infectious disease person?
It's interesting I was watching a show called Mystery Diagnosis where this girl kept getting sick and throwing up, but she also had abdominal pain. She went to so many doctors and they told her GERD, stress, endometriosis, etc. Finally after 4 years of suffering and thinking she was crazy, she went to the ER because she was throwing up for like 4 days straight and this ER doctor was determined to get to the bottom of it. He found out , after doing a CAT scan that her intestines were all twisted up--I forget the medical term for it. The doctor did say that the symptoms can come and go and that's why no one could catch it. But there was a reason--she had a tumor (not cancer) in her intestine. They removed it and straightened everything out and she's fine now.
I'm not saying that's what you have, but I thought I would tell you the story so you don't feel so bad.
Don't give up--there has to be someone who can tell you what this is. Is it possible a food allergy or something? What is your diet like? Also, you should know that too much magnesium can irritate the stomach and cause diahreea.
It's interesting I was watching a show called Mystery Diagnosis where this girl kept getting sick and throwing up, but she also had abdominal pain. She went to so many doctors and they told her GERD, stress, endometriosis, etc. Finally after 4 years of suffering and thinking she was crazy, she went to the ER because she was throwing up for like 4 days straight and this ER doctor was determined to get to the bottom of it. He found out , after doing a CAT scan that her intestines were all twisted up--I forget the medical term for it. The doctor did say that the symptoms can come and go and that's why no one could catch it. But there was a reason--she had a tumor (not cancer) in her intestine. They removed it and straightened everything out and she's fine now.
I'm not saying that's what you have, but I thought I would tell you the story so you don't feel so bad.
Don't give up--there has to be someone who can tell you what this is. Is it possible a food allergy or something? What is your diet like? Also, you should know that too much magnesium can irritate the stomach and cause diahreea.
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